As someone who has covered the health IT industry for 17 years, I’m always fascinated when I see something really grab the attention of the health IT community. That’s a hard thing to do when there are so many people pining for attention. Certainly AI is currently doing that in health IT, but in the world of interoperability TEFCA and QHINs are grabbing all of the attention. There are a lot of views on TEFCA, but the one thing that’s certain is that it’s grabbing a lot of the interoperability focus from government regulators and the industry.
ONC recently released some stats that 51% of healthcare organizations were aware of TEFCA and plan to participate. 23% know of TEFCA, but aren’t sure if they are going to participate, 25% were not aware of TEFCA and only 1% of those surveyed were aware of TEFCA and planned not to participate. That much buy in this early is a big deal and those that are on the fence are likely waiting to see how TEFCA comes together.
Needless to say, every healthcare organization should be taking the time to understand what’s happening with TEFCA and QHINs. At the recent HIMSS 2023 conference, a panel of QHINs shared their perspectives on what’s happening in a session called “Real Talk: TEFCA, Evolution or Revolution in Health Care Interoperability?” The panel included representatives from Epic, MEDITECH, Health Gorilla, and CommonWell Health Alliance. Here’s a summary of some of the key perspectives we heard during the panel.
Looking forward to this great panel: Real Talk: TEFCA,
Evolution or Revolution in Health Care
Interoperability? @CommonWell @MEDITECH @healthgorilla #HIMSS23 #hitsm pic.twitter.com/HIPjNJhtgM— Healthcare IT Today (@hcittoday) April 18, 2023
In classic Paul Wilder form, he kicked off the panel with the invite for healthcare organizations and health IT vendors to get on the TEFCA highway. It’s pretty profound that he used the word highway. Imagine if Ford or GM decided they didn’t want their cars going on the highway system as it was built. Kind of funny to think about. I expect we’ll see a similar thing with TEFCA where healthcare organizations want to take the TEFCA highway as long as there aren’t too many toll booths to get on. Check out this video interview with Paul Wilder from CommonWell to learn more about the need for healthcare organizations to get connected already.
Get on this highway! @paul_wilder #TEFCA #RealTalk #HIMSS23 pic.twitter.com/GRX4ewwAWv
— CommonWell Health Alliance (@CommonWell) April 18, 2023
Matt Doyle from Epic offered a couple views into why Epic has decided to become a QHIN and support TEFCA.
“If #TEFCA is going to invite people in and achieve critical mass, of course we are going to do it.” – Matthew Doyle, Epic on why they decided to join TEFCA. #HIMSS23 #HITsm #healthit @CommonWell pic.twitter.com/yLIq8NBs9m
— Healthcare IT Today (@hcittoday) April 18, 2023
FHIR APIs are wonderful, but they’re not sufficient on their own. —Matt Doyle @EpicShares #HIMSS23 #RealTalk #TEFCA pic.twitter.com/NtV2inP8Bq
— CommonWell Health Alliance (@CommonWell) April 18, 2023
It’s become clear to me that exchanging healthcare data is going to include multiple layers. There’s no one solution that will solve the health data sharing problem. It will include TEFCA, FHIR, HIEs, Direct Messages, APIs and much more.
While I don’t personally see TEFCA as a blank check for healthcare interoperability, it does have the backing of government. At a recent EHR user conference, I was talking with their interoperability expert and he acknowledged that the government support for interoperability pushes that standard forward in a powerful way. That’s what we see happening with QHINs.
#TEFCA is a blank cheque and will redefine what we can do with use cases and data. But corralling government agencies is a still major feat #HIMSS23 #HITsm@CommonWell @MEDITECH @healthgorilla pic.twitter.com/pnSJJHt6lU
— Healthcare IT Today (@hcittoday) April 18, 2023
While government can do a lot of good to push healthcare interoperability forward including initiatives like TEFCA and QHINs, the panel acknowledged that there’s still a lot of work left to be done. The technology is one part of the solution, but without the right policy work, all the technology in the world won’t solve the health data sharing problem.
“Interoperability is not just a tech problem. There is a lot of policy work to be done. @CommonWell opened their doors during COVID and only one state took us up on it. Solving a national policy problem takes much more collaboration.” – Paul Wilder, @CommonWell#HIMSS23 pic.twitter.com/kvowclpmKP
— Healthcare IT Today (@hcittoday) April 18, 2023
Doyle from Epic also acknowledged that data sharing in and of itself isn’t valuable. You can share all the data in the world, but if healthcare organizations don’t make use of the shared data or they don’t trust the shared data, then the sharing accomplishes nothing. Maybe we should call it meaningful data sharing? (Is that too soon or are we recovered from the scars of meaningful use?)
“Making data move is important but more importantly it’s what you do when it gets there.” – Matthew Doyle, Epic #HIMSS23 #HITsm #healthit @CommonWell pic.twitter.com/miZwc2sKnQ
— Healthcare IT Today (@hcittoday) April 18, 2023
The panel also acknowledged the power of patients getting access to their data. Not to mention the right that patients have to access their individual data. We’ve covered the power of patients having access to their data many times on Healthcare IT Today. It’s good that the QHINs are thinking about and discussing this as part of their implementation too. Patient access won’t just happen if you’re not intentional about making it available to them.
Thoughts on individual access:
“You as a patient are the ultimate error checker. You should be able to look at your health records just like your credit card statement.” – Paul Wilder, @CommonWell #HIMSS23 #hitsm pic.twitter.com/gaIHUIehvM
— Healthcare IT Today (@hcittoday) April 18, 2023
“It’s my data, I’m the patient, I should have the say who gets access to it.” —@wagnerserg of @healthgorilla #HIMSS23 #RealTalk #TEFCA
— CommonWell Health Alliance (@CommonWell) April 18, 2023
Needless to say, there are still plenty of challenges associated with healthcare interoperability. Wilder from CommonWell offered an interesting framework to consider that he calls the P to P exchange and where it gets challenging.
What is a top challenge in healthcare #interoperability?
“If we stick with the P to P exchange we are fine. Payer to payer, patient to patient or provider to provider. Once you cross those p’s it gets challenging.” – Paul L. Wilder, @CommonWell #HIMSS23 #HITsm pic.twitter.com/8WvNh8iUiL
— Healthcare IT Today (@hcittoday) April 18, 2023
Sayed-Friel from MEDITECH points out the real key to healthcare interoperability and why many have high hopes for TEFCA and QHINS. That is that sharing health data requires commitment and cooperation. Ironically, even seeing some competitors on stage talking about this is a step forward when it comes to cooperation.
“Interoperability requires a commitment & vendors working together on standards. You can’t do it yourself. It requires cooperation. We looked for an org like @CommonWell that had all of that.” – Hoda Sayed-Friel, @MEDITECH#HIMSS23 #HITsm @CommonWell pic.twitter.com/9If3NlDn91
— Healthcare IT Today (@hcittoday) April 18, 2023
Jirjis from HCA Healthcare made a great suggestion on the panel to Lean In when it comes to your interoperability efforts.
How do I get started with interoperability? Where do organizations start?
“Lean in. The table is set. It’s time to eat. Who’s hungry? – Jim Jirjis, HCA Healthcare #HIMSS23 @CommonWell pic.twitter.com/L3HcuihfRq
— Healthcare IT Today (@hcittoday) April 18, 2023
Of course, one of the challenges with healthcare interoperability has always been getting buy in for the effort. The panel offered some great benefits they can communicate to stakeholders.
TEFCA will only work if providers participate. Communicate the benefits:
– Connection to exchange partners & 3rd party vendors
– Easier interoperability
– Reduction of admin burdensTell them, this is where the puck is going & will make your life easier#HIMSS23 #hitsm pic.twitter.com/4zw0A5LtHM
— Healthcare IT Today (@hcittoday) April 18, 2023
Finally, the panel offered some really practical highlights from the discussion.
✅Joining TEFCA early = opportunity to shape it as we move forward.
✅Standards are important to data quality.
✅Interoperability takes commitment and teamwork.
✅FHIR APIs alone are not a silver bullet.
✅TEFCA will only work if providers want to participate.— CommonWell Health Alliance (@CommonWell) April 18, 2023
This summary highlights the opportunity and challenge that is TEFCA. It acknowledges that it’s still early in its development and so there’s plenty of opportunity to be able to shape what it becomes. However, it acknowledges that for it to be the success that it can be, it’s going to require collaboration, cooperation, and work from a wide variety of healthcare organizations. No one organization, company, or person can push this forward.
What are your thoughts on TEFCA? What other perspectives would you share?