Nearly 500 million records have been exchanged through the Trusted Exchange Framework and Common Agreement (TEFCA), up by a jaw-dropping 4,900% since January 2025, the Department of Health and Human Services’ health IT office announced on Wednesday.
Tom Keane, M.D., the assistant secretary of technology policy and national coordinator of health IT (ASTP/ONC), made the announcement on Wednesday morning at the ASTP/ONC 2026 Annual Meeting.
TEFCA is the government-backed health data-sharing initiative that allows patients, providers and payers to share health records. It went live in December 2023.
In addition to the massive spike in records exchanged through TEFCA, Keane announced that his office has begun sending out information-blocking notices to certain developers of certified health IT to explain potential issues with compliance.
Keane also touted regulatory updates the ASTP/ONC produced in 2025. The HTI-4 final ruleset standards for electronic prior authorizations and real-time prescription benefits for health IT products certified by the office.
The health IT office also released a proposed rule in late December, HTI-5, which guts 34 out of 60 standards for health IT. In the rule, the ASTP/ONC called the requirements redundant and outdated and estimates that it will save developers $1.53 billion in compliance costs.
“Real change is here,” HHS Secretary Robert F. Kennedy, Jr. said in a statement. “We are delivering bold, science-driven dietary guidelines and deploying transformative technology that reduces burden, lowers costs and puts patients and providers first. These actions prioritize prevention and move us decisively to Make America Healthy Again.”
Healthcare data interoperability has been a big priority of Trump’s HHS since mid-2025, when it launched a sprawling request for information on how to ease data exchange among the healthcare ecosystem for patients, providers, payers, vendors and value-based care organizations.
The Centers for Medicare & Medicaid Services (CMS) and its Innovation Center have been working on a slew of initiatives to improve Medicare beneficiaries’ access to health data, including the Health Tech Ecosystem, which it launched in July 2025.
The CMS sees the health tech ecosystem initiative working in tandem with other government-backed data exchange efforts, like TEFCA.
"We see ourselves working with TEFCA as a floor and a ceiling," Amy Gleason, acting administrator, U.S. DOGE Service, and strategic advisor to the CMS, told Fierce Healthcare in January. "There's the regulatory way to do things, and TEFCA and ASTP/ONC have to deal with more of the regulatory piece, which is just a slower process. We're really trying to just challenge the industry to do things more in a tech manner. You don't do 10-year tech projects anymore. You do iterative development and build quickly, and if it doesn't work, you throw it away early, and you iterate quickly. As we find things that work, and iterate on that, then if we need the regulation, they can come back up underneath us and raise the floor."
Electronic health records companies doubled down on their participation in TEFCA last summer. Epic announced in June that more than 1,000 hospital customers and 22,000 clinics using its EHR are now live on the government-backed data exchange.
Athenahealth announced that more than 100,000 of its providers were live on TEFCA in July, one day before CMS’ Health Tech Ecosystem announcement.