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Feds Add More FHIR to TEFCA Framework

Analysis  |  By Eric Wicklund  
   April 22, 2024

The ONC and The Sequoia Project have added new enhancements for FHIR adoption in version 2.0 of the Common Agreement, which sets thew stage for nationwide interoperability through the TEFCA framework

Federal officials are showing further support for FHIR with the release of version 2.0 of the Common Agreement, which established the foundation for the Trusted Exchange Framework and Common Agreement (TEFCA) data exchange framework.

HL7’s Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface (API) exchange has long been seen as a key element to nationwide interoperability, but many are worried that healthcare organizations are ready to embrace the standards just yet. Version 2.0, released by the U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) and The Sequoia Projects, ONC’s Recognized Coordinating Entity (RCE) for TEFCA, includes enhancements and updates for FHIR support.

“Today’s release includes framework enhancements, including greater use of FHIR, better support for use cases beyond treatment, and simplified onboarding for participants like clinicians, digital health apps, public health agencies, and other end users of health data,” Mariann Yeager, The Sequoia Project CEO and RCE lead, said in a press release.

[Also read: TEFCA Gets Ready for its Moment in the Spotlight.]

“We have long intended for TEFCA to have the capacity to enable FHIR API exchange,” ONC chief Mickey Tripathi, PhD, added in the release. “This is in direct response to the health IT industry’s move toward standardized APIs with modern privacy and security safeguards, and allows TEFCA to keep pace with the advanced, secure data services approaches used by the tech industry.

To date, The Sequoia Project and ONC have named seven Qualified Health Information Networks (QHINs), who are working to integrate TEFCA into their data-sharing activities.

Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, and Pharma for HealthLeaders.


The federal government and The Sequoia Project have developed a foundation for nationwide interoperability, with the goal of enabling healthcare organizations to share data with each other on any platform at any time.

The TEFCA standards were released late last year, and subsequent updates have added support for HL7’s FHIR API exchange.

Seven organizations have so far been named Qualified Health Information Networks (QHINs) and are working to adopt the TEFCA framework.

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