ONC Releases Draft Trusted Exchange Framework

ONC Releases Draft Trusted Exchange Framework

The Office of the National Coordinator for Health IT (ONC) has released a draft of its long-awaited Trusted Exchange Framework, which aims to improve the interoperable exchange of health information between providers.

Required by the 21st Century Cures Act, the Trusted Exchange Framework and its accompanying Common Agreement creates a common set of principles for trusted exchange of electronic health information, as well as minimum terms and conditions that healthcare providers must meet when exchanging health information. The framework aims to create a technical and governance infrastructure that connects disparate health information networks together trough a core of “qualified health information networks,” or networks who have pledged to follow the Trusted Exchange Framework and Common Agreement.

“This is designed to bridge the gap between providers’ and patients’ information systems and enable interoperability across disparate health information networks,” states the ONC webpage explaining the Trusted Exchange Framework.

Part A of the framework defines six general principles “that provide guardrails to engender trust between health information networks” for trusted information exchange, including standardization, transparency, and security and patient safety, according to the “User’s Guide to Understanding the Draft Trusted Exchange Framework” document posted to HealthIT.gov.

Part B of the framework includes minimum required terms and conditions for trusted exchange. These terms and conditions ensure that common practices are in place among all participants of the Trusted Exchange Framework. These terms include common authentication processes of trusted health information participants, a common set of rules for exchange, and a minimum core set of organizational and operational policies to exchange electronic health information exchange among different networks.

The proposal hopes to better foster trusted exchange of information in three areas:

  • Patient access
  • Population-level data exchange
  • Open and accessible APIs

The draft framework was released after ONC held three formal public listening sessions and had many other meetings with stakeholders. During a call with the press announcing the framework on January 5, ONC’s Principal Deputy Genevieve Morris said this is an attempt to “build a single on-ramp to interoperability,” according to an article in Healthcare IT News.

“It’s a floor, not a ceiling. The minimum things we need to do to support information networks,” Morris said, according to the article.

ONC will be collecting public comments on the draft framework through February 18. Those comments will then be considered while a “Recognized Coordinating Entity” (RCE) drafts the final framework. ONC officials said this RCE will be selected following a competitive bidding process that will begin later this year.


Chris Dimick (chris.dimick@ahima.org) is editor-in-chief at Journal of AHIMA.