Qualified Health Information Network (QHIN)

Key facts

Framework

Trusted Exchange Framework and Common Agreement (TEFCA)

Designated by

Recognized Coordinating Entity (RCE), under ASTP/ONC oversight

Technical rules

QHIN Technical Framework (QTF)

First designations

December 2023

Connects

Participants, which in turn connect subparticipants

What is a QHIN?

QHINs sit at the top of the Trusted Exchange Framework and Common Agreement (TEFCA) structure. Each one signs the Common Agreement with the Recognized Coordinating Entity (RCE), connects to every other QHIN and passes queries, responses and messages on behalf of its participants.

A QHIN is usually an existing health information network, such as a national exchange network, a health IT developer's network or a health information exchange (HIE), that has met TEFCA's qualification requirements. QHINs are private organizations bound by contract, not government agencies.

How a network becomes a QHIN

Designation follows a process run by the RCE:

• Application: the network shows it meets eligibility requirements covering its organization, operations and security.
• Onboarding and testing: the network proves it can exchange with other QHINs using the QHIN Technical Framework.
• Designation: the RCE designates the network, and it joins the published list of QHINs.
• Ongoing obligations: QHINs follow Common Agreement rules on exchange purposes, privacy, security and dispute resolution, and flow required terms down to participants.

Why QHINs matter

QHIN choices shape how organizations reach nationwide exchange:

• Hospitals and practices: joining a QHIN, directly or through an EHR developer or HIE, determines their path to TEFCA exchange.
• Health IT developers: becoming a QHIN or a participant affects product roadmaps, pricing and partner options.
• Payers and public health agencies: QHINs carry exchange for purposes beyond treatment where the Common Agreement and its operating procedures allow it.
• Analysts: the list of designated QHINs and their participants shows which networks are consolidating national exchange.

QHIN vs HIE

The terms describe different layers. A state or regional HIE can join TEFCA as a participant of a QHIN, and an HIE organization can also seek QHIN designation itself. QHIN status is a TEFCA role, not a type of organization.