The Office of the National Coordinator (ONC) for Health Information Technology has released a draft trusted exchange framework that proposes policies, procedures, and technical standards to further Congressionally-mandated efforts to establish a nationwide, interoperable health system under the 21st Century Cures Act of 2016. Currently, there are dozens of Health Information Networks (HINs) that operate locally, regionally, or nationally, but that do not exchange health information with each other. The draft framework focuses on principles for trusted exchange of electronic health information and minimum required terms and conditions for trusted exchange among the nation’s multiple health information networks. The trusted exchange framework aligns with HIPAA requirements, but also specifies terms and conditions to enable broader exchange of health information among both regulated (i.e., covered entities and business associates) and non-regulated entities. The framework indicates that additional and faster progress is necessary in developing interoperability, especially in the case of medical specialties—such as long-term services and supports providing post-acute care or in lieu of institutionalization, behavioral health, and other ambulatory services.

Public comments are being accepted electronically at until February 18, 2018. Subsequently, the ONC will select a Recognized Coordinating Entity (RCE), which will develop a single common agreement that qualified health information networks and their participants may voluntarily agree to adopt. Following the comment period and refinements to the draft framework, HHS expects to release a final draft of the combined trusted exchange framework and common agreement later this year.