The Sequoia Venture, performing because the Acknowledged Coordinating Entity for the TEFCA interoperability framework, has launched a revamped FHIR Roadmap for TEFCA Alternate that has a four-stage timeline for the gradual adoption of the FHIR (Quick Healthcare Interoperability Assets) commonplace for knowledge trade.
Model 2 of the Roadmap envisions FHIR Alternate between Certified Well being Info Networks (QHINs), which is Stage 3 within the plan, to be piloted in 2025, with implementation specs developed quickly after the pilots are accomplished. This can allow QHINs to leverage FHIR for trade between QHINs whereas persevering with to assist non-FHIR approaches throughout the QHINs’ inside networks.
The Workplace of the Nationwide Coordinator for Well being Info Expertise (ONC) has led a multi-year course of alongside the RCE to implement TEFCA, which was envisioned by the twenty first Century Cures Act. The thought is to create a “community of networks” for sharing well being knowledge throughout the nation. The aim is that like wi-fi networks, electrical energy grids and ATMs, the consumer expertise will grow to be as if it is a single community.
In offering some background, the RCE famous that the preliminary work on TEFCA began with extra established requirements, reminiscent of IHE-based trade of C-CDA content material. However the speedy embrace of FHIR by the trade makes it crucial that TEFCA embody a deliberate technique so as to add FHIR-based trade.
“Most FHIR implementation exercise out there has centered on point-to-point trade of FHIR assets by way of FHIR APIs with out community intermediaries. Nevertheless, some networks have leveraged their infrastructure to assist FHIR in numerous methods,” the Roadmap doc states. “For instance, just a few nationwide and state/regional networks use current IHE-based brokering infrastructure to trade FHIR payloads. As well as, early pilot work has begun to make use of community infrastructure to assist FHIR API Alternate between endpoints and a few networks are planning to supply brokered FHIR API trade.”
The Roadmap envisions 4 phases of growth to supply continuity for the FHIR actions out there and permit TEFCA coverage and technical infrastructure to speed up FHIR adoption. “It additionally bridges network-based trade communities and the customers of FHIR APIs by way of ONC-certified EHRs and CMS required APIs, which have been working in parallel up till now. We imagine that each patterns of trade shall be necessary sooner or later and that use of FHIR APIs in TEFCA can assist make these patterns complementary and at last ship on the promise of a contemporary, digital healthcare system.”
The Roadmap reveals 4 phases of FHIR trade in TEFCA, with necessities for every stage constructed on the earlier stage:
• Stage 1: FHIR Content material Assist
− Included as a part of the preliminary launch of TEFCA.
− QHIN-brokered IHE trade of FHIR payloads between QHINs accessible.
• Stage 2: QHIN-Facilitated FHIR Alternate
− QHIN assist for facilitated FHIR API trade required.
− Participant and Subparticipant trade by way of FHIR APIs accessible.
• Stage 3: QHIN-to-QHIN FHIR Alternate
− Assist for trade between QHINs by way of FHIR APIs required.
• Stage 4: Finish-to-Finish FHIR Alternate
− Assist for QHIN-brokered FHIR Alternate between Contributors and
Subparticipants.
Every stage shall be supported by a brand new model of the QHIN Technical Framework and managed by way of the change administration course of within the Widespread Settlement.
A timeline reveals Levels 1 and a pair of occurring in 2024, with Stage 3 in 2026, and Stage 4 in an unspecified future timeframe.
The RCE notes that Stage 4’s Finish-to-Finish FHIR Alternate would allow a Participant/Subparticipant to seamlessly trade FHIR knowledge between themselves and different community members by way of the QHINs and a number of different intermediaries each inside a QHINs’ community and thru the TEFCA-governed community. This requires additional analysis into optimum strategies for safe trade by way of the community by way of the QHINs. When that analysis is full, ONC will launch a pilot with TEFCA customers to find out how and when that analysis will be rolled right into a manufacturing surroundings.
The Widespread Settlement, launched in September 2021, contains six trade functions that organizations should assist to be designated as a QHIN. The trade functions embody Remedy, Cost, Well being Care Operations, Public Well being, Advantages Dedication, and Particular person Entry Providers.
The next organizations have been formally designated because the preliminary QHINS after efficiently finishing the TEFCA onboarding course of.
• eHealth Alternate
• Epic Nexus
• Well being Gorilla
• KONZA
• MedAllies
There are roughly 20 organizations formally searching for QHIN standing.
