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ONC Announces 2 More QHINs as Interoperability Plan Moves Forward

Analysis  |  By Eric Wicklund  
   February 14, 2024

The CommonWell Alliance and Kno2 are the sixth and seventh organizations to qualify to exchange healthcare information under the federal TEFCA framework

As the nation moves closer to a final federal framework on nationwide interoperability, two more healthcare organizations have been designated Qualified Health Information Networks (QHINs), capable of exchanging healthcare data through the Trusted Exchange Framework and Common Agreement (TEFCA).

The U.S. Department of Health and Human Services’ Office of the National Coordinator of Health IT (ONC) announced last week that the CommonWell Health Alliance—a nonprofit alliance of healthcare and technology associations—and healthcare connectivity company Kno2 are the sixth and seventh QHINS, joining the eHealth Exchange, Epic Nexus, Health Gorilla, KONZA, and MedAllies.

"These additional QHINs expand TEFCA's reach and provide additional connectivity choices for patients, health care providers, hospitals, public health agencies, health insurers, and other authorized healthcare professionals," ONC chief Micky Tripathi, PhD, said in a press release.

The Sequoia Project, the federally Recognized Coordinating Entity (RCE) for TEFCA management, is reviewing comments on a second version of TEFCA, which was unveiled last month. The group’s CEO and RCE lead, Mariann Yeager, said she expects the QHINs to begin implementing version 2 by the end of March.

“The most important thing for people to understand is that version 2.0 was revised to support FHIR-based exchange,” she told HealthLeaders in a recent interview. “There are new use cases to support healthcare operations and public health. The other thing is it does permit health systems that participate in TEFCA-based exchange to connect to multiple QHINS, to the extent that they support multiple data sources.”

TEFCA isn’t the only framework for health data exchange, but it does have the backing of the federal government and builds off of the expertise of the Sequoia Project. Each QHIN goes through a rigorous process to achieve the designation and must adhere to federal standards.

TEFCA actually become operational in December 2023, when the first five QHINS were announced.

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


TEFCA was established through the 21st Century Cures Act of 2016, which sought to create a nationwide interoperability framework for the exchange of electronic health information.

QHINs are health information networks that meet strict federal requirements, established by the Sequoia Project, to affect health information exchange. Seven organizations have qualified to be QHINS.

TEFCA went live in December 2023, and the participating QHINs are expected to incorporate the latest guidelines in version 2.0, including FHIR-based exchange elements, by the end of March.

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