A federal task force on Wednesday encouraged the Office of the National Coordinator for Health Information Technology to take more steps to encourage adoption of its proposed voluntary data-sharing framework, including offering funding and mandating participation as a condition of federal agency contracts.
The ONC should focus on a "carrot," rather than a "stick," approach to encourage participation in the Trusted Exchange Framework and Common Agreement, Arien Malec, co-chair of the Health Information Technology Advisory Committee's trusted exchange framework task force and a senior vice president at Change Healthcare, said during a meeting of the federal group Wednesday.
"The carrot here should be that this is the natural, easiest, fastest way to address those portions of information-blocking that require cross-network exchange," he said.
The ONC early this year unveiled its first iteration of TEFCA, a set of voluntary principles for health information networks meant to support nationwide interoperability. The framework outlines "rules of the road" for participating health information networks to follow to ensure they're using the same standards for data sharing and information security, among other considerations.
The public comment period for TEFCA's second draft, released in April, closed Monday.
Given TEFCA's status as a voluntary framework, providers and vendors offered recommendations on how the ONC could best encourage its adoption.
"You can't have too many (sticks) if you're a voluntary participation framework," Malec said.
Some groups suggested building TEFCA into the ONC's proposed information-blocking rule.
In feedback on a request for information included in the information-blocking rule, providers like Chicago-based CommonSpirit Health and Grand Rapids, Mich.-based Spectrum Health encouraged the ONC to require health IT developers to participate in TEFCA as a condition to receive certification under the agency's health IT certification program.
However, requiring TEFCA participation as a condition of certification or as necessary to comply with the information-blocking rule arguably goes beyond congressional intent, Allscripts and the EHR Association wrote in separate letters to the ONC. The ONC's directive was to develop a voluntary, non-prescriptive source of assistance to facilitate data sharing between health information networks, not a mandatory program, according to Allscripts.
Given TEFCA's already expansive reach as a voluntary approach, paired with the ongoing discussion of making it a requirement for some programs, the American Medical Association and the College of Healthcare Information Management Executives called on the ONC to undertake a formal rule-making process for the framework and common agreement.
In comments to the ONC, the AMA noted that both the ONC and the CMS requested feedback on requiring health IT developers and payers to participate in TEFCA in their companion interoperability proposals—potentially implying that the agencies intend for all stakeholders to join the program.
"As such, the TEFCA itself necessitates the formal rulemaking process to ensure appropriate stakeholder participation and federal government impact analysis and review," the group wrote.