Thursday, February 29, 2024

TEFCA QHIN-to-QHIN FHIR Change to be Piloted in 2025


The Sequoia Undertaking, appearing because the Known Coordinating Entity for the TEFCA interoperability framework, has launched a remodeled FHIR Roadmap for TEFCA Change that has a four-stage timeline for the sluggish adoption of the FHIR (Rapid Healthcare Interoperability Sources) usual for knowledge trade. 

Model 2 of the Roadmap envisions FHIR Change between Certified Well being Data Networks (QHINs), which is Degree 3 within the plan, to be piloted in 2025, with implementation specs advanced quickly after the pilots are finished. This may increasingly permit QHINs to leverage FHIR for trade between QHINs whilst proceeding to make stronger non-FHIR approaches inside the QHINs’ inside networks.

The Workplace of the Nationwide Coordinator for Well being Data Generation (ONC) has led a multi-year procedure along the RCE to put in force TEFCA, which used to be envisioned by way of the twenty first Century Treatments Act. The theory is to create a “community of networks” for sharing well being knowledge around the nation. The purpose is that like wi-fi networks, electrical energy grids and ATMs, the consumer enjoy will change into as though it is a unmarried community.

In offering some background, the RCE famous that the preliminary paintings on TEFCA began with extra established requirements, comparable to IHE-based trade of C-CDA content material. However the speedy embody of FHIR by way of the business makes it crucial that TEFCA come with a planned technique so as to add FHIR-based trade. 

“Maximum FHIR implementation task available in the market has fascinated by point-to-point trade of FHIR sources by way of FHIR APIs with out community intermediaries. On the other hand, some networks have leveraged their infrastructure to make stronger FHIR in more than a few techniques,” the Roadmap record states. “For instance, a couple of national and state/regional networks use present IHE-based brokering infrastructure to switch FHIR payloads. As well as, early pilot paintings has begun to make use of community infrastructure to make stronger FHIR API Change between endpoints and a few networks are making plans to supply brokered FHIR API trade.”

The Roadmap envisions 4 levels of building to offer continuity for the FHIR actions available in the market and make allowance TEFCA coverage and technical infrastructure to boost up FHIR adoption. “It additionally bridges network-based trade communities and the customers of FHIR APIs by way of ONC-certified EHRs and CMS required APIs, that have been working in parallel up till now. We consider that each patterns of trade shall be essential sooner or later and that use of FHIR APIs in TEFCA can assist in making those patterns complementary and after all ship at the promise of a contemporary, virtual healthcare machine.”

The Roadmap displays 4 levels of FHIR trade in TEFCA, with necessities for every level constructed at the earlier level:

• Degree 1: FHIR Content material Enhance
− Incorporated as a part of the preliminary release of TEFCA.
− QHIN-brokered IHE trade of FHIR payloads between QHINs to be had.
• Degree 2: QHIN-Facilitated FHIR Change
− QHIN make stronger for facilitated FHIR API trade required.
− Player and Subparticipant trade by way of FHIR APIs to be had.
• Degree 3: QHIN-to-QHIN FHIR Change
− Enhance for trade between QHINs by way of FHIR APIs required.
• Degree 4: Finish-to-Finish FHIR Change
− Enhance for QHIN-brokered FHIR Change between Contributors and

Every level shall be supported by way of a brand new model of the QHIN Technical Framework and controlled by way of the trade control procedure within the Not unusual Settlement.

A timeline displays Levels 1 and a couple of going down in 2024, with Degree 3 in 2026, and Degree 4 in an unspecified long term period of time.

The RCE notes that Degree 4’s Finish-to-Finish FHIR Change would allow a Player/Subparticipant to seamlessly trade FHIR knowledge between themselves and different community contributors throughout the QHINs and more than one different intermediaries each inside a QHINs’ community and throughout the TEFCA-governed community. This calls for additional analysis into optimum strategies for protected trade throughout the community by way of the QHINs. When that analysis is entire, ONC will release a pilot with TEFCA customers to decide how and when that analysis will also be rolled right into a manufacturing atmosphere.

The Not unusual Settlement, launched in September 2021, comprises six trade functions that organizations should make stronger to be designated as a QHIN. The trade functions come with Remedy, Fee, Well being Care Operations, Public Well being, Advantages Resolution, and Particular person Get right of entry to Services and products.

The next organizations have been formally designated because the preliminary QHINS after effectively finishing the TEFCA onboarding procedure.
• eHealth Change
• Epic Nexus
• Well being Gorilla
• MedAllies

There are roughly 20 organizations officially in quest of QHIN standing. 



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