QHINs Are Coming

QHINs, or Qualified Health Information Networks, will become a foundational part of the healthcare data ecosystem. These intercompatible networks, pronounced “q-hins”, are designed to serve as the national floor for patient record interoperability. The recent application approvals for the first QHINs is another marker of progress towards standardized and widespread patient data exchange.

Particle will be able to connect to QHINs once they go live over the next year. Like the Health Information Networks that Particle currently connects to, QHINs will collect records from different sources. However, QHINs also have a roadmap to enable additional services for a wider variety of network participants on an ongoing basis.

To understand QHINs, it’s necessary to know about the Trusted Exchange Framework and Common Agreement (TEFCA) as well. TEFCA is a government-sponsored initiative that established the technical and policy standards for QHINs to act as clinical data clearinghouses. TEFCA stems from 2016’s Cures Act, and it will effectively become operational in early 2024 once QHINs are live and connected with each other.

What really makes QHINs different from regular Health Information Networks - that is, what makes them “qualified” - is their designation from the administrative body of TEFCA, their upcoming ability to easily connect with one another, and their commitment to taking on new responsibilities.

The First Six QHINs

After a long application process, the first six QHINs were announced in February 2023:

• CommonWell Health Alliance
• eHealth Exchange
• Epic (as “Epic TEFCA Interoperability Services”)
• Health Gorilla
• Kno2
• KONZA

Leaders from the Department of Health and Human Services attended the announcement, and the ONC expects that all the QHINs will go live by February 2024.

While these are the first networks to be provisionally accepted as QHINs, it’s expected that more networks will establish QHINs as the technical processes are shown to work in practice and the benefits of connectivity grow. The Sequoia Project (a technology organization that serves as TEFCA’s Recognized Coordinating Entity, or administrator) will process new QHIN applications on an ongoing basis.

What QHINs Do More Of

More Cross-Compatible Than HINs: Not every HIE and HIN will become a QHIN, and most networks will connect to a QHIN instead of aiming to become one.

Until now, most Health Information Networks and Health Information Exchanges could potentially connect to each other, and had similar technical standards, but set their own rules. 

QHINs will have standardized rules that facilitate full data exchange with other QHINs. We expect that other organizations will begin to adhere to QHIN-compatible frameworks to participate in this rich trove of healthcare data.

More Purposes of Use: The Treatment Purpose of Use, where clinicians request records for patients that they are treating, is the only widely supported use of Health Information Networks today - despite legislation mandating other uses. 

QHINs will have additional pressure to expand Purposes of Use so as to comply with the TEFCA framework. QHINs were designed with the intention to allow helpful non-HIPAA entities, like clinician-oriented data tools, to sign healthcare data privacy agreements and receive data. 

More Technical Support: QHINs have all the features that you would expect from a typical HIN and more. Unlike HINs, QHINs will act as a more robust “Connectivity Broker”. They’ll provide technical capabilities like record location, targeted message delivery, a Master Patient Index, and public metrics for their participants. QHINs will have some leeway as to how to achieve these technical goals internally, so as to best serve the needs of their members. 

The TEFCA framework does include a pathway for the entire network to align on additional functions, but those will take more time to develop. QHINs will agree to add new functionality together, making it possible to bring widespread new features to healthcare providers over time.

QHINs and Particle

The driving idea behind QHINs - making interoperability easier for more participants - has already been proven successful to some extent across existing networks like CommonWell. The momentum from organizations like Epic committing to become QHIN only further bolsters the future value of the TEFCA framework.

We believe that, while infrastructure is a required ingredient, there is another major problem in the “grand recipe” - making sense of the newly liquid data and using it to create value in the healthcare ecosystem. This space is equally as complex and needed as the infrastructure itself. Particle will certainly take advantage of the new QHIN infrastructure capabilities. We can’t wait to use them to create products that go above and beyond pure transactional data exchange.