Timeline to Operationalize TEFCA

The Trusted Exchange Framework and Common Agreement (TEFCA) is now available. The publication of TEFCA marks the beginning a new era of electronic health information exchange in the US. Below is the anticipated timeline to live exchange of health information among and between Qualified Health Information Networks (QHINs) and their participants and subparticipants. 

2021 – Completed

  • Public engagement
  • Common Agreement Work Group sessions
  • RCE and ONC use feedback to finalize TEFCA

Q1 of 2022

  • Publish Common Agreement Version 1
  • Publish QHIN Technical Framework (QTF) Version 1 and FHIR Roadmap
  • Initiate work to enable FHIR-based exchange
  • Public education and engagement

Q2 of 2022

  • QHINs begin signing Common Agreement and applying for designation

Q3 and Q4 of 2022

  • Onboarding of initial QHINs
  • Additional QHIN applications processed
  • RCE establishes Transitional Council
  • RCE begins designating QHINs to share data
  • Prepare for TEFCA FHIR exchange pilots


  • Establish Governing Council
  • Follow change management process to iterate Common Agreement, SOPs, and QTF, including support FHIR-based exchange

Stay Connected

Complete the form below and join our mailing list.