TEFCA™, America’s National Interoperability Network, Reaches Nearly 500 Million Health Records Exchanged as HHS Leverages Technology and AI to Lower Costs and Reduce Burden

Today, HHS, through the Office of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT (ASTP/ONC), announced progress made in executing on President Trump’s, Secretary Kennedy’s, and Deputy Secretary O’Neill’s directive to lower the cost of healthcare for all Americans by leveraging and coordinating the nation’s strategic advantages in technology, artificial intelligence (AI), and healthcare infrastructure.

“Real change is here,” said HHS Secretary Robert F. Kennedy, Jr. “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.”

ASTP/ONC kicked off its 2026 Annual Meeting in Washington, DC with a keynote from Assistant Secretary for Technology Policy and National Coordinator for Health IT Thomas Keane, MD, MBA. Addressing the more than 1,000 in-person attendees and thousands more tuning into the livestream, Assistant Secretary Keane outlined the following accomplishments in ASTP/ONC’s first year under President Trump’s and Secretary Kennedy’s leadership:

1. Transforming health data liquidity – allowing it to flow securely and seamlessly throughout the system – and securing patient access to that data: As of today, nearly 500 million health records have been exchanged through the Trusted Exchange Framework and Common Agreement™ (TEFCA™), up from roughly 10 million in January 2025. HHS laid the foundation for TEFCA under President Trump’s first term, and the network went live a little more than two years ago. The tremendous progress over the last year is a result of the effort and commitment by HHS to deliver on the promise of a single, trusted national interoperability framework that enables true data liquidity for patients and providers. View “The History and Growth of TEFCA” fact sheet
2. Fighting Information Blocking: Assistant Secretary Keane announced that ASTP/ONC is executing on Secretary Kennedy’s directive to seriously address information blocking and has initiated its first oversight actions under 45 CFR 170.580 (“ONC review of certified health IT”). Specifically, ASTP/ONC is in the process of issuing “notices of potential non-conformity” to certain developers of certified health IT requesting explanations related to potential nonconformance with Certification Program requirements, including the Information Blocking Condition of Certification and API Maintenance of Certification requirements.
3. Using technology to directly lower costs for patients and reduce provider burden: Through the Health Data, Technology, and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization (HTI-4) Final Rule, ASTP/ONC adopted regulation standards and certification criteria for health IT that support electronic prior authorizations for both medical and pharmacy benefits. HHS projects over $19.2 billion of administrative cost savings over the next decade, while freeing providers to spend more time caring for patients. ASTP/ONC also finalized a requirement for certified health IT developers who have health IT certified to 45 CFR 170.315(b)(4) to include real-time prescription benefit capabilities in their products, allowing providers to see the cost and coverage of a prescription as part of their prescribing workflow. The new real-time prescription benefit certification criterion was also added to the definition of Base EHR in 45 CFR 170.102.
4. Lowering health IT developer burden by modernizing health IT certification: On December 22, 2025, ASTP/ONC published the Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule which included deregulatory actions that would remove 34 and revise seven of the existing 60 certification criteria. Eliminating criterion that are redundant, outdated, or already well established in the market would save certified health IT developers an estimated $1.53 billion in compliance costs—freeing capital to be invested toward innovation that improves patient lives and increases affordability.
5. Leading the Department-wide push to unlock clinical AI: Through the HHS Artificial Intelligence Request for Information (RFI), ASTP/ONC is coordinating the Department’s OneHHS approach to use regulation, reimbursement, and research & development levers to accelerate AI adoption in clinical care. HHS is currently seeking feedback from all interested stakeholders. Additionally, focusing on the most widespread clinical AI use case, ASTP/ONC released a Diagnostic Imaging RFI to solicit public feedback that may inform future ASTP/ONC proposals to modernize the interoperability of diagnostic imaging across health IT.
6. Advancing health data standardization through the US Core Data for Interoperability (USCDI): ASTP/ONC released the draft USCDI v7 on January 29, 2026, proposing 29 new data elements and one significantly revised element to strengthen nationwide interoperability. Draft USCDI v7 expands standardized health data to support more efficient adverse event reporting, nutrition information exchange, and quality improvement, ultimately modernizing how health information is used across the entire health care system to Make America Healthy Again.
7. Strengthening America’s behavioral health infrastructure: ASTP/ONC, in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA), announced nine Behavioral Health IT (BHIT) pilot programs supported by a $20+ million investment. Spanning 45 exchange partners across nine states, the pilots will test behavioral health–specific data elements in real-world settings to inform future standards, technical specifications, and policies for the broader health care community.
8. Making electronic health information usable and actionable through AI: In the coming days, ASTP/ONC will launch the EHIgnite Challenge, a two-phase prize competition to improve the usability, readability, and actionability of single-patient electronic health information (EHI) exports. The EHIgnite Challenge will catalyze the development of tools and workflows, focused on the application of AI, that transform raw EHI into clear, usable information to better support care transitions, provider onboarding, and patient understanding and engagement. Awards will support both concept development and prototype solutions through 2027.

“The Make America Healthy Again movement is about empowering Americans to take control of their health,” said HHS Deputy Secretary Jim O’Neill. “Under Dr. Keane’s leadership, ASTP/ONC is building the policy foundation for technology that gives patients access to their information, real choices in their care, and the tools they need to make the best decisions for their health.”

“As we begin to realize the power of AI applied to healthcare, data liquidity will be a key defining need,” said Assistant Secretary Keane. “By unlocking true interoperability, we are ensuring every American can securely access, use, and benefit from their health information—empowering patients, supporting clinicians, and accelerating better health outcomes nationwide.”

Assistant Secretary Keane reminded attendees to comment on ASTP/ONC’s HTI-5 proposed rule, the HHS AI RFI, ASTP/ONC’s Diagnostic Imaging RFI, and the Draft USCDI v7.

More information about ASTP/ONC’s work can be found at healthit.gov, on LinkedIn, or @HHS_TechPolicy.