Barriers to health IT interoperability are not just technical; they also include legal and policy impediments.

To address such barriers, the eHealth Exchange Cooperative took on the responsibility of developing the legal infrastructure to support the exchange of health information among participants. Because eHealth Exchange is constantly growing and evolving, so too must its rules and processes for operation. Change is stewarded by the eHealth Exchange Coordinating Committee.

Role of the Coordinating Committee

The overarching role of the Coordinating Committee is to provide the needed governance, oversight, management and support of the trust fabric for the Exchange participants. The roles and responsibilities of the Coordinating Committee set forth in the Data Use and Reciprocal Services Agreement (DURSA) include:
  • Determining whether to admit a new participant
  • Maintaining a definitive list of all transaction patterns supported by each of the participants
  • Developing and amending operating policies and procedures in accordance with Section 11 of the DURSA
  • Receiving reports of breaches and acting upon such reports in accordance with Section 14.03 of the DURSA
  • Suspending or terminating participants in accordance with Section 19 of the DURSA
  • Resolving disputes between participants in accordance with Section 21 of the DURSA
  • Managing the amendment of this agreement in accordance with Section 23.02 of the DURSA
  • Fulfilling all other responsibilities delegated by the participants to the Coordinating Committee
  • Evaluating, prioritizing and adopting new performance and service specifications, changes to existing performance and service specifications and the artifacts required by the validation plan in accordance with Section 10 of the DURSA
  • Maintaining a process for managing versions of the performance and service specifications, including migration planning
  • Evaluating requests for the introduction of emergent specifications into the production environment used by the participants to transact message content
  • Coordinating with ONC to help ensure the interoperability of the performance and service specifications with other health information exchange initiatives including, but not limited to, providing input into the broader ONC specifications activities and ONC Standards and Interoperability Framework initiatives