By John Blair

When nationwide health data exchange governed by the Trusted Exchange Framework and Common Agreement (TEFCA) became operational in late 2023, it marked a key stop on the road to interoperability.

TEFCA is designed to improve interoperability by establishing standards and infrastructure to ease data exchange among key healthcare industry players such as providers, payers, and their information technology partners.

Qualified Health Information Networks (QHINs) are a critical component of the TEFCA network-to-network exchange, providing shared services and governance to securely route queries, responses, and messages across networks for key healthcare stakeholder, including patients, providers, hospitals, health systems, payers, and public health agencies.

QHINs are designed to become the “on ramp” for all electronically accessible health information without special effort on the part of the user. Under TEFCA, all healthcare stakeholders will connect to a QHIN, enabling the seamless sharing of data.

Once connected, any two hospitals, for example, will be able to easily share clinical data, even if they are using different QHINs. This is similar to making a cellular phone call. Regardless of the caller’s and receiver’s cellular networks, the call is connected seamlessly without any special action on the part of users.

However, as every user of technology knows, there are sometimes glitches that require assistance from an expert. That’s why it’s important for stakeholders to understand what type of support their QHIN will provide. Here are a few critical factors for stakeholders to consider.

Strong working relationships with other QHINs. In the cell phone analogy, a Verizon customer would reach out to Verizon if they were having connection issues. If the problem was related to a connection issue between the Verizon and AT&T networks, Verizon would work through the problems with AT&T and not expect the customer to reach out directly to AT&T for resolution.

Similarly, a provider having an issue exchanging data with another provider would reach out to their QHIN. The QHIN’s support team would then troubleshoot with other QHINs as needed. Interoperability success requires that a QHIN is adequately staffed with trained individuals who are committed to performing outreach to other QHINs and developing relationships with their peers in other networks. With strong relationships in place, a QHIN is well-positioned to escalate and resolve issues when they occur.

Strong collaboration with technology partners. EHR vendors and other technology providers often partner with QHINs to deliver interoperability to their end users. This requires collaboration to ensure optimal end-user experience. When necessary, QHIN support staff must be willing to work with their partners to proactively identify potential points of failure or to troubleshoot when issues do occur.

All aspects of interoperability are prioritized. Ultimately, to fully support providers, payers, and other end users, QHINs must prioritize all aspects of interoperability, whether within the confines of their own networks or not. That begins with a strong support infrastructure that prioritizes the proactive identification of all potential failure points along the message delivery cycle and the creation of strong working relationships with other networks.

As the network of networks for interoperability, TEFCA QHINs are only as strong as the weakest QHIN. To ensure interoperability success, a QHIN’s network support staff must work effectively with other QHINs and partners to create a unified virtual network.

When seeking a QHIN partner that can deliver a positive interoperability experience, stakeholders cannot overlook the importance of support teams who are knowledgeable, collaborative, and willing to go the extra mile to ensure interoperability success.

About the author: Dr. John Blair is the CEO of MedAllies.