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For years, interoperability has been one of healthcare’s most persistent challenges; the idea that a patient’s health information should move as easily as the patient does.
Now, a major milestone suggests the industry is moving closer to that reality.
More than 1,000 hospitals and 22,000 clinics using Epic are now live on the Trusted Exchange Framework and Common Agreement (TEFCA), marking one of the largest real-world expansions of nationwide EHR interoperability to date.
The development reflects growing momentum toward a more connected healthcare system; one where information can be securely accessed across organizations, care settings, and state lines.
Why Has Interoperability Has Been So Difficult in Healthcare?
Despite decades of EHR adoption, health data exchange has often remained fragmented. Many providers still operate in environments where:
- Records don’t easily follow patients outside a health system
- Data sharing requires custom interfaces or regional agreements
- Clinicians lack full visibility into outside encounters
- Administrative teams spend time chasing documentation manually
The result is a system where care is often delivered without the complete patient story — and where coordination gaps create inefficiencies for both clinical and operational teams. Interoperability has long been the missing link between digital records and truly connected care.
TEFCA: A National Framework for Secure Exchange
TEFCA was created under the bipartisan 21st Century Cures Act to tackle one of healthcare’s biggest challenges: fragmented information.
Instead of relying on dozens of one-off connections, TEFCA provides a common framework and governance structure that lets hospitals, clinics, and agencies share data securely and at scale. It’s designed to make health information exchange easier, safer, and more consistent for everyone involved.
Epic customers connect to TEFCA through Epic Nexus, a federally designated Qualified Health Information Network (QHIN) that launched in December 2023.
With over 1,000 hospitals now participating, TEFCA is rapidly moving from policy vision into operational reality.
Interoperability Matters Beyond Patient Care
We often think of interoperability as something that helps doctors and nurses. But it affects the back office just as much. When patient information is scattered or incomplete, billing and revenue teams spend extra time chasing records, fixing coding issues, and answering payer questions.
By connecting systems and sharing data reliably, interoperability gets the right information into the right hands sooner. That means cleaner claims, fewer delays, and a smoother revenue cycle; all while supporting better patient care.
“The Patient’s Full Story at the Point of Care”
Interoperability is not just about data movement; it’s about clinical impact.
Stanford Health Care, one of the earliest Epic Nexus participants, has already highlighted the value of TEFCA-enabled exchange.
“When we have the patient’s full story at the point of care, we can provide better-informed diagnoses, fewer duplicate tests, and better care plans,” said Matthew Eisenberg, MD, Associate Chief Medical Information Officer at Stanford Health Care.
This captures the central promise of interoperability: ensuring that critical health information is available wherever care happens, not trapped inside organizational silos.
Making Interoperability Accessible for Rural and Underserved Providers
One of TEFCA’s biggest benefits is that it helps level the playing field for smaller and rural healthcare organizations. In the past, these providers often faced barriers to participating in large-scale health information networks, including:
- Limited IT resources
- High costs for building connections
- Complex governance rules
- Lack of access to national exchange frameworks
TEFCA simplifies and standardizes how health information is shared, reducing administrative hurdles and making it possible for providers of all sizes to connect to nationwide networks. This change helps all providers work together more smoothly, so patients benefit from seamless care.
Epic’s Longstanding Role in Interoperability
Epic’s expansion into TEFCA builds on years of interoperability development.
Care Everywhere, Epic’s first interoperability network, launched in 2008 In 2014, Epic co-founded Carequality, now supporting millions of clinical exchanges nationwide.
For over a decade, Epic reports that 100% of U.S. health systems using Epic have been interoperable. Epic leaders view TEFCA participation as the next phase of scaling secure exchange.
“The energy around TEFCA adoption is clear, and the Epic community is leading the way,” said Rob Klootwyk, Director of Interoperability at Epic.
What Nationwide Interoperability Enables Next?
While TEFCA exchange initially focuses on treatment-based data sharing, its potential reach is broader. Epic notes that TEFCA and its customers are already facilitating connections that support:
- Public health reporting
- Individual access to health information
- Broader federal participation
The Social Security Administration and the Department of Veterans Affairs are expected to join the network later this year, expanding TEFCA’s nationwide footprint even further.
How Interoperability Supports Revenue Cycle Success?
National standards like TEFCA make it easier for providers of all sizes to exchange data. When your EHRs are connected, your billing processes run more smoothly: fewer missing records, fewer manual checks, and faster, more accurate claims.
Organizations that use these connections to streamline workflows, prevent denials, and automate claims don’t just improve cash flow; they turn connected care into connected financial results.
Interoperability Is the Backbone of Modern Healthcare
With Epic Nexus and TEFCA connectivity expanding rapidly, healthcare is entering a new era. Interoperability isn’t just a technical upgrade anymore; it’s becoming the way care actually happens. When systems can talk to each other seamlessly:
- Patient information moves with the patient, not just the chart
- Care teams have the full picture to make smarter decisions
- Administrative work slows down less and teams can focus on care
- Sharing data across hospitals and clinics becomes the everyday standard
In the years ahead, being able to connect and share data won’t be optional; it will be how healthcare gets done.
