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Building a Healthy Digital Future with HL7 FAST FHIR at Scale

[fa icon="calendar'] Feb 4, 2026 10:38:20 AM / by Janice Reese posted in FHIR, CMS, FHIR Accelerator, FAST, FHIR Implementation Guides, FHIR Community, FAST Security, FAST Identity, FHIR Consent, FAST Directory

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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.

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From Policy to Practice: FAST Advances Consent, Identity, Security and Directory for CMS-Aligned Networks

[fa icon="calendar'] Dec 18, 2025 11:02:33 AM / by FAST Project Management Team posted in FHIR, FAST, FHIR Connectathon, FHIR Implementation Guides, ONC FAST, FHIR Community, webinar, FAST Security, FAST Identity, FHIR Testing, FAST Directory

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The HL7® FHIR® at Scale Taskforce (FAST) continues to translate national interoperability policy into implementable, real-world infrastructure. This month marks several major milestones, including the opening of the FAST Consent Ballot, the official publication of FAST Identity STU 2 and FAST Security STU 2, and continued progress on FAST National Directory toward STU 2. This reinforces the growing momentum toward CMS-Aligned Networks powered by FAST. 

These advances demonstrate how standards, trust frameworks, directory infrastructure and testing at scale converge to support scalable, secure and interoperable data exchange across the healthcare ecosystem. 

 

FAST Consent Ballot: Advancing Scalable, Network-Ready Consent 

The FAST Consent Implementation Guide (Edition 1 – US Realm) has entered formal HL7 balloting, providing the industry with a practical, interoperable approach to consent management at scale. 

The guide is designed to support: 

  • Computable and portable consent representations across organizational and network boundaries 
  • Subscription-based workflows for consent updates and downstream disclosures 
  • Alignment with FAST Identity, FAST Security, and FAST Directory infrastructure 
  • Use cases spanning payer-to-payer exchange, provider workflows, HIEs, and consumer-mediated access 

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