TEFCA
Trusted Exchange Framework and Common Agreement
TEFCA is the US framework that connects health data networks nationwide through a common legal and technical agreement, operationalized by QHINs.
TEFCA (the Trusted Exchange Framework and Common Agreement) establishes a nationwide floor for health information exchange in the United States. It defines a common set of principles, a legal agreement, and technical requirements so that data can flow across otherwise separate networks.
TEFCA is operationalized through QHINs — Qualified Health Information Networks — that agree to exchange data with one another on behalf of their participants. Collectively, QHINs and their participants reach the large majority of US hospitals.
TEFCA is increasingly FHIR-forward: its roadmap moves exchange toward FHIR-based query alongside legacy document exchange, which means participants and QHINs need reliable translation at the edges of their networks.
How this relates to Health1st
For QHINs, HIEs, and their participants, Health1st sits at the network edge — translating the heterogeneous v2, C-CDA, and FHIR formats trading partners send into the conformant FHIR that TEFCA-based query expects, and back.
Related terms
A QHIN is a network designated under TEFCA to exchange health data nationwide with other QHINs on behalf of its participants.
FHIR is HL7's modern, web-native standard for exchanging healthcare data as modular JSON/XML resources over RESTful APIs.
C-CDA is the HL7 XML standard for clinical documents such as the Continuity of Care Document, discharge summary, and referral note.
Ready to turn months of interface work into days?
See a live HL7 v2 ↔ FHIR translation on your own message types. No obligation.