TEFCA and Health Tech Ecosystem Work Together to Accelerate Healthcare Data Exchange

Speaking at a panel during the HIMSS26, officials from the Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT (ASTP/ONC) outlined how the two frameworks pursue interoperability through different approaches.

Federal health officials and industry leaders said two major U.S. interoperability initiatives, the CMS-led Health Technology Ecosystem and the Trusted Exchange Framework and Common Agreement (TEFCA), are designed to complement each other in accelerating healthcare data exchange.

Speaking at a panel during the HIMSS26, officials from the Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT (ASTP/ONC) outlined how the two frameworks pursue interoperability through different approaches.

Thomas Keane, assistant secretary for technology policy and national coordinator for health IT, said TEFCA provides a broad regulatory framework for nationwide health information exchange, while the CMS-aligned Health Technology Ecosystem focuses on rapid innovation and testing new interoperability capabilities.

Keane compared the two approaches using an analogy shared earlier by Steve Posnack, ASTP/ONC’s principal deputy national coordinator. “Where TEFCA looks to be a rising tide that lifts all boats, networks that have pledged to be a CMS-aligned network are more like speedboats shooting out ahead to achieve specific milestones,” he said.

The CMS-led initiative, introduced in July 2025, promotes application programming interface (API)–based data exchange and the use of Fast Healthcare Interoperability Resources (FHIR) standards to simplify the sharing of medical records. The effort includes participation from health IT vendors, technology companies, healthcare providers and payers.

Amy Gleason, acting administrator of the U.S. DOGE Service and strategic advisor for CMS, said engagement with the ecosystem is growing rapidly. The initiative initially launched with about 60 companies and now has more than 700 participants contributing to collaborative workgroups.

According to Gleason, the ecosystem focuses on enabling patients to access their health information more easily without relying on multiple provider portals. Patients could retrieve their records through digital applications using identity-based authentication and monitor who accesses their health data.

The initiative also aims to improve data exchange between providers and payers by enabling easier access to claims and clinical data and developing a provider directory to support trusted connections across the network.

Officials emphasized that TEFCA continues to serve as the broader infrastructure for interoperability, with regulatory processes that can take years to finalize. By contrast, the CMS ecosystem operates as a testing environment where new solutions can be developed and validated more quickly.

Keane said innovations emerging from the ecosystem could later inform regulatory policies developed through the TEFCA framework.

During the session, CMS also highlighted new identity verification options for Medicare.gov users and noted ongoing enforcement of federal information-blocking rules, including notices of potential nonconformity issued to certain health IT vendors under the certification program.

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