Data Strategy Briefing — October 28, 2025
TEFCA’s FHIR roadmap targets national production exchange by 31 December 2025, so QHINs and participants must complete fourth-quarter certification, security attestations, and runbook testing ahead of the cutover window.
Executive briefing: The Office of the National Coordinator for Health IT (ONC) and the TEFCA Recognized Coordinating Entity (The Sequoia Project) committed in the September 2023 TEFCA FHIR Roadmap to enable nationwide FHIR-based exchange by 31 December 2025. The RCE’s 2024 updates confirmed production testing, certification, and security attestation milestones running through Q4 2025 so QHINs can activate FHIR APIs alongside the existing QHIN Message Delivery pattern. Health systems, payers, and public health agencies now need to finalise endpoint inventories, mutual TLS configurations, and conformance packages to avoid last-minute blocking issues in the year-end cutover.
Key data governance checkpoints
- Endpoint registration. Confirm organisational FHIR endpoints are registered with designated QHINs and mapped to the exchange purposes described in the roadmap’s Phase 2 deliverables.
- Security and trust. Align mutual TLS, OAuth 2.0, and token endpoint controls with the TEFCA Security Requirements for FHIR-Based Exchange addendum so production traffic can be authorised without exceptions.
- Conformance evidence. Capture logs, test results, and certification artefacts from the FHIR Exchange Testing Platform to satisfy RCE onboarding audits.
Operational priorities
- Use case enablement. Prioritise FHIR workflows for treatment, individual access services, payer-to-payer exchange, and public health reporting to meet the roadmap’s initial use case bundle.
- Performance monitoring. Stand up dashboards that track round-trip latency, error codes, and throughput for FHIR-based exchanges compared with existing IHE transactions.
- Issue escalation. Define operational runbooks that document how TEFCA participants escalate interface failures, security incidents, and conformance deviations to their QHIN and the RCE.
Enablement moves
- Schedule joint testing sessions with QHIN onboarding teams to validate FHIR API behaviour, patient matching, and consent handling using production-like data.
- Update vendor contracts and business associate agreements to reflect TEFCA FHIR obligations, including support expectations for consent APIs and audit trails.
- Train clinical, interoperability, and security staff on the roadmap’s phased adoption model so they understand sequencing of additional FHIR resources planned for 2026.
Sources
Zeph Tech guides TEFCA participants through FHIR onboarding, coordinating testing, conformance evidence, and cross-network runbooks ahead of the 2025 activation milestone.