ONC, through the Recognized Coordinating Entity (RCE, i.e., the Sequoia Project), released the TEFCA Public Health Educational Guidance document.

The draft document was released 1/19/24.

APHL submitted comments on the draft rule to the RCE on 2/12/24.

Document Summary

This informational guide describes TEFCA, how a QHIN works, and how it will support public health use cases. It is an overview of the TEFCA program; it can serve as a useful primer for those who are new to TEFCA, and it is not too technical.

As of January 2024, the first two public healht use cases are ELR and eCR. Public Health Implementation XP SOPs will continue to be built out over time.

Additional PH use cases that may be considered include:

• Vital Statistics Birth Records • Vital Statistics Death Records • Cancer Registry Reporting • Immunization Registry • Syndromic Surveillance • Health Care Surveys • Population Health • Social Determinants of Health (SDoH) • Chronic Disease Conditions (e.g., Hypertension; Diabetes) • Bidirectional Data Exchange for Referrals (BSeR) (e.g., tobacco quitline; other interventions)

The document acknowledges that legacy reporting may continue even after these use cases are live on QHINs.

APHL Feedback Summary

• The guidance should provide better with real-world examples

• This should be a living document, updated as public health use cases are built out.

• The document should address the impact to PHLs. Will QHINs connect directly to PHLs?

• The document should acknowledge crucial role of intermediaries like AIMS; data security provided by intermediaries is crucial.

• The document should be more specific in how public health jurisdictions may overcome their particular legal challenges

• Public health jurisdiction participation in TEFCA won't be sustainable without funding.