As we approach 2023 it is amazing that interoperability, true broad-based connectivity between healthcare systems, looks like the Verizon heatmap back in 2005 when there was as much white on the map as there was red. Much like AT&T, Verizon, and T-Mobile worked diligently to provide coverage to everyone in the U.S., TEFCA (Trusted Exchange Framework and Common Agreement) is driving the QHIN “network” to accomplish the same outcome. Depending on where you sit in healthcare today it may feel like 1986 or 2023. The breadth of connectivity, the exchange of data, and the benefit of both feels significantly different depending on where you sit inside the healthcare ecosystem. We are confident that this disparity in coverage will change quickly as QHIN’s, their participants and sub-participants see the benefits of nationwide coverage. Today nobody can seem to survive without their cell phone, tomorrow no one in healthcare will tolerate a disconnected system any longer.
Therasa Bell, Cofounder, President and CTO at Kno2, has spent her career in healthcare IT, so it’s very meaningful to hear her speak of Kno2’s intention to become a designated QHIN (Qualified Health Information Network) under the TEFCA, asserting, “This is a turning point”.
I recently sat down with Bell in Kno2’s Boise office to chat all things TEFCA. When TEFCA released their application for QHIN designation in August 2022, Kno2 was already fully prepared to engage with ONC’s latest attempt to address healthcare collaboration and communication. This certainly isn’t the first acronym-laden attempt to “fix” healthcare, which led to the logical question, why would Kno2 get involved with TEFCA at this point?
The Road to TEFCA is Paved with Good Intentions…And Solid Follow-Through
The strategy isn’t to jump on the latest and greatest thing, chasing relevance at the cost of intention. No, where Bell focused her response was on the work that Kno2 has been doing for years as part of their core passion that formed the very basis of the company: bringing calm to the chaos, and to truly solve the complexity with healthcare connectivity and communication. Their early involvement as one of the initial implementers of Carequality serves as a precursor to TEFCA. “We’ve been there from the beginning,” said Bell. She goes on to explain that Kno2 has provided leadership, volunteering resources, including early, lasting and active participation in the Common Agreement Workgroup, which helped to shape the vision and proposed execution for TEFCA. “So, this is not only an organic continuation of the process, but an extension of the company’s core business model as the largest aggregator of networks in healthcare.
I’ll be honest, it was refreshing to hear a President & Co-Founder of a healthcare IT company celebrating the dropping of the word “interoperability” from their tag line. Where that term has created buzz (and groans) for decades now, the focus has shifted toward real, meaningful exchanges of data…regardless of what you call it. And that’s where Bell places TECFA; it’s meaningful.
She says of Kno2, “We enable interoperability and the magic happening on the edge.” But the not-so-secret sauce is in the recognition that the care continuum doesn’t just take place in the traditionally served markets of hospitals and large health systems, nor exclusively under the supervision of MDs. It’s more. And as COVID taught us, so much more…
The Time Is Right to Bring Everyone into the Folds via QHINs
What’s beautiful about the timing of TEFCA is that there is no shortage of lessons learned in healthcare IT. We’ve seen initiatives play out – for better or worse – and had a chance to evaluate what standards and solutions survive the test of time. “Experience,” Bell explains, is the first thing that makes TEFCA different from all prior attempts at enabling healthcare exchange. For the first time, we’re collectively not trying to reinvent the wheel.
Leveraging the best practices and experience of Direct Secure Messaging, Carequality, CommonWell Health Alliance® and most recently FHIR®, we’re learning from the last decade-plus of efforts, and starting with a wiser perspective of what’s possible and where to pick up the proverbial baton. Kno2 brings to this a demonstrated history of commitment to represent historically overlooked segments in healthcare, including post-acute, care in the home, therapies, EMS, vision, dental, behavioral health, specialty providers and more. This paves their path to becoming a QHIN on a solid foundation of experience and intention. This means opening up the doors for participation in communication and collaboration with those outside of the major health systems – as well as welcoming EHR participation, patient access and 3rd party connectivity for payment and operations workflows. Which continues to be pivotal for exchanging and capturing rich data from the vast infrastructure created by these vendors.
This is how TEFCA embraces the “and” potential of bringing together the acute and post-acute worlds – and all those providers in between, near and dear to Therasa Bell’s heart – to exploit the traction and tailwinds of change that are rife for resulting in real, meaningful outcomes.
Focusing On “The Edge” As A Market Differentiator and Industry Game-Changer
What was unique about Kno2’s early intentions of building nimble, accessible, and cost-effective solutions to swiftly impact care delivery and health outcomes was in the focus on what Bell calls, “The Edge.” This cohort spans EHR vendors, digital health platforms, patient engagement applications…including any consumer of the Kno2 Communication API. Bell adds, “We’ve even got organizations like Xerox or Konica Minolta that have implemented our API in their devices as they look to participate and make their devices relevant (in healthcare).”
Bell explains that for Kno2, QHIN designation goes well beyond doing the fundamental work required by TEFCA. This effort will be about maximizing the value of the workflows each participant receives from QHIN-to-QHIN exchange. True to form and without missing a beat, Bell returned the conversation to the big picture goal versus the initiative du jour when she said, “It’s not about the QHIN application itself, or the technology itself…it’s really about usage”.
Without careful consideration of improving workflows to bring efficiency to care providers and comfort to patients you risk falling short of adoption.
Kno2’s confidence in TEFCA is solid and remains steadfast in its’ focus to meet the standards outlined for designated QHINs, while continuing their work on researching and developing “wrapper services” to deliver meaningful effective workflows for all the users on “The Edge.” It’s all about the long game, which is why Bell says that Kno2 is not trying to be the first QHIN; “We want to be the best QHIN.” And that goes a long way when it means usable, effortless and impactful solutions to serve everyone in healthcare.
Check out the other videos in this series with Theresa Bell:
- Why get involved with TEFCA?
- What sets Kno2 apart?
- Who is Kno2 hoping to serve?
- How is TEFCA different?
About Kno2
From its inception, Kno2 has connected every meaningful network and endpoint involved in the exchange of patient information, and in turn has become the most expansive and comprehensive communication network available in healthcare today, unifying and centralizing complete clinical exchange workflows in a single solution. Our QHIN connection will be developed within our existing Communication API, simplifying the effort required by new and existing technology vendors and providers to participate in TEFCA. Participants using Kno2 as their QHIN will benefit from all historical connections made to the network, enabling secure, effortless and maximized exchange of patient information. With nearly a decade of innovation and expansion around push and pull-based networks such as Direct Secure Messaging, becoming an initial implementer of Carequality and connecting to many the nations HIEs, Kno2 is well positioned to becoming a QHIN. To learn more about Kno2’s pursuit for QHIN designation, visit https://kno2.com/qhin/.
Kno2 is a proud sponsor of Healthcare Scene.
