Regional / state HIE
Cross-organization exchange for a region, state, or care community.
Health Information Exchange
HIE and TEFCA integration services
We build HIE platforms that move patient data across organizations (C-CDA document exchange, FHIR APIs, and QHIN connectivity under TEFCA) with master patient indexing and consent management at the core.
HIPAA-ReadyTEFCAC-CDAFHIR R4
Trusted by global innovators
What are HIE integration services?
HIE integration services connect your EHR, care platform or network to health information exchanges, Carequality, CommonWell and TEFCA QHINs, so you can query and share patient records across organizations. Agnotic Technologies builds the patient matching, C-CDA and FHIR exchange, consent checks and audit logging that make each query land on the right patient.
An HIE moves a patient's record between organizations that don't share a database. That means resolving identity with a master patient index (MPI), exchanging summaries as C-CDA documents and increasingly serving discrete FHIR data, so receiving systems get structured resources rather than a PDF-like blob.
The policy layer is now inseparable from the technology. TEFCA and its Qualified Health Information Networks (QHINs) set a national floor for data sharing, and every exchange must honor patient consent and keep an auditable access trail. We build the plumbing and the governance together.
What it is
How does a health information exchange work?
A health information exchange lets independent organizations share a patient's clinical data. It resolves identity with a master patient index, exchanges summaries as C-CDA documents and discrete data over FHIR, and enforces consent on every disclosure.
Under TEFCA, exchanges connect to Qualified Health Information Networks for national reach. We build the technical plumbing and the governance layer together so sharing is both possible and trustworthy.
Exchange architecture
See how we design master patient indexing, C-CDA and FHIR exchange, consent, and QHIN connectivity across the HIE platforms we build.
What do our HIE integration services include?
Each capability ties a data-sharing function to the standard or policy that makes it interoperable and trusted.
Master patient index (MPI)
Probabilistic and deterministic patient matching across source systems so a record from one organization resolves to the right person everywhere else.
C-CDA document exchange
Generate, parse, and reconcile Consolidated CDA documents (CCD, referral notes, and discharge summaries) the workhorse format for cross-organization clinical summaries.
FHIR data services
Expose discrete data over FHIR R4 APIs and support US Core profiles so receiving systems consume structured resources instead of parsing documents.
TEFCA & QHIN connectivity
Connect to the national exchange framework through a Qualified Health Information Network, and to networks such as Carequality and CommonWell, so your participants reach data beyond the local footprint under a common trust agreement.
Consent management
Opt-in/opt-out models, purpose-of-use enforcement, and granular consent so data only flows where the patient and policy allow, with every decision recorded.
Audit & access logging
Immutable, queryable logs of every query and disclosure aligned to HIPAA, so participants can answer who accessed a record, when, and why.
Where it runs
Who needs an HIE connection?
ACO & network data sharing
Data aggregation across an accountable care organization's participants.
Care transitions
Discharge and referral summaries shared across acute and post-acute settings.
Payer-provider exchange
Bidirectional clinical data sharing supporting value-based programs.
Public health reporting
Standardized reporting feeds to public health agencies.
Patient record aggregation
Longitudinal patient records assembled from many source systems.
Why do identity, consent and audit come first?
HIE fails when identity, consent, and audit are afterthoughts. We build them as the foundation, then layer exchange on top.
TEFCA
QHIN-ready national framework alignment
C-CDA + FHIR
Document and discrete-data exchange
MPI
Cross-system patient matching
Compliance-First Healthcare App Development Services Backed by Global Standards
15-Minute Scoping Call01
HIPAA
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, strict access controls, and traceable audit logs.
02
GDPR
General Data Protection Regulation
Implement lawful consent flows, data minimization, retention controls, and secure processing for sensitive health data.
03
FHIR
Fast Healthcare Interoperability Resources
Enable standardized health data exchange across apps, care teams, and systems through standards-based FHIR APIs.
04
HL7
Health Level Seven International
Support enterprise-grade interoperability with HL7-based integrations for records, events, and clinical messaging workflows.
05
HITRUST
Health Information Trust Alliance
Align security programs to healthcare-specific control and risk management practices trusted by providers and ecosystem partners.
06
HITECH
Health Information Technology for Economic and Clinical Health Act
Design with breach notification readiness, digital record safeguards, and operational controls that support regulated care programs.
07
SaMD
FDA Software as a Medical Device
Plan software quality, traceability, and documentation pathways for products that may require SaMD review and submission.
08
MDR (EU)
Medical Device Regulation (European Union)
Prepare EU market-ready processes for risk classification, evidence tracking, and lifecycle governance under MDR expectations.
09
SAMHSA
Substance Abuse and Mental Health Services Administration
Apply confidentiality controls and consent-aware sharing models for behavioral and mental health data experiences.
Standards we build against
Which exchange standards do we build against?
C-CDAFHIRTEFCAIHEHIPAA
Our Process
How do we build an HIE integration?
Identity resolution, document and FHIR exchange, and governance are built together so the HIE is trustworthy from launch.
1.
Discovery & governance mapping
We map participants, data-sharing agreements, consent models, and TEFCA/QHIN requirements before building the exchange layer.
Governance-first design
2.
MPI & identity resolution
We stand up the master patient index with matching rules and stewardship tooling so records resolve to the right patient across systems.
Identity at the core
3.
C-CDA & FHIR exchange
We build C-CDA document exchange and FHIR R4 data services with US Core profiles, validated against real participant data.
Standards-native
4.
QHIN connectivity & go-live
QHIN onboarding, consent enforcement, and phased participant rollout with exchange-volume and access-audit dashboards.
Always audit-ready
Facts and sources
Which rules shape HIE integration?
Short facts we design around, each linked to its primary source.
45 CFR Part 172 implements TEFCA: it aims to ensure full network-to-network exchange of health information and sets the qualifications and process for designating a Qualified Health Information Network (QHIN).
Source: 45 CFR Part 172 (eCFR)The information blocking regulations restrict practices by health care providers, certified health IT developers and health information networks that interfere with access, exchange or use of electronic health information.
Source: 45 CFR Part 171 (eCFR)45 CFR 170.205(a)(4) adopts the HL7 Consolidated CDA (C-CDA) Release 2.1 templates for clinical notes as a standard for certified health IT.
Source: 45 CFR 170.205 (eCFR)The HIPAA Privacy Rule permits a covered entity to disclose protected health information for the treatment activities of a health care provider.
Source: 45 CFR 164.506(c) (eCFR)
Featured case study
Read Case StudyLera Health: compliant women's health platform
Related proof of compliant delivery: on Lera Health we built the privacy-first data layer, consent handling, and secure workflows end to end, the same governance and auditability an HIE requires to be trusted by its participants.
Why Partner With Us
15-Minute Scoping CallWhy teams build exchange with us
HIE is equal parts standards and governance. We bring both, plus the audit discipline participants demand.
Governance-first by default
Consent, purpose-of-use, and audit designed into the exchange from sprint one: the foundation participants trust.
Interoperability depth
C-CDA, FHIR US Core, and TEFCA are our working vocabulary, so your team isn't teaching us the exchange landscape.
Pragmatic sequencing
We land a working exchange between core participants first, then scale connectivity: value early, national reach later.
Built to scale participants
Architecture that adds participants and QHIN reach without re-plumbing identity, consent, or audit.
Frequently Asked Questions
Cost scales with participant count, matching complexity, and how much national connectivity you need. A focused exchange between a handful of organizations is far smaller than a regional HIE with a full MPI, consent engine, and QHIN onboarding. We scope by participants and data types, then phase the build so an initial exchange delivers value before national reach is added.
It depends on how many participants and networks you connect, how hard patient matching is across their systems, the consent model and whether you onboard through a QHIN. Governance and data-sharing agreements often gate go-live more than engineering does, so we start them in parallel with the build.
If a regional or national network already meets your needs, connecting to it is faster and cheaper than building. Build when you need a private exchange across a defined set of participants, want control over matching and consent, or are creating an ACO or payer-provider data layer. Many clients do both: build a private hub and connect it outward through a QHIN.
We ingest and share data through the interfaces each participant exposes: FHIR R4 APIs and US Core profiles where available, C-CDA documents and HL7 v2 feeds where not. The MPI resolves identity across them, and terminology services normalize SNOMED, LOINC, and ICD-10 so aggregated data stays consistent.
TEFCA is the national framework that lets networks exchange data under a common trust agreement, with Qualified Health Information Networks (QHINs) as the connective backbone. You don't have to build QHIN capability yourself: most exchanges connect through an existing QHIN. We design your platform so that connectivity is a configuration step, not a rebuild.
We implement your consent model (opt-in, opt-out, or granular) with purpose-of-use enforcement on every disclosure and an immutable audit log of who accessed what. Consent and audit are built into the exchange core, so privacy holds up to participant and regulatory scrutiny rather than living in a side system.
Planning a health information exchange?
Share your participants and data-sharing goals. We'll return a phased plan covering MPI, C-CDA and FHIR exchange, consent, and TEFCA/QHIN connectivity.
contact@agnotic.com
Partnerships
contact@agnotic.com