The federal government’s national health information exchange framework reached a major milestone in 2026, with nearly 500 million health records now flowing through its network.
The Trusted Exchange Framework and Common Agreement, known as TEFCA, is a federally overseen infrastructure designed to help hospitals, clinics, insurers, government agencies and other healthcare organizations securely share patient records across networks and systems.
TEFCA is administered by the Assistant Secretary for Technology Policy within HHS and operates through Qualified Health Information Networks, or QHINs, which serve as gateways to the broader exchange. The framework launched a little more than two years ago after years of federal development.
The initiative aims to replace fragmented, point-to-point data-sharing arrangements with a standardized national network governed by common rules.
Editor’s note: This article was updated July 1.
Here is a look at TEFCA’s 2026 milestones:
- As of February 2026, nearly 500 million health records had been exchanged through TEFCA, up from roughly 10 million in January 2025, according to HHS. Assistant Secretary for Technology Policy Thomas Keane, MD, shared the figure during the ASTP/ONC 2026 Annual Meeting in Washington, D.C.
- The Social Security Administration connected to TEFCA in early spring 2026 through the eHealth Exchange QHIN, enabling a government benefits determination exchange purpose. The agency said interoperability is expected to cut disability claims processing times by more than 50% in many cases, allowing faster decisions for applicants.
- In April 2026, health systems using Epic’s EHR began electronically sharing patient records with the Social Security Administration through TEFCA, helping accelerate disability determinations by up to 50%, according to an April 8 news release from Epic. The TEFCA connection expanded the Social Security Administration’s reach to an additional 13 hospitals and 374 clinics.
- On June 26, HHS stated more than 1 billion health records have been exchanged through TEFCA in less than a year. Along with the milestone, ONC said it would be conducting additional reviews of Qualified Health Information Networks, or QHINs, to help ensure participating organizations comply with TEFCA’s rules and operating requirements.
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