Network Comparison
National exchange frameworks differ in how they manage trust, routing, and patient discovery.
Health Gorilla handles these variations automatically when you integrate through its APIs, but understanding the differences can help you anticipate data-retrieval behavior and response content across networks.
Feature Comparison
| Framework | Key Characteristics | Routing and Trust Model | Patient Discovery | Directory Behavior |
|---|---|---|---|---|
| Carequality | Provider-initiated queries using SAML assertions and document-level retrieval | SAML-based trust with Implementer-delegated authorization | Queried in real time at request | Requires endpoint publishing and maintenance |
| CommonWell | Vendor-based exchange with centralized linking and automated discovery | OAuth-based trust via network brokers | Pre-linked using deterministic and probabilistic matching | Directory centrally managed |
| eHealth Exchange | Legacy network using IHE XCA/XDS protocols for document query and retrieval | SAML-based trust via DURSA and direct peer connection | Queried in real time at request | Requires endpoint registration and certificate exchange |
| TEFCA (QHIN Exchange) | Federated framework governed by common national policies and technical standards | QHIN-to-QHIN routing with RLS-based trust and policy enforcement | Patient discovery through Record Locator Services | Directory managed at QHIN level |
Implementation Notes
- Query Initiation: Carequality and eHealth Exchange use direct query-based exchange; CommonWell uses pre-established patient links; TEFCA supports both real-time and delegated queries.
- Record Availability: Response content depends on each partner’s participation level, directory accuracy, and data-sharing configuration.
- Participation Requirements: Only Carequality and TEFCA require participant directory listings and supporting documentation for routing and trust.
- Health Gorilla’s Role: Health Gorilla serves as an Implementer for Carequality, a Participant in CommonWell and eHealth Exchange, and a designated QHIN under TEFCA.