TEFCA - Trusted Exchange Framework and Common Agreement
The Trusted Exchange Framework and Common Agreement (TEFCA), developed by the Office of the National Coordinator for Health IT (ONC) under the 21st Century Cures Act, establishes a universal governance framework for nationwide health information exchange. TEFCA enables interoperable exchange of electronic health information among Qualified Health Information Networks (QHINs). Version 2.0 effective 2024 with operational exchanges beginning.
TEFCA - Trusted Exchange Framework and Common Agreement is a compliance framework from United States (ONC) with 11 domains and 29 controls that map to 210 other frameworks. The largest domains are TEFCA: Exchange Purposes (6 controls), Trusted Exchange Framework Principles (5 controls), TEFCA: Operations and Compliance (4 controls). Every control below carries what it requires and what an assessor expects to see.
Framework summaries on this platform are AI-assisted interpretations for educational and compliance planning purposes. They do not reproduce or replace the official standards. Refer to the authoritative source for the definitive text. Framework names and trademarks belong to their respective organisations.
Framework Domains (11)
Conformance
| Code | Title |
|---|---|
| TEFCAREC-1 | Common Agreement Conformance and Onboarding |
Exchange
| Code | Title |
|---|---|
| TEFCAREC-3 | Exchange Use Cases and Information Blocking |
Identity
| Code | Title |
|---|---|
| TEFCAREC-4 | Identity Proofing and Authentication |
Privacy and Security
| Code | Title |
|---|---|
| TEFCAREC-2 | Privacy, Security, Minimum Necessary |
TEFCA: Exchange Purposes
| Code | Title |
|---|---|
| TEFCA-EP-GOV | Exchange Purpose Government Benefits Determination |
| TEFCA-EP-HCO | Exchange Purpose Health Care Operations |
| TEFCA-EP-IA | Exchange Purpose Individual Access Services |
| TEFCA-EP-PH | Exchange Purpose Public Health |
| TEFCA-EP-PMT | Exchange Purpose Payment |
| TEFCA-EP-TR | Exchange Purpose Treatment |
TEFCA: Operations and Compliance
| Code | Title |
|---|---|
| TEFCA-COMP-01 | Annual Compliance Attestation and Reporting |
| TEFCA-COMP-02 | Information Blocking Compliance |
| TEFCA-OP-01 | Service Level Agreements and Availability |
| TEFCA-OP-02 | QHIN Directory and Endpoint Management |
TEFCA: Participant Onboarding and Offboarding
| Code | Title |
|---|---|
| TEFCA-PART-01 | Participant and Subparticipant Onboarding |
| TEFCA-PART-02 | Participant Offboarding and Suspension |
TEFCA: QHIN Designation and Governance
| Code | Title |
|---|---|
| TEFCA-GOV-01 | Governance and Cooperation Among QHINs |
| TEFCA-QHIN-01 | Qualified Health Information Network Designation Criteria |
| TEFCA-QHIN-02 | QHIN Application and Designation Process |
TEFCA: Security, Authentication and Privacy
| Code | Title |
|---|---|
| TEFCA-SEC-01 | QHIN Security Requirements |
| TEFCA-SEC-02 | Authentication and Mutual TLS |
| TEFCA-SEC-03 | Privacy and Notice Obligations |
TEFCA: Technical Interoperability
| Code | Title |
|---|---|
| TEFCA-INT-FHIR | FHIR Implementation for TEFCA Exchange |
| TEFCA-INT-IHE | IHE Profile Implementation for TEFCA Exchange |
Trusted Exchange Framework Principles
Trusted Exchange Framework Principles
Your Compliance Coverage
If you comply with TEFCA - Trusted Exchange Framework and Common Agreement, you already cover:
Taiwan PDPA
7%
2 controls mapped
Compare →Federal Decree-Law No. 45 of 2021 on the Protection of Personal Data (UAE PDPL)
7%
2 controls mapped
Compare →Azerbaijan Law on Personal Data (2010)
7%
2 controls mapped
Compare →+ 207 more: ISO/IEC 27400:2022 (7%), Albania Law on Protection of Personal Data (Law No. 9887, 2008, amended 2014) (7%)
See all 210 mapped frameworks ↓Maps to 210 other frameworks
Coverage is not the same as your position
This page shows what TEFCA - Trusted Exchange Framework and Common Agreement overlaps with in general. Where your organisation actually stands, against the standard you are going for and the certifications you already hold, is a different question. Same graph and the same recorded refutations, scoped to you rather than to a pair.
The Compliance Position Diagnostic, $5,000 fixed, ten business daysWhat is TEFCA - Trusted Exchange Framework and Common Agreement and who does it apply to?
TEFCA - Trusted Exchange Framework and Common Agreement is a compliance framework from United States (ONC) with 11 domains and 29 controls. The Trusted Exchange Framework and Common Agreement (TEFCA), developed by the Office of the National Coordinator for Health IT (ONC) under the 21st Century Cures Act, establishes a universal governance framework for nationwide health information exchange. TEFCA enables interoperable exchange of electronic health information among Qualified Health Information Networks (QHINs). Version 2.0 effective 2024 with operational exchanges beginning. It is used by organisations to establish and maintain compliance with industry standards and regulatory requirements.
What does TEFCA - Trusted Exchange Framework and Common Agreement actually require?
TEFCA - Trusted Exchange Framework and Common Agreement has 29 controls organised across 11 domains. The largest domains are TEFCA: Exchange Purposes (6 controls), Trusted Exchange Framework Principles (5 controls), TEFCA: Operations and Compliance (4 controls). Each control defines specific requirements that organisations must implement to achieve compliance.
If I already comply with another framework, how much of TEFCA - Trusted Exchange Framework and Common Agreement do I already cover?
TEFCA - Trusted Exchange Framework and Common Agreement maps to 210 other compliance frameworks. The top mapping partners are Taiwan PDPA (7% coverage), Federal Decree-Law No. 45 of 2021 on the Protection of Personal Data (UAE PDPL) (7% coverage), Azerbaijan Law on Personal Data (2010) (7% coverage). Use our comparison tool to explore control-level mappings between frameworks.
How do I implement TEFCA - Trusted Exchange Framework and Common Agreement?
Start your TEFCA - Trusted Exchange Framework and Common Agreement compliance journey by running a self-assessment on our platform to identify your current compliance posture. Our AI advisory can answer specific questions about TEFCA - Trusted Exchange Framework and Common Agreement requirements, and cross-framework mapping helps you leverage existing controls from other frameworks you may already comply with. Create a free account to access all 29 controls and track your progress.
Start Your Compliance Journey
Create a free account to run self-assessments, get AI advisory, and track your compliance progress across 686 frameworks.
Get Started Free →Free forever — no credit card required