This article was originally published on LinkedIn by Jay Nakashima, President, eHealth Exchange.
As healthcare organizations prepare for the future of nationwide data exchange, the Trusted Exchange Framework and Common Agreement™ (TEFCA™) continues to grow and add networks, bringing diverse electronic health information sharing choices to participants. With 10 designated Qualified Health Information Networks® (QHINs™) now available, the big question is: How do you choose the right one for your organization?
This was the focus of a recent eHealth Exchange webinar, TEFCA Is Not Going Away—What To Know Before You Choose a QHIN, featuring perspectives from:
- Erica Galvez, CEO, Manifest MedEx
- Gary Parker, Chief Data Officer, Data Governance Office; Director, Alabama HIE One Health Record, Alabama Medicaid Agency
- Eddie Gonzalez Loumiet, Senior Advisor, Association of Public Health Laboratories (APHL)
- Mike Yackanich, Vice President of Technology Operations, eHealth Exchange
A Common Misperception
“A common misperception with TEFCA is that all designated QHINs are created equal,” said moderator Tina Feldmann, Marketing Director at eHealth Exchange. “Yes, each has signed the same common agreement and passed technical and security requirements, but there are key differences you need to evaluate.”
Six Things To Consider When Choosing a QHIN
Drawing on the recently published eBook on QHIN evaluation, the panel explored six areas that organizations should examine:
1. Establishing and Maintaining Trust
Healthcare data is one of the top targets for cybercriminals, making trust paramount. “The number one term that came up in our member survey was trust,” said Gonzalez Loumiet. “It’s taken 20 years for APHL to earn it—and we needed a QHIN partner with the same track record.” Galvez added, “Every time we’ve had a concern or a question, the transparency and responsiveness of eHealth Exchange reinforced our trust.”
2. The Effort to Connect
Onboarding to TEFCA can be complex, but the level of support from a QHIN makes a difference. “The onboarding program is so thorough and well designed,” said Galvez. “While I can’t downplay the complexity and lift to onboard, the eHealth Exchange support and partnership every step of the way was tremendous.” Yackanich noted that eHealth Exchange provides one-on-one weekly technical meetings to ease the process.
3. Technical Architecture
TEFCA defines standards for QHIN-to-QHIN exchange but leaves room for differences in how each network is built. “We believe the highest trust model is to be a true pass-through—not to persist data, not to stand up a clinical data repository, and no secondary use,” explained Yackanich. Parker emphasized the importance of eHealth Exchange’s federated Record Locator Service (RLS) approach: “By only receiving queries relevant to my region, we reduce false positives and keep control of patient matching.”
4. Reach
A QHIN’s size and scope matter, especially while TEFCA adoption is ramping up. “More direct connections mean more complete patient data at the point of care,” said Parker. Gonzalez Loumiet added that APHL’s partnership with eHealth Exchange has accelerated electronic case reporting nationwide, involving 56,000 healthcare facilities and 7,000 providers.
5. Experience
TEFCA requires QHINs to have at least two years of national-scale experience, but not all experience is equal. “Having a seasoned and expert partner is critical,” emphasized Galvez. “We’ve benefited tremendously from eHealth Exchange’s long-standing leadership in interoperability.” Parker, who also chairs the eHealth Exchange QHIN Governance Committee, highlighted the value of participant-led governance: “It allows us to lead together while benefiting from eHealth Exchange’s depth of knowledge.”
Moderator Tina Feldmann added that the eHealth Exchange’s core network has been participant-led from the very beginning with the Coordinating Committee. “To support a participant-led QHIN Governing Council was a very smooth transition for us.”
6. Alignment with Approach, Values, and Focus
Every QHIN operates differently. It’s essential to evaluate how each one aligns with your organization’s mission and priorities. “We are also a nonprofit, so the mission orientation and commitment to serving the public are tightly aligned between our organizations,” said Galvez. “That matters a lot to us.” Gonzalez Loumiet agreed, noting the importance of “shared values like transparency, effectiveness, and innovation—especially during challenging times.”
Ready To Evaluate QHINs?
This article only scratches the surface of a rich discussion among early adopters of TEFCA. Here are more resources for you to help you to evaluate QHINs:
🎥 Watch the full webinar recording to hear directly from Galvez, Parker, Gonzalez Lumie, and Yackanich as they share lessons learned and advice for organizations evaluating QHINs.
📖 Download the free ebook, “Why TEFCA? Why Now? A Guide To Choosing a QHIN.” It serves as a primer to TEFCA and offers practical insights on:
- Key questions to ask potential QHINs,
- How to compare technical approaches, and
- What to look for in trust, governance, and alignment.
Together, the recording and eBook provide a comprehensive toolkit to help your organization make an informed QHIN selection.
