On July 24, the Office of the National Coordinator for Health Information Technology (ONC) kicked off a new, inclusive and ongoing effort in support of the trusted exchange framework and common agreement provisions in section 4003 of the 21^st Century Cures Act (Cures).

On behalf of ONC, thank you to all those who participated in the kick-off meeting and joined to learn more about the current landscape, we truly appreciate your insight and experience.  With more than 500 stakeholders joining in from across the country, National Coordinator for Health Information Technology Don Rucker, MD, Principal Deputy National Coordinator Genevieve Morris, and a number of panelists described the current state of trusted exchange between networks that support the flow of health information.  Panelists noted both successes and the many challenges that remain.

As Genevieve Morris noted in her remarks, progress has been made, “but more work needs to be done to push hard towards interoperability.”  Your input,  in the months to come is critical as ONC moves forward with implementing Cures and we look forward to hearing from you—including during the current public comment period (submit your comments).

Below are a few highlights from the meeting:

• Dr. Rucker outlined three important outcomes for a trusted exchange framework. First, patients can access their health information electronically without any special effort. Second, providers and organizations accountable for managing the health of populations can receive necessary and appropriate information on a group of individuals without having to access one record at a time, which would allow them to analyze population health trends, outcomes, and costs; identify at-risk populations; and track progress on quality improvement initiatives. Third, the health information technology (health IT) community should have open and accessible application programming interfaces to encourage entrepreneurial, user-focused innovation to make health information more accessible and to improve electronic health record (EHR) usability.
• Cynthia Fisher highlighted the importance of data liquidity.  Fisher, founder of WaterRev (an organization dedicated to sustainable water use) and ViaCord (a company that tests, types, freezes, and stores the umbilical cord blood of newborns for its potential use in treating certain disorders and diseases), shared her personal experience and underscored the importance of keeping the patient at the center of care and enabling the flow of information.
• The importance of the patient was echoed throughout the meeting.  We heard from Carequality, CARIN Alliance, CommonWell, Digital Bridge, DirectTrust, eHealth Exchange, National Association for Trusted Exchange and the Strategic Health Information Exchange Collaborative who shared how their organizations support the flow of information to benefit patient care. Commenters shared their individual thoughts with ONC on a range of related issues, including trust, interoperability, and patient access.
• We also heard about the current state of exchange frameworks and agreements across the country—including some similarities and differences that exist between trust frameworks and agreements.  Some of the similarities noted between the exchange frameworks included the ability to share information across disparate networks and principles designed to establish trust.  Some of the differences noted included how organizations authenticate participants and reciprocate the sharing of information among participants.

What are the next steps? 

Your voice is needed! We invite you to join the conversation, tell us your experiences, and share your thoughts on a trusted framework and common agreement.  Please share your comments on issues like standardization, transparency, non-discrimination, patient safety, access, and choice, or to comment generally.

A 30-day public comment period is now open and comments will be accepted through 11:59 pm on August 25, 2017.

After the comment period closes, work will continue. Two additional sessions will be scheduled later this year and ONC expects to release a draft Trusted Exchange Framework and Common Agreement in 2018.

We encourage you to stay engaged – and stay tuned – as we work to implement sections of the 21^st Century Cures Act.