ONC seeks a new feedback loop for TEFCA’s growing exchange network

The federal health-information-exchange framework known as TEFCA may be getting a more formal listening post. In a public-inspection notice filed August 14 and scheduled for Federal Register publication August 17, the Office of the National Coordinator for Health IT is asking OMB to approve a new three-year collection for monitoring feedback from the networks that participate in TEFCA.

This is not a new data-sharing mandate, an enforcement action, or one of those rules that quietly rearranges everyone’s Tuesday. It is a 30-day Paperwork Reduction Act request. But it shows ONC building a more regular way to hear how the framework is functioning as participation grows—a mundane administrative move with some useful connective tissue.

### What It Is

TEFCA, the Trusted Exchange Framework and Common Agreement, is the national framework intended to let qualified health information networks exchange electronic health information under shared technical and legal terms. ONC oversees a Recognized Coordinating Entity, which administers key parts of the Common Agreement and its baseline requirements for participating networks.

The proposed generic clearance would allow ONC to collect routine, qualitative feedback about service delivery and program performance connected to TEFCA. The agency says the collections would support standardized monitoring and performance reports for participants, including the Qualified Health Information Networks, or QHINs, that can exchange data through the framework.

### What’s Changing

If OMB approves the request, ONC would have a three-year vehicle for feedback activities concerning such issues as timeliness, accuracy, issue resolution, training, and participants’ experience with the program. The notice estimates 15 respondents, roughly seven feedback activities a year, and 1,420 burden hours annually—4,260 over three years. It describes the feedback as qualitative, meaning it is meant to illuminate perceptions and operational friction rather than produce a statistically generalizable survey.

ONC ran a 60-day comment period earlier this year, received no comments, and says it made no changes to the proposed collection. The current notice begins the OMB-review stage; its published copy still identifies the comment period as 30 days rather than providing a fixed calendar date.

### Why It Matters

For health systems and clinicians, the immediate obligation remains indirect: the anticipated respondents are QHINs, not individual practices. Still, TEFCA’s usefulness is ultimately judged downstream, where exchange either helps a patient’s record follow them or produces another exquisitely engineered detour. A structured feedback channel could give ONC better visibility into whether the framework’s participating networks are encountering recurring service or coordination problems.

The narrower point is worth keeping straight. This notice proposes a monitoring-and-feedback collection, not a new clinical reporting requirement or a change to what may be exchanged. Yet as TEFCA moves from architecture to routine use, the machinery for measuring its experience is becoming part of the architecture too.

Read the ONC public-inspection notice on Federal Register (https://www.federalregister.gov/public-inspection/2026-16766/agency-information-collection-activities-proposals-submissions-and-approvals-generic-clearance-for)