Strategy 11 min read

TEFCA Readiness Playbook: What to Validate Before You Commit to an EHR

TEFCA is no longer abstract policy. As QHIN participation grows, provider organizations should require concrete interoperability evidence from EHR vendors, not marketing claims.

By Nathan Boyd, MBA

TEFCA Basics for Decision Makers

TEFCA establishes a common legal and technical framework for nationwide health information exchange through Qualified Health Information Networks (QHINs). For providers, this affects referral workflows, record retrieval latency, and data completeness for transitions of care.

Practical implication: your EHR's interoperability roadmap should show how TEFCA-aligned exchange works in your daily workflows, not only in a sandbox demo.

How to Validate Vendor Interoperability Claims

  1. Ask for current-state architecture: where exchange runs today vs. roadmap promises.
  2. Request production metrics: request/response volumes, timeout rates, and reconciliation success.
  3. Demand workflow demonstrations: referral intake, ED discharge ingestion, and duplicate-chart resolution.
  4. Check data quality: coded problems, allergies, meds, and encounter provenance must be computable.

Provider Operating Model for TEFCA

Governance

Assign a named interoperability owner with authority across IT, HIM, compliance, and clinical operations. TEFCA outcomes degrade when ownership is split across disconnected teams.

Data Stewardship

Build field-level data standards for problems, meds, allergies, immunizations, and care-team identifiers. Interoperability volume without data discipline creates noise, not value.

Service-Level Targets

Set internal SLAs for reconciliation tasks: inbound summary review, problem-list update, and chart-linking completion. Tie them to operational dashboards.

Security and Privacy Controls

  • Minimum-necessary access and role scoping for query-based exchange.
  • Audit trails that clearly separate user query, automated retrieval, and downstream chart writes.
  • Exception handling for sensitive records and consent-constrained categories.

90-Day Go-Live Plan

  1. Month 1: baseline current exchange success and reconciliation delays.
  2. Month 2: pilot with one referral-heavy service line and one hospital partner.
  3. Month 3: expand to enterprise workflows with monitoring and defect triage cadence.

Use this alongside our interoperability guide and vendor evaluation framework so procurement and operations stay aligned.

Editorial Standards

Last reviewed:

Methodology

  • Reviewed TEFCA framework publications and Sequoia project implementation resources.
  • Mapped framework concepts into provider-side operating controls and EHR procurement checkpoints.
  • Prioritized items with direct effect on care-transition workflow quality and auditability.

Primary Sources