The U.S. Department of Veterans Affairs (VA) and Department of War (DOW) have joined the Trusted Exchange Framework and Common Agreement (TEFCA), expanding nationwide electronic health information exchange across federal and civilian healthcare providers. 

The Department of Health and Human Services (HHS) announced the expansion in Washington on November 5.

The move is intended to help veterans, active-duty service members and their families access coordinated care when they receive treatment across different healthcare systems.

TEFCA is a nationwide framework that establishes common technical and governance requirements for exchanging electronic health information. Rather than creating a single centralized database, it connects existing health information networks, allowing authorized organizations to exchange records across participating systems.

The expansion builds on a network that already includes nearly 25,000 participating organizations and approximately 110,000 unique connections to healthcare providers, hospitals, clinics and public health authorities. 

More than 2 billion health records have been exchanged through TEFCA since December 2023, according to HHS.

“Wherever our beneficiaries seek care, whether at a military treatment facility, a VA medical center, or a participating local hospital, their critical health information will travel securely with them across connected care settings,” said Leslie Sofocleous, director of the Federal Electronic Health Record Modernization office, in the announcement.

Interoperability Brings New Governance Responsibilities

The expansion highlights the importance of common data standards, identity management and secure information exchange across large, interconnected healthcare systems. 

Participating organizations must be able to identify authorized users, establish legitimate purposes for accessing records and maintain appropriate privacy and security protections.

For chief data officers (CDOs), the development offers a practical example of how data governance enables interoperability at scale. As more federal agencies connect to shared exchange frameworks, maintaining consistent data definitions, access controls, data quality and accountability across organizational boundaries becomes increasingly important.

The move also comes as HHS steps up scrutiny of organizations that restrict legitimate access to health information. Last month, the department had issued seven letters of potential nonconformity over suspected health information blocking.