TEFCA promises true data interoperability, but industry must address security challenges

A person is admitted to the emergency division following an auto accident. They’re unconscious, bleeding internally, and desires quick surgical procedure. An aide locates the person’s pockets and determines that they aren’t native and that the hospital has no affected person data for them.

The surgeon now faces an important and probably harmful resolution. An estimated 8 million People take blood thinners, making any surgical procedure a lot riskier. It’s additionally true that co-morbidities and their severity have a direct bearing on surgical outcomes, size of keep, and a whether or not affected person is discharged on to house. However the person will die with out intervention, the surgeon determines, and an working room is booked.

The final word objective of the Trusted Alternate Framework and Widespread Settlement (TEFCA) is to open up medical data amongst suppliers, hopefully eliminating the state of affairs above. Submit-TEFCA, the identical unconscious particular person is admitted. An aide enters the affected person’s driver’s license quantity into the digital well being data system (EHR), the place a match is discovered throughout the nation. The attending doctor then can entry knowledge from different well being data networks that share widespread purposeful and technical necessities for alternate. With extra data, the surgeon could make more-informed selections concerning the particular person’s medical care.

There’s little doubt {that a} full TEFCA rollout will save lives and enhance affected person care and outcomes. Challenges stay, nevertheless, centered on how you can preserve knowledge privateness and safety because the variety of digital connections will increase exponentially amongst knowledge networks.

To assist preserve affected person and supplier confidence in data-sharing networks and cut back knowledge breaches and cyber publicity, accreditation applications are wanted to advertise finest practices, administrative simplification, widespread interchange requirements, open competitors, and — above all — the safety of knowledge alternate.

Affected person knowledge yearns to be free

TEFCA was formally launched in January 2022 and encompasses a typical set of rules, phrases, and situations to help nationwide alternate of digital well being data throughout disparate well being data networks and platforms. The final word goal is to free affected person knowledge from data silos, creating a typical framework for quick data sharing. The U.S. Division of Well being and Human Companies expects preliminary testing for the primary networks in This fall of this 12 months.

Rules name for the creation of certified well being data networks (QHINs) that conform to widespread phrases of alternate, together with purposeful and technical necessities. QHINs type the communications hub of the TEFCA community, routing queries, responses, and messages amongst people, suppliers, and amenities which can be exchanging knowledge.

EHR vendor Epic introduced its intent in June to change into a QHIN. Epic helped construct consensus on TEFCA’s requirements and procedures, so whereas the announcement is no surprise, it’s nonetheless a shot within the arm for the fledgling regulation.

True interoperability of affected person knowledge has been the objective for about so long as EHRs have existed. However anybody who visits a couple of medical supplier in a 12 months is aware of the trade stays a good distance from it — even amongst suppliers throughout the similar hospital or well being system. Affected person portals, private well being passports, in case of emergency (ICE) smartphone apps, and different applied sciences have been used as examples of knowledge sharing, however anybody who’s tried to navigate any of those is aware of that data is extraordinarily restricted.

Even given at this time’s know-how, acquiring medical data requires telephone calls, fax machines, and endurance, a number of endurance. It’s not unusual for a affected person to attend days or even weeks to accumulate wanted data. As irritating as it’s for sufferers, it’s equally time-consuming and irritating for medical workers to subject and fill these requests.

TEFCA holds the promise of a greater means ahead, however the healthcare trade should first come to grips with its knowledge breach downside — which is the place trade third-party accreditation and certification might help.

Accreditation might help guarantee safety of knowledge interchange

Certification of IT networks can go a good distance towards assembly the interoperability problem whereas instilling confidence that healthcare suppliers are exchanging knowledge securely amongst themselves and with sufferers.

Healthcare continues to be suffering from knowledge breaches and ransomware assaults that regularly put affected person knowledge in danger. In 2021, greater than 700 healthcare organizations reported breaches of greater than 500 data to the Workplace for Civil Rights’ Breach Portal, higher referred to as the HIPAA “wall of disgrace.” These 704 breaches compromised practically 46 million affected person data. Practically three-quarters of incidents have been attributed to hacking, with one other 20% being brought on by unauthorized entry. And whereas suppliers reported 72% of all breaches, enterprise associates represented 13% of the whole quantity, affecting greater than 10.5 million sufferers.

Healthcare programs are comprised of interlinked applied sciences, care companions, and enterprise associates — any certainly one of which may be the weak hyperlink within the safety chain. For the eleventh consecutive 12 months, healthcare has had the very best breach-related prices, which now high $9 million per incident.

Two current surveys underscore the necessity for accreditation of healthcare networks to assist maintain knowledge secure. Within the first, 80% of CIOs and CISOs says their firms have skilled a breach originating with a third-party vendor prior to now 12 months. A second survey reveals that 44% of hospitals and well being programs failed to fulfill primary protocols beneath the U.S. Nationwide Institute of Requirements and Know-how (NIST) Cybersecurity Framework (NIST CSF).


TEFCA interoperability requirements will undoubtedly enhance the move and availability of affected person data and the standard of clinician decision-making in emergent circumstances. However that free move of knowledge can’t happen in an interchange setting that’s rife with weaknesses and vulnerabilities.

Hospitals, well being programs, acute and post-acute care amenities, know-how distributors, and enterprise associates should already handle general danger methods and publicity internally and with companions. Trade accreditation and certification of the safety and privateness of these knowledge connections is important to make sure adherence to requirements and finest practices whereas defending the safety, privateness and confidentiality of affected person knowledge.

Picture: ipopba, Getty Photographs

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