The Arkansas Attorney General’s office has become aware of increased phishing attempts targeting health care professionals. OHIT reminds its users that we do not send unsolicited emails requesting your login or personal information. If you receive a suspicious email that appears to be from SHARE or OHIT please notify your facility’s privacy or security staff.

TEFCA: Pioneering a New Frontier in Health Data Interoperability in the United States

Little Rock, Arkansas                       In an era where digital innovation shapes the very fabric of healthcare, the United States embarks on a transformative journey with TEFCA, heralding a new epoch in health data interchange. This might not be the stuff of mainstream media frenzy, but it’s undeniably a monumental leap in healthcare’s evolution. Spearheaded by the Office of the National Coordinator for Health Information Technology (ONC) and The Sequoia Project as the Recognized Coordinating Entity®, TEFCA’s inception last year marks the dawn of a unified health information network. This network-of-networks strategy, incorporating Qualified Health Information Network (QHIN) as pivotal data exchange conduits, promises providers, patients, and payers unfettered, secure access to comprehensive patient health records, transcending geographical barriers.

The Role of QHINs in the TEFCA Ecosystem

Five pioneering organizations have been selected as the initial QHINs, eHealth Exchange, Epic Nexus, Health Gorilla, KONZA and MedAllies, a testament to their unwavering dedication to upholding the zenith of privacy and security in national health data exchange. Naturally, the current roster of QHINs represents just the beginning. It’s logical to anticipate the inclusion of additional QHINs as time progresses. The ONC has indicated that they foresee a continuous stream of applications and anticipate approving more QHIN applicants on an ongoing basis. QHINs are the pillars of TEFCA network-to-network exchange, providing shared services and governance to securely route queries, responses, and messages across networks for eligible participants including patients, providers, hospitals, health systems, payers, and public health agencies. The Office of Health Information Technology, that oversees the State Health Alliance for Records Exchange (SHARE) is poised to join a QHIN, actively monitoring the evolving landscape to ensure its alignment with the highest standards of data exchange and interoperability.

The Essence of Interoperability and TEFCA’s Nationwide Impact

TEFCA, an acronym for the Trusted Exchange Framework and Common Agreement, is the United States’ inaugural, government-sanctioned blueprint for cross-network healthcare record exchange. Its significance cannot be overstated. Imagine needing urgent medical care in an unfamiliar city, or visiting a new healthcare facility, or being referred to a specialist outside your usual network. In these scenarios, and many others, the seamless sharing and accessing of your health information is crucial. This is the essence of interoperability – ensuring that the right information is available to guide your care, whenever and wherever you need it.

TEFCA’s rollout coincides with the 60th anniversary of President John F. Kennedy’s moonshot speech, echoing his sentiment of embracing challenges not for their ease, but for their difficulty and the consequent unification and enhancement of our collective capabilities. The criteria set by the ONC for QHINs are stringent, encompassing cybersecurity, HITRUST accreditation, and financial stability, among others. This challenge is deliberate and fitting, considering QHINs are to be the bedrock of critical national infrastructure. Ensuring stringent data privacy and security is paramount for TEFCA’s vision to flourish.

The Future of Healthcare Interoperability and TEFCA’s Role

As the healthcare sector strides towards universal interoperability, there’s a compelling incentive for industry organizations to champion TEFCA’s implementation. Whether it involves joining a QHIN or becoming one, the guiding principle should be the welfare of the patients we serve, a mission too vital to defer.

In this landscape of evolving healthcare interoperability, the State Health Alliance for Records Exchange (SHARE) – Health Information Exchange (HIE) in Arkansas stands as a paradigm of progress. SHARE HIE has diligently cultivated robust relationships with providers, payers, and hospitals across Arkansas, laying a foundational network for enhanced, boots-on-the-ground interoperability. Through these partnerships, SHARE has provided pivotal services that streamline and secure the exchange of health information, thereby improving patient outcomes and operational efficiencies within the state.

The integration of TEFCA’s framework with the QHIN model promises to further elevate the capabilities and reach of SHARE HIE. By aligning with a QHIN in the future, SHARE can extend its interoperability capabilities beyond state borders, facilitating a more seamless and expansive exchange of health information. This will not only enhance the quality of care for patients within Arkansas but also ensure that Arkansans receive consistent and informed care when they seek medical attention outside the state.

Source: The Sequoia Project, User’s Guide to the Trusted Exchange Framework and Common Agreement – TEFCA

TEFCA’s role, in conjunction with the efforts of SHARE and other HIEs, signifies a transformative step towards a fully interconnected health information landscape in the United States. This integration supports the broader vision of a health system where data fluidity enhances patient care, regardless of location, and where healthcare providers have access to comprehensive information, they need to make well-informed decisions. The ultimate beneficiary of this advanced interoperability is the patient, who will receive more coordinated, timely, and effective care.


SHARE is uniquely positioned to offer a TEFCA connection to our Participants in the future. We already offer access to other nationwide data sharing networks (e.g., eHealthExchange, Patient Centered Data Home (PCDH)), and we plan to offer a connection to future nationwide TEFCA network exchange that meets the legal and compliance requirements of Arkansas. The Office of Health Information Technology wants our customers and stakeholders to remember that TEFCA is not intended to and will not replace the value that Participants derive from participating in the SHARE HIE. A TEFCA connection will be another way of getting and moving data where it needs to go to serve patients, but TEFCA will not replace the host of HIE services that our customers currently enjoy, including Portal Access, 24-hour Hospitalization Reports- Emergency Department & Inpatient Discharges, ADT Notifications Service, Hospital Readmission Reports, Immunization Reporting, Public Health Reporting, DCFS Foster Care Daily Reports, Results Delivery and Health Information Service Provider (HISP) services.

Accessing a patient’s comprehensive medical record is crucial for delivering top-quality care, and this is achievable primarily through interoperability,” remarked Anne Santifer, Director at the Office of Health Information Technology. “As SHARE is the designated statewide HIE in Arkansas, its role in facilitating critical interoperability is paramount. This unified approach towards universal interoperability will enable clinicians to connect effectively across the state and provide superior care to patients, irrespective of the electronic health record systems they use,” Santifer stated.

To explore the full range of data services offered by SHARE, please visit