Trusted Exchange Framework and Common Agreement

The HIT Policy, Standards, and Join committee are no longer active and have been replaced.

In the 21st Century Cures Act (Cures Act), Congress identified the importance of interoperability and set out a path for the interoperable exchange of Electronic Health Information. Specifically, Congress directed ONC to “develop or support a trusted exchange framework, including a common agreement among health information networks nationally.”

The Draft Trusted Exchange Framework, released on January 5, 2018, outlines a common set of principles for trusted exchange and minimum terms and conditions for trusted exchange. This is designed to bridge the gap between providers’ and patients’ information systems and enable interoperability across disparate health information networks (HINs).

  • Principles for Trusted Exchange (Part A)—guardrails and general principles that Qualified Health Information Networks (QHINs) and Health Information Networks (HINs) should follow to engender trust amongst Participants and End Users.
  • Minimum Required Terms and Conditions for Trusted Exchange (Part B)—specific terms and conditions that will be incorporated into a single Common Agreement by a Recognized Coordinating Entity (RCE).

The final Trusted Exchange Framework and Common Agreement (TEFCA) will include Parts A and B, as well as the Common Agreement, and will be published in the Federal Register and on this website in late 2018.


The Draft Trusted Exchange Framework builds on and recognizes the significant work done by the industry over the last few years to broaden the exchange of data to meet the needs of patients and the providers who serve them. It aims to scale interoperability nationwide by providing a single “on-ramp” to allow all types of healthcare stakeholders to join any health information network they choose and be able to participate in nationwide exchange, regardless of what health IT developer they use, health information exchange or network they contract with, or where the patients’ records are located. The Trusted Exchange Framework aims to ease the flow of information between healthcare stakeholders and expand patient access to their health data, while allowing for a competitive marketplace that fosters innovation and development of new technologies to improve care coordination, population health management, and patient outcomes.

We encourage stakeholders to submit comments on any component of the Trusted Exchange Framework, including comments on the feasibility of the policies outlined in Part A and the language included in Part B.

Content last reviewed on February 28, 2018
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