Those of us working across health policy, technology, and standards are reimagining a system where individuals experience better outcomes, lower costs, and greater trust in how their health information is used and shared.
At HL7® International, a global standards development organization with members and affiliates in more than 50 countries, we are meeting our challenge head-on through collaboration and innovation. The HL7® FHIR® at Scale Taskforce (FAST) Accelerator takes that mission further by tackling the hard problems of scalability: Identity, Security, Consent, and National Directory services. These components are the backbone that supports the CMS Health Tech Ecosystem and Aligned Networks Pledge.
Paired with the Da Vinci Project, which applies FHIR to payer–provider workflows like prior authorization, clinical data exchange, payer data exchange, and patient cost transparency. HL7 is aligning infrastructure with real-world use cases. Da Vinci has recognized the value of FAST standards by selecting FAST Security as part of their security recommendations in their core health record exchange (HRex) specifications, showing a convergency across the ecosystem.
Where Sequoia’s RCE Role Elevates the Work: TEFCA as the National Trust Layer
FAST isn’t building infrastructure in a vacuum. Its work aligns with the Trusted Exchange Framework and Common Agreement (TEFCA), led by The Sequoia Project as the Recognized Coordinating Entity (RCE) for ASTP/ONC. TEFCA is a national framework for the secure and trusted exchange of clinical data across networks.
Sequoia operationalizes TEFCA:
- Establishing the policies, rules, and trust framework that Qualified Health Information Networks (QHINs) must follow
- Certifying networks to ensure secure, nationwide exchange
- Coordinating standards alignment across government, industry, and vendors
FAST Security is referenced by the RCE and TEFCA as a component of this trust model and is being adopted and considered internationally as a model for secure, interoperable data exchange.
The result is a unified path forward for CMS programs, Medicaid modernization, multi-network exchange, and emerging FHIR-based use cases.
Empowering Patients and Consumers Through Trusted Connections
At the center of all this work is the individual.
The promise of interoperability is realized only when people can access, understand, control, share, and use their own data to improve their health. FAST is creating the specification for the infrastructure to make that possible:
- FAST Identity: a consistent digital identity across networks
- FAST Security: a modern, federated trust aligned with TEFCA
- FAST Consent: empowering individuals to control how data moves
- FAST National Directory: outlines a national directory infrastructure
Combined with TEFCA’s governance, this ecosystem strengthens data integrity, reduces friction, and supports a learning health system powered by real-time trusted data.
CMS Aligned Networks: Turning Strategy into Reality
CMS, HL7, and the RCE are advancing a coordinated model where:
- FAST provides scalable infrastructure
- Da Vinci delivers implementable use cases and implementation guides
- TEFCA & The Sequoia Project, ensure a unified governance and trust framework at a national scale
This alignment transforms interoperability from policy aspiration into operational reality.
Building a Healthier, More Connected America
As these initiatives converge, we move toward a digital infrastructure where:
- Patients access and share their data seamlessly
- Providers receive complete, trusted information at the point of care
- Payers reduce administrative burden and advance value-based care
- Public health gains timely, accurate data to protect communities
This is the backbone of a resilient, learning, patient health system.
The Road Ahead
Achieving this vision requires ongoing collaboration. HL7’s FAST and Da Vinci leadership, working in alignment with TEFCA through The Sequoia Project as the RCE, are building the bridge to a nationwide, trusted interoperability framework. The future is clear: secure, scalable, equitable data exchange that empowers individuals and strengthens care delivery across America.
👉 Your voice matters. Join us in shaping the next phase by participating and contributing!
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For those looking to stay informed or contribute, the FAST team welcomes you to join our listserv, engage through public calls, participate in testing at Connectathons or join FAST as a member to help shape our work. These collaborative efforts are key to building solutions that benefit the entire health IT ecosystem, ensuring that consent management is not only feasible but scalable across varied healthcare settings.
Be sure to follow the FAST LinkedIn page to stay up- to-date on where FAST is presenting and other timely news.
