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Ep. 61: Cerner's Dr. David McCallie on TEFCA, USCDI and Interoperability

Published on 2/27/2018

When it was introduced in 2009, the goal of meaningful use was to establish certification requirements for health IT. Then came the 21st Century Cures Act in 2016, which expanded on meaningful use to include enabling access to all electronically accessible health information across providers, patients, public health, registries and payers alike. 

Finally, on January 5, 2018, the Office of the National Coordinator released two draft documents: one that deals with the Trusted Exchange Framework Cooperative Agreement or TEFCA, which the 21st Century Cures Act directed ONC to develop as the guardrails for nationwide health information exchange. The other draft document, called the U.S. Core Data for Interoperability or USCDI, defines the “what” for health information exchange by laying out the data classes that are to be exchanged. 

In this episode of The Cerner Podcast, we’re joined by Dr. David McCallie, Cerner’s senior vice president of medical Informatics. He discusses some of the details surrounding TECFA and USCDI and gives his thoughts on what’s next on the path toward interoperability. 

Dr. McCallie answers the following questions: 

  • First, let’s talk through why each of these draft documents were necessary. What questions did the Cures Act create, and how do these draft documents – TEFCA and USCDI – answer them?  
  • TEFCA’s content is multilayered, including an outline of general principles designed to create trust between Health Information Networks as well as outlining the minimum required terms and conditions for trusted exchange. Can you tease out these different elements for our listeners? 
  • USCDI is being associated with the term interoperability to define what electronic data should be accessible and able to be exchanged under the Cures Act. Based on this, we may consider the USCDI as a floor as to what electronic health data should be accessible and exchangeable and how that should occur. Understanding, of course, that the USCDI is still currently in draft form and could change, what are your expectations? 
  • Let’s bring this back up for a high-level context. What do TECFA and the USCDI mean in the broader conversation around interoperability? 
  • As more health care organizations understand TEFCA and the USCDI’s requirements and implications, their to-do lists will grow. What should hospital and health care leadership be thinking about right now? 

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