Final week the Trusted Alternate Framework and Frequent Settlement (TEFCA) Lastly went reside.

The Workplace of the Nationwide Coordinator for Well being Data Know-how (ONC) has been working to launch TEFCA for greater than half a decade, billing the undertaking as one thing that may improve interoperability and improve sufferers' entry to their healthcare information. Nonetheless, a former ONC chief thinks TEFCA is ill-suited to furthering any of those targets – and that the data-sharing community might even hinder interoperability.

Don Rucker is at present Chief Technique Officer for the well being information platform 1upHealth and served as head of the ONC from 2017 to 2021. He believes that TEFCA is constructed on an archaic information sharing protocol that may stop the initiative from being helpful.

TEFCA was initially outlined within the twenty first Century Cures Act, which was handed in 2016. The initiative goals to ascertain a nationwide well being data trade community that shares a typical set of rules, phrases and situations to facilitate the safe and seamless trade of knowledge between disparate international locations. well being data methods.

When the ONC introduced the launch of TEFCA final week, it designated 5 organizations as certified well being data networks: eHealth Alternate, Epic Nexus, Well being Gorilla, Konza and MedAllies. The ONC stated these Certified Well being Data Networks, or QHINs, will set up direct connections to one another, selling interoperability between the networks they embody.

The meant purpose of the TEFCA Community is to make it simple for healthcare suppliers and sufferers to shortly entry well being information once they want it, whatever the EHR vendor. However the protocol on which TEFCA is constructed is simply too dated for the initiative to ship on these guarantees, Rucker argued.

TEFCA makes use of an IHE doc trade protocol from the Nineties, he identified. This information trade structure wasn't constructed for the computable information codecs and programming languages ​​of as we speak's Web, Rucker explains.

“[The IHE protocol] doesn’t assist you to calculate what your well being, health or well-being is, or issues like whether or not the medicines you take make sense for you,” he acknowledged. “There's completely no method to try this with TEFCA, so it's a really previous and albeit fairly insecure strategy to networking.”

Entry to well being information gained't enhance as a result of nobody desires to attempt to load a ton of hard-to-analyze information into an arcane API, Rucker identified.

To ensure that TEFCA to really assist higher information entry for healthcare suppliers and sufferers, it might have to be modernized to deal with computable information, i.e. FIR particulars, he argued. Nonetheless, TEFCA primarily permits its individuals to dam entry to computable information fields and forestall the trendy APIs that energy nearly each different side of our internet utilization, Rucker famous.

“For anybody who makes use of TEFCA even as soon as, the EHR distributors might refuse to provide them the information in a contemporary, computable method and demand that they get the information in a gradual, unreliable, mediated, uncomputable method. This was launched as an exception to the ban on blocking data, which is a double destructive. For instance, Epic, which has lobbied for this, might refuse to provide a patient-selected digital app the information in a type that may be calculated,” he defined.

The ONC has stated that TEFCA will start supporting fashionable APIs equivalent to FHIR and HL7 in 2024. Rucker isn’t very snug with that promise. He notes that he want to see the technical plans and is confused as to why the undertaking wouldn’t. begin with fashionable protocols within the first place.

Picture: GarryKillian, Getty Photographs