21st Century Cures: Key Interoperability Provisions

Among the health IT provisions outlined in 21^st Century Cures, many sections provide directives to ONC related to improving interoperability. Learn about these initiatives and HIMSS's feedback to help drive these efforts.

Trusted Exchange Framework and Common Agreement (TEFCA)

The draft Trusted Exchange Framework and Common Agreement (TEFCA) includes the policies, procedures and technical standards that build from existing health information network (HIN) capabilities and enables them to work together to provide that single “on-ramp” to electronic health information regardless of the developer, health information exchange, or where a patient’s records are located. A version two of this draft was released in April 2019. 

• HIMSS Comments on Trusted Exchange Framework and Common Agreement Draft | February 2018

U.S. Core Data for Interoperability (USCDI)

The draft USCDI specifies a common set of data classes to provide a minimum baseline of data classes that must be commonly available for interoperable exchange. It also seeks to establish a process for identifying and specifying new data classes that should be added to the common set of data classes. The initial draft of USCDI builds off the Common Clinical Data Set (CCDS). In February 2019, ONC released a Notice of Proposed Rulemaking (NPRM) to Improve Interoperability of Health Information, which included USCDI Version 1 (USCDI v1) as a proposed standard for inclusion in the EHR Certification Criteria. 

Information Blocking Definition

The Cures Act directs ONC to define information blocking and provide guidance on common barriers to trusted exchange. The Cures Act also authorizes fines from the Office of Inspector General (OIG) for each case of information blocking. In February 2019, ONC released a Notice of Proposed Rulemaking (NPRM) to Improve Interoperability of Health Information, which included guidance for information blocking activities, including exceptions for cases where such blocking is admissable. 

• HIMSS Comments on  21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program (RIN: 0955-AA01) | June 2019

EHR Reporting Program

The Cures Act tasks ONC with the creation of an EHR Reporting Program as a condition of their certification and maintenance of certification. In fall 2018, ONC began a transparent process to solicit feedback from the industry on what criteria and methods of collection should be explored for this program. The Program's reporting criteria aims to address the following five categories: Security; interoperability; usability and user-centered design; conformance to certification testing; and other categories, as appropriate to measure the performance of certified EHR technology.

• HIMSS Comments on ONC's EHR Reporting Program | October 2018