The Department of Health and Human Services (HHS) released the draft Trusted Exchange Framework on Jan. 5. In a news release, HHS says the framework will be a "significant step toward achieving interoperability," which is a requirement of the 21st Century Cures Act of 2016.

The draft of the framework, issued by HHS's Office of the National Coordinator for Health Information Technology (ONC), "advances Congress' intent that building and maintaining trust is an important core element in ensuring that health information is available where and when it is needed to manage patient health and care."

The framework proposes policies, procedures and technical standards designed to advance the single on-ramp to interoperability requested by Congress. Per HHS, implementation of the framework will be facilitated through ONC in collaboration with a single recognized coordinating entity that is slated to be selected through a competitive process. The coordinating entity will develop a single common agreement that Qualified Health Information Networks and their participants will voluntarily agree to adopt.

"The draft Trusted Exchange Framework we issued today reflects the successes and challenges already existing in the exchange of health information and is designed to help guide the nation on its path to interoperability for all," Don Rucker, M.D., national coordinator for health information technology, said in a statement.

In HHS's statement, ONC will continue to engage with federal partners, such as the Department of Veterans Affairs (VA) and other stakeholders, to establish interoperability that allows health information to be used effectively in care and treatment decisions.

Here's how the framework supports achieving nationwide interoperability:

  • Patient access: Patients must be able to access their health information electronically without any special effort.
  • Population-level data exchange: Providers and payer organizations accountable for managing benefits can receive population-level health information, allowing them to analyze population health trends, outcomes and costs; identify at-risk populations; and track progress on quality improvement initiatives.
  • Open and accessible APIs: The health IT community should have open and accessible application programming interfaces (APIs) to encourage entrepreneurial, user-focused innovation to make health information more accessible and to improve electronic health record usability.

The framework would allow organizations to create agreements based on a particular business need to exchange information that may be different from those outlined in the proposal, the HHS statement said. It's also designed to prevent potential information blocking.

"The principles and direction we released, combined with the support of providers, existing health information networks, health IT developers, and federal agencies, are designed to help improve patient care, care coordination and the overall health of the nation," Rucker said.

According to Health IT Security, the draft framework specifically addressed how it aligns with HIPAA regulations: "HIPAA requires covered entities and business associates to remain HIPAA compliant even when conducting electronic transactions, such as electronic billing and fund transfers."

Additionally, ONC said it had worked with OCR to ensure that the framework does not contradict federal rules.

"Health information networks typically operate as business associates and currently have business associate agreements, otherwise known as participation agreements, in place with their participants," the draft said. "These agreements facilitate the exchange of electronic health information since they perform functions or activities on behalf of, or provide certain services for covered entities, such as determining and administering policies or agreements that define business, operational, technical or other conditions or requirements for enabling or facilitating access, exchange, or use of health information between or among two or more covered entities."

The comment period on this draft framework will be open through Feb. 20.