TEFCA unites the health information networks and allows healthcare stakeholders to connect and participate in nationwide health information exchange
An initiative by US government, which was released by Office of the National Coordinator (ONC), “Trusted Exchange Framework and Common Agreement” unites the health information networks (HINs) and allows hospitals and other healthcare stakeholders to connect and participate in nationwide health information exchange. It also establishes “Qualified Health Information Networks” (QHINs) as a mode to assist healthcare stakeholders with a standardized methodology for HIE (Health Information Exchange) inter-connectivity, as well as with a new administrative organization, the Recognized Coordinating Entity (RCE). Here a question arises that what exactly is the role of Recognized Coordinating Entity (RCE). In simpler words, it can be said that the RCE oversees TEFCA and along side, it acts as the leading body that will be having the power to make TEF constructively operational.
According to a recent report, there are over 100 HINs currently operational only in the U.S, which do not share data with each other; in contrast, there are many other organizations, which have resorted to connect multiple HINs—burdening them with soaring implementation expenses for restricted interoperability. To resolve this issue, TEFCA means to give interoperability considerably bring down expenses by healthcare organizations simple access to the information important to give higher quality consideration. TEFCA designates a certain number of HINs to serve as “Qualified Health Information Networks” (QHINs). To encourage interoperability, information is shared because of inquiries sent by the members from a HIN; if the essential information can’t be found inside the system of the QHIN they take an interest in, at that point the QHIN will share the question to different QHINs until the point when the information is found and returned. This technique adequately joins separate HINs and the QHINs they take an interest in together into a unified, interconnected framework.
Initially, TEFCA is being implemented as a voluntary system. So, its success will somewhere rely on influential healthcare stakeholders that joining TEFCA merits the assumption required to make their frameworks perfect. While the offer for interoperability is clear, decision makers will likewise need to think about the dangers and their potential results previously choosing whether to take an interest. No doubt, security and protection issues will be critical factors in any examination of the doubt of joining TEFCA—no one needs their association to be the objective of the feature getting data leak and endure the related lawful and reputational costs.
It is believed that only a connected system alone would not be enough. Considering the sensitive nature of healthcare data, there should be a provision of powerful auditing capabilities to ensure the security of data. In simpler words, patients could be able to see who got to their records, when and for what reason. This way, TEFCA will meet its real goal of transparency and provide a strong disincentive for misuse and inappropriate data access.
For the patients to be completely ensured, solid guidelines for capturing consent and logging access—joined with exhaustive reviews—will be required. Presently, the draft TEFCA requires Qualified Health Information Networks (QHINs) to catch consent and keep up a review log. In any case, it is observed that the requirements for capturing consent mainly focuses on the patient’s initial consent to join the system so, it seems to be insufficient on how different providers will demonstrate that they have an genuine need to access that patient’s information. Proper standards for performing reviews of the logs have not been explained yet. However, it will eventually be required.
TEFCA: The Way Ahead…
A mechanism is required to be set up for patients to get to log information identified with their personal health information (PHI). Such initiatives will help building. If patients have a mechanism to monitor their personal data, then watchdogs and proactive citizens could take on a critical role in providing oversight to TEFCA, ensuring that it is used only for its intended purposes. Over time, this would also allow people to build trust in the framework, which is particularly important thing about TEFCA’s deliberate nature, so we can achieve TEFCA’s vision of “a framework where people are at the priority of their consideration and where providers can safely access and utilize their health data
Here, I will end my blog with few queries which ONC should investigate in future drafts of TEFCA.
• First, Would Health Information Networks (HINs) be permitted to access the information security endeavors of different members, or will they be compelled to enable different patients to get to their information in any case?
• Secondly, which mechanisms will be in used to ensure the privacy of sensible health data?
• Third is regarding the audits; like which organization will be having the access to perform the required audits?