ONC's draft interoperability framework floats 'network of networks' concept

The Trusted Exchange Framework, required by the 21st Century Cures Act, includes a common agreement of exchange procedures.
By Jessica Davis
03:08 PM
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ONC interoperability standards

The U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology released the much anticipated Trusted Exchange Framework to bolster its interoperability work as required by the 21st Century Cures Act.

“This is really a network of networks concept,” ONC head Donald Rucker, MD, said during a press call Friday.

The proposed framework establishes a set of minimum requirements and conditions for a trusted exchange and attempts to streamline patient data access and exchange provisions set out in the 21st Century Cures Act.

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Part A of the framework establishes principles for exchange and principles to help networks support interoperability, while Part B gets into the legal language and outlines how participation agreements should be constructed to support the process.

Specifically, Part B of the framework brings up problem areas that have hindered issues with data exchange in the past.

The proposal has three target areas: patient access, population-level data exchange, and open and accessible APIs.

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The agency has been working to develop the framework since summer of 2017 through a series of three public listening periods and hundreds of stakeholder meetings, calls and the like. ONC’s Principal Deputy Genevieve Morris on the press call said it’s an attempt “to build a single on-ramp to interoperability.”

“It’s a floor, not a ceiling: The minimum things we need to do to support information networks,” Morris said.

The public comment period will remain open until Feb. 18. From there, Morris said the ONC will review comments and make sure the industry is on board. If so, the ONC will release the cooperative agreement in the spring when the agency will give organizations time to apply.

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The ONC hopes to be engaged with those stakeholders in August to work with them on a common agreement, Morris explained. Further, while the ONC created this draft framework, the final framework will be drafted by a recognized coordinating entity (RCE).

Morris explained the RCE will have experience with minimum terms and conditions and create a full common agreement, complete with the necessary legal terms to support data exchange between networks.

The RCE will be selected by the ONC through a competitive bidding process to maintain transparency, and the selection process is set to begin later this year. The RCE also will be responsible for oversight of those organizations that voluntarily agree to the framework, including security and ensuring processes are in place for bad actors.

“This is not really dissimilar from other network governance. I would look at this as coordinating things, rather than a lot of policing needed. I don’t think that’s how networks tend to work,” said Rucker. “Getting this sort of larger coordination is really an opportunity to allow current participants to expand the scope of their businesses.”

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com