Reminding all, please submit any questions via the chat function. Thank you.

I have to drop, thank you again for the opportunity to provide an update on FAST! Stephen.Konya@hhs.gov

the timelines for FHIR support generally are such that it seems like places will already be expected to support FHIR before TEFCA really happens - why would TEFCA serve as a bridge to FHIR given that?

To the data quality objective, given the primary purpose is optimal CDS for pt care, how do we ensure clinical informatics guidance is more normalized across the HC ecosystem which can then enable more standardized admin and research processes.

why a focus on documents? documents are typically full of unstructured data that isn't standardized or very easy to use in parts

are you suggesting that patients not use mobile apps or that patients go through TEFCA or that all third party apps need to go through TEFCA?

why should payers have the right to control how patients use clinical data that originates from their providers anyway?

This is where using an independent third party to review for privacy/security and specific requirements can allow Tech App Developers to prove to others that they can be trusted.

It seems like TEFCA and FAST have the same fundamental objective, ie establish a nationwide info exchange infrastructure to support myriad data exchange and analytics use cases. Can you share opinion on how to best keep the impl glide paths aligned and not conflicting.

Thank you for bringing up tactical examples. What about enforcement? We are currently seeing payers, provider and covered actors who think they don’t need to be compliant, w

When will see enforcement from ONC?

Totally agree. TECFA is delivering infrastructure. It needs to be about handling many data exchange types. The detailed support for workflows is handled by its QHIN members. Today documents is the most common for provider workflows. Future workflows with all stakeholders very likely would use FHIR

last week the Sequoia representative said that you needed to be an existing, well-established, financially stable company to be considered for QHIN approval - can you (Tim) square that with the vision you just expressed with seeing unexpected QHINs and (implied) interesting, unexpected uses

sorry, established HIE/experienced well-established exchange not just company

doesn't the entire non-provider/payer/21st cen cures/etc depend on having the participation of the provider community too (and they're required to participate by the end of next year per ONC rules if I remember correctly) - bifurcation by type of organization seems like it would be moving away from the idea of interoperability, a patient-centric system, and the other pieces of that batch of stuff

TEFCA and FAST are not mutually exclusive. An organization adopting FAST standards can participate in TEFCA. Don't understand why the question was framed as one vs. the other

TECFA and FAST are definitely not mutually exclusive and we must ensure that they never are.