- The government's health IT agency has selected nonprofit Sequoia Project to serve as the recognized coordinating entity (RCE) overseeing the implementation of the Trusted Exchange Framework and Common Agreement (TEFCA). The Sequoia Project, a public-private partnership that advocates for nationwide health IT exchange, will start work on its responsibilities this week.
- The RCE is mostly responsible for developing and implementing the Common Agreement portion of the interoperability guidelines: creating baseline technical and legal requirements for different health IT systems, companies and groups to communicate with each another and share electronic information.
- In its new role, the Sequoia Project will also choose and monitor qualified health information networks (QHINs). The four-year agreement with the Office of the National Coordinator for Health IT is funded for $900,000 for the first year.
TEFCA, a provision of the 21st Century Cures Act, is meant to advance the trusted exchange of EHR and other health IT data among health information networks. ONC sees TEFCA as a nationwide on-ramp for interoperability. What body would oversee how different health information networks communicate was one of the major questions following the agency's release of the second iteration of TEFCA in April.
ONC, which has said it planned to tap a private-sector organization for the job in the past, answered that question definitively Tuesday. Along with shaping and implementing the Common Agreement, the Sequoia Project will designate QHINs, monitor their activities, modify and update their technical requirements, make sure actors are compliant with the Common Agreement and create a long-term strategy for TEFCA support beyond its RCE tenure — all while taking stakeholder input into account through virtual public listening sessions.
"We're hitting the ground running," Mariann Yeager, CEO of the Sequoia Project, told Healthcare Dive. "Over the next couple of weeks we're really going to work on getting organized, gearing up, getting the work plan finalized and then we'll very quickly turn our attention to reviewing the public comments to TEF 2.0" and drafting the Common Agreement.
The interoperability-focused nonprofit was "selected through a competitive process to help with the interoperable flow of health information," ONC head Don Rucker said in a statement.
Each application was reviewed by an independent panel, which then scored the applications individually and met as a group to discuss their strengths and weaknesses before making a recommendation, an agency representative told Healthcare Dive.
ONC declined to say the number of applications it received or what other organizations applied to be the RCE.
The Sequoia Project was founded in 2012 and has been in charge of the nationwide health information network exchange, called the eHealth Exchange. It became an independent body in 2018. Another of the nonprofit's efforts, an initiative to interconnect data sharing networks called Carequality, relaunched as an independent nonprofit last year.
The group was the logical choice for the RCE, experts said.
"Many of our members, based upon the criteria, felt Sequoia was really the only group that was positioned for this," a representative for health IT executive group CHIME told Healthcare Dive.
Many industry stakeholders took to Twitter to celebrate the news, including representatives of companies Health Gorilla and CommonWell Health Alliance, which plan to apply to become QHINs.
Congratulations to newly minted RCE @Sequoiaproject. Great choice by @ONC_HealthIT. We at @healthgorilla look forward to pursuing QHIN status to bring nationwide interoperability to more stakeholders, esp in underserved communities. #interoperability— Steven Yaskin (@steveY23) September 3, 2019
As a future leading QHIN, @CommonWell looks forward to building on our relationship with @CarequalityNet and @sequoiaproject, who deservedly earned the RCE award from @ONC_HealthIT. #Interoperability https://t.co/jqZsA1grAY— Jitin Asnaani (@jitin) September 3, 2019
"We're humbled and honored that so many have that confidence in us to really work together with them," Yeager said. "This is really going to be a team effort."
The Sequoia Project is ready to face stakeholder concerns around TEFCA implementation, especially the fast timeline for compliance with interoperability rules, she said.
"We're very practical. The multi-year plan we presented in our [RCE application proposal] takes into account the need for all of us to be thoughtful in moving forward in phased approaches," Yaeger said. "We believe we can actually meet the timeframe desired" while building "the community of trust to have a product that is trusted and embraced."
The Sequoia Project will receive $900,000 in government funding for fiscal year 2019, with funding in future years dependent on funding availability and satisfactory completion of RCE milestones.