What is TEFCA?

Though the Trusted Exchange Framework and Common Agreement (TEFCA), is a relatively new development in healthcare, it has major implications for every healthcare organization and its patients. 

In short, TEFCA outlines the terms and conditions that will allow for the exchange of electronic health information (EHI) across different Health Information Networks (HINs). This will make it possible for providers, risk adjusters, and payers to access patients’ health information when and where they need it.

We believe TEFCA is a powerful mechanism for increasing efficiency, driving down costs, and improving patient outcomes. While not the end-all-be-all solution, it’s a vital step in the right direction toward national interoperability. 

In this article, we’ll provide a high-level overview of what TEFCA is and why it matters for value-based care organizations. 

What is the Purpose of TEFCA? 


TEFCA focuses on developing a Common Agreement that will enable information exchange without compromising security. 

Currently, seven organizations have met the criteria to become Qualified Health Information Networks (QHINs), which interface with each other and are accessible through most other HIEs, so providers can easily exchange medical records across networks. 

These organizations have signed a “Common Agreement” which defines the baseline requirements for securely sharing health information, and the “Trusted Exchange Framework,” which outlines the common principles and values these organizations agree to maintain. With these two documents as the foundation, HINs are then able to securely share information across networks. 

Since the release of the first draft in 2018, TEFCA has undergone several revisions based on public input and the addition of the Trusted Exchange Framework, Minimum Required Terms and Conditions, and QHIN Technical Framework. The most recent version, TEFCA 2.0, was published in April 2024. 

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Why TEFCA Matters

As outlined by the Office of the National Coordinator for Health Information Technology, TEFCA is designed to achieve three key goals:

  1. Establish a universal standards and policies for nationwide interoperability
  2. Simplify connectivity so organizations can securely exchange information, improving patient care in the process 
  3. Give patients access to their health care information 

Under TEFCA, it’s more efficient than ever to share electronic health information: organizations no longer need to join multiple HINs or build one-off BandAid tech solutions in an effort to achieve interoperability. 

TEFCA is a significant step toward making medical records available when key stakeholders need them, and it does so without compromising the security of healthcare organizations or the privacy of their patients. Under TEFCA, organizations can only request core health data for a specific set of purposes: 

  • Treatment
  • Payment
  • Health care operations
  • Public health
  • Government benefits determination
  • Individual access services 

Moving Toward National Interoperability

The pace of change in healthcare may be slow, but that doesn’t mean that progress isn’t happening. With the growth of telehealth and the increase of patient expectations around quality of care, it’s more important now than ever for providers and other stakeholders to have access to complete patient medical histories — especially for those operating in a value-based care environment. 

At Credo, we’re committed to helping organizations access the records they need, when they need them. And TEFCA is one important piece of the puzzle that makes those efforts possible. 

We’re one of the first companies using these national interoperability networks to compile records from more than 65,000 EHRs, HIEs, and clinical endpoints. This allows us to compile and deliver complete medical histories on every patient, so our clients can feel empowered to risk adjust accurately and deliver the highest quality of care.

To learn more about our solutions, schedule a demo today.

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