Microsoft Healthcare, Redmond, WA, United States.
Department of Biomedical Informatics, Harvard Medical School, Boston, MA, United States.
J Med Internet Res. 2022 Nov 4;24(11):e41750. doi: 10.2196/41750.
The federal Trusted Exchange Framework and Common Agreement (TEFCA) aims to reduce fragmentation of patient records by expanding query-based health information exchange with nationwide connectivity for diverse purposes. TEFCA provides a common agreement and security framework allowing clinicians, and possibly insurance company staff, public health officials, and other authorized users, to query for health information about hundreds of millions of patients. TEFCA presents an opportunity to weave information exchange into the fabric of our national health information economy. We define 3 principles to promote patient autonomy and control within TEFCA: (1) patients can query for data about themselves, (2) patients can know when their data are queried and shared, and (3) patients can configure what is shared about them. We believe TEFCA should address these principles by the time it launches. While health information exchange already occurs on a large scale today, the launch of TEFCA introduces a major, new, and cohesive component of 21st-century US health care information infrastructure. We strongly advocate for a substantive role for the patient in TEFCA, one that will be a model for other systems and policies.
联邦可信交换框架和通用协议（TEFCA）旨在通过扩大基于查询的健康信息交换，实现全国范围内的连接，从而减少患者记录的碎片化。TEFCA 提供了一个通用协议和安全框架，允许临床医生、可能的保险公司员工、公共卫生官员和其他授权用户查询数亿患者的健康信息。TEFCA 为将信息交换编织到我们国家的健康信息经济结构中提供了机会。我们定义了 3 个原则来促进 TEFCA 中的患者自主权和控制：（1）患者可以查询自己的数据，（2）患者可以知道何时查询和共享他们的数据，以及（3）患者可以配置共享有关他们的信息。我们认为，TEFCA 在推出时应该解决这些原则。虽然今天已经大规模进行健康信息交换，但 TEFCA 的推出引入了 21 世纪美国医疗保健信息基础设施的一个主要的、新的和有凝聚力的组成部分。我们强烈主张在 TEFCA 中赋予患者实质性的角色，这将成为其他系统和政策的典范。
