Epic and TEFCA: Overview

The Trusted Exchange Framework and Common Agreement (TEFCA) is a U.S. government-sponsored exchange framework for healthcare data interoperability that aims to provide a single network on-ramp for a wide variety of health information exchange use cases. Epic customers connect to the TEFCA network through the Epic Community’s Qualified Health Information Network (QHIN): Epic Nexus. The Epic Nexus QHIN connects to other QHINs, allowing for advanced interoperability with minimal setup.

If you wish to connect with an Epic customer through the TEFCA network for any use case, your first step is to onboard to a QHIN. Currently, the Epic Nexus QHIN is only for Epic community members, but there are several other QHINs. Connecting to any QHIN gives you the ability to exchange with anyone connected to any other QHIN.

TEFCA supports a variety of use cases. Today, Epic organizations participate in the framework for the Treatment, Individual Access Services, and Public Health Reporting use cases.

TEFCA for Treatment

Epic organizations respond to requests for the TEFCA Required Treatment Exchange Purpose Code as described in the documentation on the website of TEFCA’s Recognized Coordinating Entity.

TEFCA for Individual Access Services

One of the interoperability pathways TEFCA supports is the ability for patients to use apps of their choice to retrieve copies of their medical records from participants in the framework. In TEFCA, this is referred to as Individual Access Services (IAS). The idea is that individuals can use TEFCA-connected IAS apps as an alternative to patient portal apps offered by their healthcare providers. Patients might then use the app to self-report or track their health data, which can also provide valuable information to their doctor.

TEFCA also raises the bar for privacy and security. Before an IAS app can connect to a QHIN, it must voluntarily agree to comply with certain privacy and security requirements from HIPAA. Apps must also explicitly ask for permission before they can sell patient data.

Epic Nexus Participants respond to IAS requests in TEFCA using the FHIR-based approach described here. Currently, T-IAS is the only exchange purpose of use supported by Epic Nexus for FHIR clients. Epic Nexus Participants currently act exclusively as FHIR Responding Nodes.

TEFCA for Electronic Case Reporting to Public Health Agencies

Epic organizations can push electronic case reports to public health agencies participating in the TEFCA ecosystem.