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TEFCA QHINs

Health Gorilla operates as a designated Qualified Health Information Network (QHIN) under the federal Trusted Exchange Framework and Common Agreement (TEFCA). By connecting through Health Gorilla, your organization participates in nationwide exchange with all other QHINs without negotiating separate agreements or managing individual trust frameworks.

Data Coverage

Exchange under TEFCA supports the full range of information defined by the U.S. Core Data for Interoperability (USCDI) and federal interoperability policies, including encounter summaries, discharge summaries, laboratory and diagnostic results, medications, immunizations, allergies, conditions, and clinical notes.

TEFCA also supports public-health and individual-access transactions where applicable. All responses are normalized by Health Gorilla into FHIR resources with provenance metadata for consistent retrieval and audit tracking.

Delegation of Authority

By designating Health Gorilla as your QHIN connection, your organization delegates all TEFCA-level onboarding, security, and compliance responsibilities. Health Gorilla manages connectivity to other QHINs, publishes required directory information, and ensures all legal and technical obligations defined by the Recognized Coordinating Entity (RCE) are met.

Participation

When your organization connects through Health Gorilla, your participation in TEFCA exchange is automatically enabled under Health Gorilla’s QHIN framework. You don’t need a separate agreement with the Recognized Coordinating Entity (RCE).

Health Gorilla enforces TEFCA participation rules, permitted purposes of use, and compliance requirements during request processing to ensure secure and appropriate data exchange.

Reciprocity

TEFCA requires reciprocal contribution of clinical data. To access records from other QHINs, your organization must share encounter data, laboratory results, immunizations, and other supported resources through Health Gorilla. Health Gorilla enforces these reciprocity and policy requirements automatically to ensure consistent data sharing and compliance with TEFCA standards.

Technical Notes

Health Gorilla supports multiple interoperability standards within TEFCA, including:

  • Protocols: FHIR, HL7 C-CDA, and IHE profiles specified in TEFCA technical standards
  • Identity matching: Health Gorilla’s Master Patient Index (MPI) combined with TEFCA Record Locator Services (RLS) and the Common Agreement Directory Service (CADS)
  • Delivery options: Synchronous API responses or asynchronous push via FHIR Subscriptions