Many new opportunities for healthcare data exchange are brewing this week under a universal policy for nationwide interoperability.
Surescripts approved for TEFCA participation
Surescripts Network Alliance participants, including electronic health records and other technology vendors, health plans, health systems and pharmacies, can now exchange data under the Trusted Exchange Framework and Common Agreement on the Surescripts Health Information Network.
The Sequoia Project designated Surescripts' Interconnect a TEFCA Qualified Health Information Network (QHIN), according to the announcement on Tuesday. The company initially applied for QHIN status in 2023.
The new QHIN can provide health systems and others with directory management, patient matching, document query and delivery, the company said.
"Surescripts Health Information Network will leverage the industry-leading reliability, support and deep partnership that our parent company, Surescripts, is known for," Tara Dragert, the company's chief product officer and the president of its HIN, said in a statement.
New interoperability checklist for payers
On Tuesday, the Sequoia Project's payer workgroup published a checklist to help payers comply with critical interoperability regulations that go into effect on Jan. 1, 2027 – and which are proving to be challenging for many payer organizations.
Called the Payer-to-Payer Fast Healthcare Interoperability Resources API Compliance Readiness Checklist, it is designed to help payers prepare for compliance with components of the Centers for Medicare & Medicaid Services CMS-0057-F rule governing healthcare data sharing.
"It is important that payer interoperability is prepared for the upcoming CMS deadline," Mariann Yeager, the Sequoia Project's CEO, said in a statement.
Because patients may change their health insurance companies on an annual basis, CMS requires previous and new payers to exchange information for the switch.
"The goal of this regulation is to improve continuity of care for patients when they change their health plans," added Robert Oakley, strategy and interoperability lead at Evernorth Health Services and co-chair of the Payer-to-Payer Workgroup.
Under TEFCA 2.0, exchange must be supported for API exchange using FHIR, an HL7 spec. Payers can use the editable checklist to identify both explicit and implicit regulatory and operational requirements, the Sequoia Project said.
"This checklist makes it easier for payers to facilitate the payer-to-payer exchange," said Oakley.
Partnership to increase TEFCA participation
Redox, a healthcare data interoperability provider, announced earlier this month that it has joined the CommonWell Health Alliance QHIN.
"Our partnership with CommonWell provides an easier path forward for Redox customers who want to participate in TEFCA," Trip Hofer, the company's CEO, said in a statement. "With access to CommonWell's network, our customers will be able to obtain more comprehensive data than is possible with point-to-point connections."
The company said it offers participants, even those on a legacy network, to write back in real time with direct connections.
"In the future, our interoperability platform will allow these customers to easily test, compare and switch between networks and QHINs with minimal risk," Hofer noted.
"TEFCA enables mostly read-only data exchanges, but operational workflows in healthcare commonly require writing data back into the provider workflow," he explained. "Without this capability, full interoperability will remain out of reach."
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.