Delegates Open Forum by Brendan Keeler

This open forum focused on delegates and their role in health information networks. Led by Brendan Keeler, Practice Lead at HTD, the discussion explored network design principles, the history of health information exchanges, and how TEFCA addresses business associates and ancillary applications in data exchange.

• Network design principles and their impact on health information exchanges
• Evolution of health information networks: from EHR era to on-ramps and TEFCA
• Care Quality's "On Behalf Of" (OBO) and Commonwell's "Adjacent Products" approaches
• TEFCA's delegate model and its implications for network participants
• Reciprocity requirements and their importance in maintaining network value

• Comparison of pass-through, gateway, and clinical document repository models in health information networks
• Debate on the value and risks of "view-only" applications in the network
• Exploration of reciprocity requirements and their impact on network health
• Discussion on the potential misuse of treatment purpose designations for operations use cases

• TEFCA's delegate model aims to tighten control and increase transparency in network participation
• Reciprocity is crucial for maintaining network value and trust
• "View-only" applications may pose risks to network health if not properly managed
• There's a need for careful scrutiny of initiator-only exceptions in the network
• Secondary use of data remains a concern that needs to be addressed

• Share slides and recording of the forum with participants
• Consider exploring TEFCA operations and health plan involvement in future discussions
• Gather feedback on forum content and format for future improvements