TEFCA™ Is Maturing — and That’s a Good Thing
TEFCA was always intended to be a living framework. The latest SOP updates released by the RCE in January 2026 reinforce that vision and represent an important step in TEFCA’s evolution from foundational policy into operational maturity. This round of updates brings needed clarity to how TEFCA is executed—especially around response obligations, IAS participation, and the practical application of exchange purposes.
Several of the changes strengthen transparency and individual choice, particularly for Individual Access Services (IAS). Requiring clearer disclosure of IAS capabilities and giving individuals more control over whether their data is shared reflects a more mature, trust-based approach to nationwide exchange. The updates to the Exchange Purpose and implementation SOPs also acknowledge an operational reality many of us have experienced: not all exchange purposes are the same. By expanding and clarifying Health Care Operations exchange purposes and more precisely defining response expectations, TEFCA is reducing ambiguity while supporting scalable, predictable exchange.
Even within Treatment exchange, the updated SOPs apply a more nuanced and clearly defined approach to response obligations—clarifying who must respond, when, and under what conditions—while continuing to encourage broader participation. Taken together, these updates strengthen TEFCA’s governance foundation.
They don’t change the framework’s direction—they sharpen it. And that clarity is exactly what nationwide interoperability needs as TEFCA continues to scale.
Dianne Koval, RHIA, CCEP, CHPS
Vice President, Operations
