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21st Century Cures Act Trusted Exchange Framework and Common Agreement Public Comments

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Over the coming months, the Office of the National Coordinator for Health Information Technology (ONC) will host a series of meetings and webinars to inform our work related to our implementation of the 21st Century Cures Act (Cures Act) trusted exchange framework and common agreement provisions outlined in Section 4003 of the law. ONC looks forward to working with stakeholders on implementation of this Cures Act provision—an integral component of the nationwide network-to-network exchange of health data and a critical part of ONC’s charge to support nationwide interoperability.

As part of our engagement with stakeholders, we are beginning a 30-day public comment period to receive comments on the trusted exchange framework and common agreement provisions in Section 4003 of the Cures Act—including comments specifying considerations, concerns, and success stories for the exchange of health data across networks. The comment period will close on August 25, 2017.

This form is meant to provide the public with a simple and organized way to submit comments. Use of this form is entirely voluntary, and commenters may find it helpful to submit unstructured comments or use the structured form as an addendum to narrative cover pages. Materials from the July 24, 2017 meeting can be found here

To be considered, all comments must be submitted according to the instructions. For security reasons, attachments are not allowed on the online comment form. If you wish to submit a letter or attachment ONLY, please send them to exchangeframework@hhs.gov. The public comment period for the Trusted Exchange Framework and Common Agreement will end at 11:59pm EDT on ­­­­­­­­­August 25, 2017.

Inspection of Public Comments: All comments received before the close of the comment period will be available for public inspection, including any personally identifiable or confidential business information that is included in a comment. Please do not include anything in your comment submission that you do not wish to share with the general public. Such information includes, but is not limited to: a person's social security number; date of birth; driver's license number; state identification number or foreign country equivalent; passport number; financial account number; credit or debit card number; any personal health information; or any business information that could be considered proprietary. All comments will be reviewed and made public at a later date on HealthIT.gov.


Comment Areas

Comment Area 1:


Adhere to industry and federally recognized technical standards, policies, best practices, and procedures.

Comment Area 2:


Conduct all exchange openly and transparently.

Comment Area 3:

Cooperation and Non-Discrimination

Collaborate with stakeholders across the continuum of care to exchange electronic health information, even when a stakeholder may be a business competitor.

Comment Area 4:

Security and Patient Safety

Exchange electronic health information securely and in a manner that promotes patient safety and ensures data integrity.

Comment Area 5:


Ensure that patients and their caregivers have easy access to their electronic health information.

Comment Area 6:

Data-Driven Choice

Exchange multiple records at one time to enable identification and trending of data to lower the cost of care, improve the health of the population, and enable consumer choice.

General Comments

Stakeholders may submit additional comments in this section that do not fit in the above categories.  Alternatively, commenters may submit their comments in their entirety in this category if they choose.  We note that while we encourage use of the above comment areas, it is not required. 












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