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. 


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

Q1 and Q2 of 2022

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

Q3 and Q4 of 2022

  • Finalize additional SOPs
  • QHIN application review
  • Prepare for TEFCA FHIR-based exchange pilot

Q1 and Q2 of 2023

  • Public announcement: First Approved QHIN Applicants
  • Onboarding of initial QHINs
  • Additional QHIN applications processed
  • Launch TEFCA FHIR-based exchange pilot

Q3 and Q4 of 2023

  • Additional QHIN applications processed
  • Continue onboarding of initial QHINs
  • Establish Governing Council
  • Refine Common Agreement, SOPs, and QTF, including to support FHIR-based exchange
  • First QHINs go-live with IHE document exchange


  • Additional QHIN applications processed
  • Continue onboarding of candidate QHINs
  • Refine Common Agreement, SOPs, and QTF
  • First QHINs go-live with FHIR-based exchange

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