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Hospitals’ ability to seamlessly exchange patient health information across the care continuum is critical to ensuring clinicians have access to the information they need for clinical decision-making and care coordination. Hospitals use various methods for exchange, and increasingly rely on various health information networks such as state, regional, and local health information exchange organizations (HIOs), prominent national health information exchange networks (national networks) that connect healthcare providers, HIOs, public health authorities, and payers, and electronic health record (EHR) vendor networks to support clinical information exchange.
Beginning in late 2023, hospitals also had the option to participate in the Trusted Exchange Framework and Common Agreement™ (TEFCA™), a nationwide interoperability framework designed to connect these various health information networks with a set of baseline policy and technical requirements to promote secure, nationwide information sharing. TEFCA enables exchange between networks to help limit the need for hospitals to join multiple networks to be able to exchange.
This dataset provides information on hospitals’ participation in health information networks—HIOs, national networks, and EHR vendor networks—as well as current and planned participation in TEFCA using the latest available data from the last 3 waves of the American Hospital Association (AHA) Information Technology (IT) Supplement Survey.
Source data: 2022-2024 AHA IT Supplement Survey. AHA Healthcare IT Database.
| Data Field | Data Description | Additional Information |
|---|---|---|
| aha_id | American Hospital Association (AHA) member ID | |
| mcrnum | CMS Certification Number (CCN). This is a unique 6-digit identifer issued to all hospitals participating in Medicare. | |
| mstate | The U.S. state in which the hospital is located. | |
| year | Survey year. This dataset only includes the latest year of available data for a given hospital. For example, if a hospital responded to the survey in 2022 and 2024, only 2024 data are shown. | |
| hio | HIO participation. Indicates hospitals currently participating in a state, regional, and/or local health information exchange or health information organization (HIO). Equals '1' for participants and equals '0' for non-participants, including hospitals that did not respond to the survey question. | |
| national_network | National network participation. Indicates hospitals currently participating in at least one of the following national health information exchange networks: CommonWell Health Alliance, e-Health Exchange, Carequality (network-to-network trust/governance framework). Equals '1' for participants and equals '0' for non-participants (including hospitals that did not respond to the survey question). | |
| vendor_network | EHR vendor network participation. Indicates hospitals currently participating in an electronic health record (EHR) vendor-based-network that enables record location and exchange within the EHR vendor's network of users (e.g., Epic's Care Everywhere). Equals '1' for participants and equals '0' for non-participant (including hospitals that did not respond to the survey question). | |
| tefca_part | TEFCA participation. Indicates hospitals currently participating in the Trusted Exchange Framework and Common Agreement (TEFCA). Equals '1' for participants and equals '0' for non-participants (including hospitals that did not respond to the survey question). | |
| tefca_plan | Planned participation in TEFCA. Indicates hospitals that plan to participate in the Trusted Exchange Framework and Common Agreement (TEFCA), but do not currently participate (as of the indicated survey year). Equals '1' for hospitals that plan to participate and equals '0' for all other hospitals, including current participants, those who do not plan to participate, and hospitals that did not respond to the survey question. |
Construction of the file
This dataset uses information from the last three waves of the American Hospital Association (AHA) Information Technology (IT) Supplement Survey (2022-2024) to report on hospital’s participation in health information networks. The population of hospitals included in this dataset was limited to U.S. based non-federal acute care hospitals including general/medical hospitals, children’s hospitals, surgical, and cancer hospitals. In order to provide the most up-to-date information on hospital participation in health information networks, this dataset only includes the latest year of available data for a given hospital. For example, if a hospital responded to the survey in 2022 and 2024, only 2024 data are shown. This file includes 2,253 hospital responses from 2024, 639 from 2023, and 358 from 2022. All measures indicate participation as of the survey year.
Participation in a state, regional, and/or local health information exchange organization comes from the survey question, “Please indicate your level of participation in a state, regional, and/or local health information exchange (HIE) or health information organization (HIO).” A hospital was considered to be participating in an HIE/HIO if they reported that an HIE/HIO was operational in their area and they were participating and actively exchanging data in at least one HIE/HIO. Missing data were assumed to be non-participants.
Participation in a national network or EHR vendor network comes from the survey question, “Which of the following national health information exchange networks does your hospital currently actively participate in (i.e., operational exchange)?” A hospital was considered to be participating in a national network if they reported participation in at least one of the following national health information exchange networks: CommonWell Health Alliance, e-Health Exchange, or Carequality (network-to-network trust/governance framework). A hospital was considered to be participating in an EHR vendor network if they reported participation in an EHR vendor-based-network that enables record location and exchange within the EHR vendor's network of users (e.g., Epic's Care Everywhere). Missing data were assumed to be non-participants.
Participation in TEFCA comes from the survey questions, “Are you aware of the Trusted Exchange Framework and Common Agreement (TEFCA)?” “If yes, are you planning to participate in TEFCA exchange (such as through your HIE or other national network)?” A hospital was considered to be participating in TEFCA if they reported they were currently participating. A hospital was considered to be planning to participate in TEFCA if they reported they were planning to participate, regardless of whether they already had a partner/contract in place. Missing data were assumed to be non-participants.
Data linkages
This dataset contains linkage variables that can be used to combine this data with other hospital datasets.
The “aha_id” variable contains the unique identifier assigned by AHA to all hospitals. It can be used to link this dataset to AHA’s Annual Survey, the full IT Supplement, and other AHA databases and datasets.
The “mcrnum” variable is the hospital’s unique CMS Certification Number (CCN) identifier. The CCN is issued to all unique hospitals who are registered and participate in CMS programs and treat CMS beneficiaries. The variable can be used to link to a variety of CMS public use files relating to hospital participation, performance, and utilization. It is the identifier ASTP/ONC uses to identify hospitals in its public use files, like the Certified Health Information Technology Reported by Hospitals for Promoting Interoperability Performance dataset.