Kaiser Permanente, Johns Hopkins and 25 others pledge to join TEFCA, prioritize interoperability

Updated May 24 at 1:30 P.M.

The total number of Epic customers pledging to join the electronic medical record provider in its participation in the Trusted Exchange Framework and the Common Agreement (TEFCA) has jumped to 29

After announcing the participation of 20 health systems plus health tech company KeyCare and health information exchange OCHIN on Monday, seven more organizations have joined the pledge including Kaiser Permanente.

According to Matt Doyle, interoperability software development lead at Epic, the EMR company is optimistic that nearly all of the 2,000 hospitals and 600,000 clinicians that use Epic across the country will participate. 

Last week, MedAllies announces its approval as the seventh prospective Qualified Health Information Network (QHIN) under TEFCA. As an approved candidate, the health information service provider will now embark upon pre-production testing and completion of its project plan. If successful, it will join the "network of networks."


Epic announced the first cohort of health systems pledging to join the national health information-sharing network dubbed TEFCA.

Epic is a member of the inaugural group of six prospective QHINs that were recognized by the Department of Health and Human Services (HHS) earlier this year. Today, Epic announced that 20 health systems along with health tech company KeyCare and health information exchange OCHIN will be joining TEFCA with the goal of increasing interoperability in healthcare.

Notable participating health systems include Cedars-Sinai, Mayo Clinic, MetroHealth, Mount Sinai Health System, NYU Langone Health, Stanford Health Care and UC Davis Health.

“By joining TEFCA, these health systems reaffirm their ongoing commitment to improving patient care by advancing health information exchange,” Matt Doyle, interoperability software development lead at Epic, said in a press release. “Our plan is to deliver software this year that will help our customers to be among the initial participants in TEFCA, and we’re optimistic that nearly all of the 2,000 hospitals and 600,000 clinicians that use Epic across the U.S. will participate.”

TEFCA is a public-private partnership mandated by the 21st Century Cures Act in 2016. Health systems that will be joining the framework via Epic range from large hospitals to safety net providers. These provider organizations currently use Epic’s interoperability tools to improve information sharing, the company said.

Starting in 2008, providers began using Epic’s interoperability platform named Care Everywhere. The electronic medical record provider calls the platform the first of its kind. As of today, the platform exchanges 14 million patient charts daily, half of which occur with organizations using other vendor systems.

Epic was a founding member of the Carequality framework, a nationwide exchange framework that includes all of Epic’s U.S.-based hospitals and 70% of all U.S. hospitals. Carequality was spearheaded by The Sequoia Project, an organizing entity that facilitated conversations between HHS and private enterprises in developing TEFCA.

“Stanford Health Care is excited to join the nationwide TEFCA framework,” Matthew Eisenberg, associate chief medical information officer at Stanford Health Care, said in a press release. “We have long supported regional partnerships to promote data sharing for treatment and our North California partners have been trailblazers in national interoperability as early participants in the Carequality Framework. We are excited about the vision of a simpler if not single on-ramp to secure, national health information exchange that will benefit all of our patients and providers.”

The voluntary TEFCA framework is nonbinding and establishes a core set of data available for secure, fruitful exchange. Epic is joined by five other organizations, including CommonWell Health Alliance and eHealth Exchange, that have volunteered to take the steps to become QHINs.

HHS’ Office of the National Coordinator for Health IT released the first draft of TEFCA in January 2018 with policies, procedures and technical standards for meaningful information exchange between providers, state and regional health information exchanges and federal agencies.

Interoperability between healthcare entities has been shown to improve health outcomes, ease the patient burden of repeating health information and alleviate the tedium laid on nurses and clinicians forced to translate patient data between siloed systems.

“While most Americans probably won't recognize that you scored some real touchdowns in the last several months of work, at some point, it's going to click that something is changed, that all of a sudden, that specialist instantly got the information that was needed to keep them alive,” HHS Secretary Xavier Becerra said at the February event recognizing Epic and other QHINs. “At some point, the synapses will click and they'll realize something has changed in the way we do healthcare.”