The Road to TEFCA: Are We There Yet?

If you feel like interoperability has been a buzzword in healthcare for a long time, you’re not wrong. Two of the largest interoperability networks, CommonWell and Carequality, were founded over a decade ago in 2013 and 2014, respectively.

Despite a 10 year-plus push for improved interoperability in the healthcare space, we are still not quite “there yet.” “There” is a place where meaningful data is exchanged efficiently and securely across the ecosystem for not just treatment use cases, but also health plan-oriented use cases like payment and operations.

The strides that have been made

The Moxe team was glad to see the Sequoia Project, the Recognized Coordinating Entity (RCE) for TEFCA, release a bundle of new Standard Operating Procedures (SOPs) last month. This new batch included SOPs for Public Health and Operations, as well as updates to Individual Access.

There was big news from Carequality and Epic last month as well. Carequality announced updates to their framework to more closely align with TEFCA policies and procedures, laying the groundwork for the future convergence of the two frameworks. Epic followed with news of their intent to secure commitments from all Epic customers to transition to TEFCA before the end of the year, with plans to get all of those customers live on TEFCA before the end of 2025.

What’s still missing

While TEFCA is helping the industry make strides towards true interoperability, its rollout will likely continue to be slow and steady.

With the release of the Health Care Operations SOP, we learned that responses to Operations queries will not be required for another 18 months from the date of the SOP’s publication, which puts us in February 2026.

Until responses are required for use cases that are critical to running the business of healthcare, organizations cannot solely rely on TEFCA for their data exchange needs.

How Moxe can help

Moxe has been purpose-built for payment and operations use cases. With broad buy-in from health systems and health plans, we’re one of the only networks facilitating the exchange of clinical data at scale for use cases outside of treatment.

Our solutions are designed to help customers today, while being flexible to respond to the demands of the future, no matter how slowly FHIR is adopted or TEFCA evolves.

Once TEFCA and QHINs are valid sources of data for health plans at scale, we’re ready to utilize that data on behalf of our customers. Until then, we continue to help both payers and providers build data exchange programs that bolster the frictionless exchange of information while balancing concerns for patient privacy and data security.

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