The Sequoia Undertaking, performing because the Acknowledged Coordinating Entity for the TEFCA interoperability framework, has launched a revamped FHIR Roadmap for TEFCA Change that has a four-stage timeline for the gradual adoption of the FHIR (Quick Healthcare Interoperability Assets) commonplace for knowledge alternate.
Model 2 of the Roadmap envisions FHIR Change between Certified Well being Data Networks (QHINs), which is Stage 3 within the plan, to be piloted in 2025, with implementation specs developed quickly after the pilots are accomplished. It will allow QHINs to leverage FHIR for alternate between QHINs whereas persevering with to help non-FHIR approaches inside the QHINs’ inner networks.
The Workplace of the Nationwide Coordinator for Well being Data Know-how (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 person expertise will develop into 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, similar to IHE-based alternate of C-CDA content material. However the speedy embrace of FHIR by the business makes it crucial that TEFCA embody a deliberate technique so as to add FHIR-based alternate.
“Most FHIR implementation exercise out there has targeted on point-to-point alternate of FHIR assets through FHIR APIs with out community intermediaries. Nevertheless, some networks have leveraged their infrastructure to help FHIR in numerous methods,” the Roadmap doc states. “For instance, just a few nationwide and state/regional networks use present IHE-based brokering infrastructure to alternate FHIR payloads. As well as, early pilot work has begun to make use of community infrastructure to help FHIR API Change between endpoints and a few networks are planning to supply brokered FHIR API alternate.”
The Roadmap envisions 4 levels of improvement 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 alternate communities and the customers of FHIR APIs through ONC-certified EHRs and CMS required APIs, which have been working in parallel up till now. We consider that each patterns of alternate can be vital sooner or later and that use of FHIR APIs in TEFCA may help make these patterns complementary and eventually ship on the promise of a contemporary, digital healthcare system.”
The Roadmap reveals 4 levels of FHIR alternate in TEFCA, with necessities for every stage constructed on the earlier stage:
• Stage 1: FHIR Content material Help
− Included as a part of the preliminary launch of TEFCA.
− QHIN-brokered IHE alternate of FHIR payloads between QHINs obtainable.
• Stage 2: QHIN-Facilitated FHIR Change
− QHIN help for facilitated FHIR API alternate required.
− Participant and Subparticipant alternate through FHIR APIs obtainable.
• Stage 3: QHIN-to-QHIN FHIR Change
− Help for alternate between QHINs through FHIR APIs required.
• Stage 4: Finish-to-Finish FHIR Change
− Help for QHIN-brokered FHIR Change between Members and
Subparticipants.
Every stage can be supported by a brand new model of the QHIN Technical Framework and managed through the change administration course of within the Frequent Settlement.
A timeline reveals Levels 1 and a couple of taking place 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 Change would allow a Participant/Subparticipant to seamlessly alternate 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 alternate by way of the community through 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 Frequent Settlement, launched in September 2021, contains six alternate functions that organizations should help to be designated as a QHIN. The alternate functions embody Therapy, Cost, Well being Care Operations, Public Well being, Advantages Dedication, and Particular person Entry Companies.
The next organizations have been formally designated because the preliminary QHINS after efficiently finishing the TEFCA onboarding course of.
• eHealth Change
• Epic Nexus
• Well being Gorilla
• KONZA
• MedAllies
There are roughly 20 organizations formally looking for QHIN standing.
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