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Health Gorilla’s Path to Becoming a Qualified Health Information Network

Our team at Health Gorilla, a leading aggregator of health data in the United States, recently announced our intention to become one of the first designated Qualified Health Information Networks (QHIN) under the Trusted Exchange Framework and Common Agreement (TEFCA). Our flexible interoperability platform was built to execute the goals of the 21st Century Cures Act Trusted Exchange Framework and Common Agreement (TEFCA) and provides connections between healthcare providers, health plans, public health agencies, and individuals. Once designated by The Sequoia Project, the Recognized Coordinating Entity (RCE) for TEFCA, Health Gorilla will operate as a QHIN in a “network of networks” structure, connecting with other QHINs to facilitate national exchanges of data between QHINs, Participants, and Sub-participants.

The 21st Century Cures Act, signed by President Obama in 2016, calls on ONC to “develop or support a trusted exchange framework, including a common agreement among health information networks nationally.” The Office of the National Coordinator for Health Information Technology’s (ONC) three primary goals are to provide a single on-ramp for nationwide connectivity, attach all electronic health information (EHI) to the correct patient, and support nationwide scalability; all of which establish a floor for universal interoperability across the country. In July 2021, ONC and the RCE released a timeline for completing the Trusted Exchange Framework, intending to have QHINs operational in the first quarter (Q1) of the calendar year 2022. The timeline supports the release of the final Trusted Exchange Framework in the first quarter of 2022, along with the Common Agreement V1 Final and the Qualified Health Network Technical Framework V1 Final. Once finalized, health information networks will be able to apply to become QHINs and will begin sharing data on a rolling basis after being selected and onboarded.

The Common Agreement, released in September 2021, includes six exchange purposes that organizations must support to be designated as a QHIN, all of which we are uniquely positioned to satisfy. The exchange purposes include Treatment, Payment, Health Care Operations, Public Health, Benefits Determination, and Individual Access Services.  

Health Gorilla’s proprietary platform and robust data engine make us uniquely positioned to satisfy all six permitted exchange purposes outlined in the Common Agreement. Our platform and FHIR-based APIs facilitate national health information exchanges for permitted purposes and integrates with most major EMR systems and diagnostic vendors that connect payers, labs, providers, patients, and public health officials with aggregated health data. Our platform addresses the need for individual access by supporting identity proofing and connecting individuals with access to their information. Our recent entrance into the life insurance market addresses the process of Benefits Determination by securely providing life insurance underwriters, re-insurers, and risk assessors with HIPAA-compliant, permission-based access to structured and complete medical records. 

Our team is committed to supporting legal, functional, and technical requirements for those health information networks designated as QHINs, and bring a robust process engine that supports:  

  • High capacity networks to broker the exchange of transactions
  • A flexible platform that supports a broad range of standards, including FHIR, HL7, C-CDA, and IHE Profiles
  • Comprehensive master patient index (MPI) and record locator services (RLS)
  • IAL2 verification and identity proofing for providers and patients, using Kantara certified products
  • A comprehensive security program, ensuring the security of the Health Gorilla Platform and participants. SOC-2 Type 2 certified, HIPAA-certified, and pursuing HITRUST certification
  • A comprehensive governance program to ensure the highest level of compliance with industry regulations and certify exchange purposes of Participants and Subparticipants

We continue to be active stakeholders and thought leaders, supplying public input on the TEFCA model as the documentation and requirements continue to evolve and are advocating for FHIR as a data format for national exchanges of data. We will continue to participate in several implementation workgroups and pilot efforts, working towards expanding FHIR. We strongly believe that the FHIR adopted principles of reuse, performance, usability, fidelity, and implementability to address the needs of the industry and align with the three overarching goals of the ONC to develop a Trusted Exchange Framework (TEF) and a Common Agreement. 

We were an early adopter of FHIR and have built a FHIR-native data platform with substantial analytical capabilities compliant with FHIR R4 profiles to ensure scalable medical record retrieval. We provide a suite of industry-leading APIs and software products that power fundamental healthcare workflows and data exchange scenarios, where participants can leverage Health Gorilla’s published APIs for easy “on-ramp” to the national exchange of data.

In May of 2020, Health Gorilla was recognized in the Duke University Interoperability Report as the only clinical exchange portal that met functional and security requirements for public health departments. The report stated that Health Gorilla, who is a Member of  CommonWell and an Implementer on Carequality, “provides query access to all acute care sites on both networks, and maintains its own set of services (MPI and RLS) and capabilities (event notifications) that could increase utility for public health.” 

Since that report came out, we have continued our expansion and recently became a member of eHealth Exchange, making us one of the only data sources for all three national networks in the country and are well-positioned to be granted the QHIN designation. 

Today, Health Gorilla acts as the single-source provider of Health Information Exchanges for the Puerto Rico Department of Health. We operate as the interoperability solution connecting payers, labs, providers, patients, and public health officials. This HIE has brought forward a new era of interoperability to Puerto Rico by streamlining care, reducing costs, empowering patients and providers, and giving public health officials the data they need to act decisively. Our platform now connects over one million residents of Puerto Rico. It enables healthcare providers to access and share patient medical record data securely and electronically across more than 430 care sites and more than 4,350 providers.

For additional information on Health Gorilla’s pursuit of our QHIN designation, please refer to the full press release.

Health Gorilla will also be attending HLTH 2021 at the Boston Convention & Exhibition Center, located in the Seaport District. You can stop by and speak with the Health Gorilla team at booth 715 if you’re interested in learning more about our platform or our interest in becoming one of the first designated QHINs. Our team has also published a glossary of terms and frequently asked questions if you are unfamiliar with TEFCA, the 21st Century Cures Act, or QHINs and are interested in exploring the topics in more depth.