You’re probably seeing the acronym QHIN more often—maybe in RFP language, from a prospective healthcare system buyer, or from your own product team kicking around ideas on data access.
If you’re leading sales, strategy, or product at a digital health company, the pressure to understand how QHINs fit into your U.S. market plan is increasing. There’s a sense that you’re supposed to “plug into” this new model. But what that actually means—and when it matters—still feels unclear to a lot of teams I work with.
So let’s break it down. What are QHINs? What’s the point of TEFCA? And how should you think about this infrastructure shift in the context of real GTM work: selling, integrating, and scaling inside U.S. enterprise healthcare systems?
What is a QHIN?
QHIN stands for Qualified Health Information Network. These are organizations designated under a federal framework called TEFCA—the Trusted Exchange Framework and Common Agreement—that are meant to facilitate secure, standardized clinical data exchange at a national level.
Think of QHINs as hubs. If you join a QHIN, you’re connected to every other participant in that QHIN, as well as participants in other QHINs. That’s the vision: more access, fewer one-off integrations, and better patient data liquidity across the country.
Why QHINs Exist: TEFCA in Plain Terms
To make sense of QHINs, you have to understand TEFCA. TEFCA is a federal effort, years in the making, to fix what most of us in digital health already know is a problem: too many data silos, too many proprietary networks, too much friction in accessing patient records across systems.
Even though the 21st Century Cures Act pushed for greater data sharing and patient access, the reality on the ground has been slower to catch up. APIs are still uneven. EHR vendors cooperate only to a point. And for startups or smaller vendors, gaining real-time access to clinical data across systems has often meant negotiating one-off partnerships or building costly custom integrations.
TEFCA is meant to change that.
The idea is to set up a common set of technical and legal requirements so that organizations—payers, providers, vendors—can all connect to the same trusted framework. Instead of building one-to-one pipes, you connect once to a QHIN, and that QHIN connects you to everyone else.
It’s a big idea. And as of this year, it’s not just a theory—there are certified QHINs, and data exchange under TEFCA is starting to happen.
Making Sense of the QHIN List
As of March 2025, there are eight organizations officially designated as QHINs under TEFCA. If you’re in a commercial or product role at a digital health company, you’re probably wondering: Do I need to partner with one of these? And if so, which one?
Let’s look briefly at what each QHIN brings to the table, and where you might encounter them in a sales conversation or buyer evaluation process.
One of the oldest and largest health information networks in the U.S., eHealth Exchange connects a broad mix of stakeholders, including federal agencies like the VA and DoD. If your buyer serves government populations, this QHIN may already be in use.
This is Epic’s own data exchange layer. If you’re selling into Epic shops—and let’s be honest, that’s a lot of the U.S. market—it’s increasingly likely this QHIN will be in the picture. But keep in mind: Epic Nexus is optimized for Epic-to-Epic exchange. If your product spans non-Epic systems, you’ll still have integration work ahead.
This one’s showing up more often in digital health RFPs. Health Gorilla provides a developer-friendly platform for clinical data retrieval across networks. It also offers FHIR-based APIs and has been particularly active in supporting use cases across payers, life sciences, and value-based care vendors.
A regional HIE with growing national capabilities. You’ll typically see KONZA in states like Kansas, Missouri, and Oklahoma, but they’re expanding. Their focus has been on improving data exchange to support population health and public health reporting.
Best known for its roots in Direct Secure Messaging, MedAllies has evolved into a broader interoperability player. If your buyer mentions “referral networks” or secure provider-to-provider messaging, MedAllies might be the underlying infrastructure.
This is a vendor consortium originally founded by companies like Cerner, athenahealth, and McKesson. They’ve pushed hard on interoperability for years. If your buyer uses one of these EHRs—or is part of a network that supports national exchange—you might run into CommonWell.
Kno2 focuses on making interoperability accessible across post-acute care, ambulatory settings, and small providers. If your product supports transitions of care or operates outside traditional hospital walls, Kno2 might already be in place.
eCW runs its own network and has now joined TEFCA as a QHIN. If you’re working with ambulatory clinics or smaller provider groups on eCW, this matters—but keep in mind that interoperability outside the eCW ecosystem may still require other tools.
| QHIN Name | Description |
| eHealth Exchange | Longstanding national health information exchange. Includes federal agencies and large healthcare systems |
| Epic Nexus | Epic’s data exchange network, focused on its large installed base |
| Health Gorilla | Clinical data network serving digital health, payers, and life sciences |
| KONZA | Regional health information exchange with growing national data-sharing infrastructure |
| MedAllies | Strong focus on secure provider-to-provider data exchange |
| CommonWell | Broad-based health IT vendor alliance for interoperability |
| Kno2 | Interoperability services across care settings and IT systems |
| eClinicalWorks | EHR vendor with its own national health information network |
Each of these is now officially certified as a QHIN under TEFCA by the Office of the National Coordinator for Health IT (ONC) and The Sequoia Project, which serves as the Recognized Coordinating Entity (RCE).
That’s the technical framing. But here’s where we need to zoom out and ask a harder question:
What do QHINs actually do for you?
What QHINs Actually Do (and Don’t Do)
QHINs solve for exchange. They’re focused on enabling access to clinical records across organizations that have agreed to a common framework. That’s valuable—but it’s not the same as solving for integration, workflow, or analytics.
If you’re building a digital health solution that needs to pull structured patient data and insert it into a care management dashboard, for example, a QHIN might get you the raw data. But it’s probably not going to help you parse that data, match patients, or map fields to your app schema. That’s where you’d need an integration partner.
This isn’t to say QHINs aren’t valuable. They are—especially if you’re trying to demonstrate interoperability readiness to enterprise buyers or participate in value-based contracts that require broad access to clinical records.
But if you’re trying to sell an application that sits inside workflows, surfaces insights in context, or sends data back to an EHR, you’ll probably still need an integration partner like Redox, Particle, 1upHealth, or ELLKAY alongside—or instead of a QHIN.
| Functionality | QHINs | Integration Partners (e.g., Redox, ELLKAY) |
| National clinical data exchange | Yes | Sometimes |
| Standards-based network participation | Yes (TEFCA) | Varies |
| Custom EHR integration | No | Yes |
| FHIR API normalization | Varies | Yes |
| Workflow-level integration | No | Yes |
| Ongoing interface support | No | Yes |
| Security certifications (e.g., HITRUST) | Varies | Yes (usually) |
QHINs in Sales and Procurement Conversations
So what does this mean for your product and your commercial strategy? Let’s zoom out and look at this in the context of a healthcare sales cycle.
In the past, most RFPs didn’t require QHIN participation. That’s changing. Larger healthcare systems—especially those involved in federal programs or trying to streamline data exchange across partners—are starting to ask questions like:
- Are you TEFCA-aligned?
- Which QHIN(s) do you support?
- Can you ingest data from our QHIN of record?
If you’re not prepared to answer these, your sales cycle gets longer. Worse, you risk looking less “enterprise-ready” compared to competitors who’ve built QHIN alignment into their messaging.
But this doesn’t mean you have to pick a QHIN today. It means you need a credible position on how your product handles data exchange, and when partnering with a QHIN makes sense in your model.
Here’s a framework you can use:
| If your product… | Then you may want to… |
| Needs real-time clinical data retrieval | Align with a QHIN that supports FHIR-based APIs (e.g., Health Gorilla) |
| Supports population health or risk contracts | Monitor TEFCA adoption by payers and regional HIEs |
| Works across care settings | Explore Kno2 or CommonWell for broader post-acute coverage |
| Is sold to Epic-heavy systems | Understand how Epic Nexus handles data flow and access |
| Already works with Redox, 1up, etc. | Clarify how QHIN access complements—not replaces—those tools |
Questions to Ask When Evaluating a QHIN Partner
This part is worth slowing down for. Not all QHINs are equal in capability, coverage, or commercial alignment. If you’re considering formal participation—or just thinking about building to one—these are the types of questions I encourage GTM and product teams to ask:
- What types of participants does this QHIN serve (healthcare systems, payers, vendors)?
- Does the QHIN support real-time FHIR access or just document exchange?
- What does onboarding look like? Are there developer tools, sandbox environments, support?
- Are there transaction fees or network participation costs?
- How does the QHIN approach patient matching and record location across networks?
- Can you restrict or prioritize specific data types (e.g., labs, meds, notes)?
- Are your target accounts already part of this QHIN? (You can usually ask.)
The last one is particularly important. A QHIN’s value to your business is directly tied to how often it shows up in your target market. If none of your buyer personas are currently connected, it may be more of a “future-state” investment than an immediate advantage.
What’s Next for QHINs and TEFCA?
Right now, QHIN participation is optional. But we’re starting to see early signs that may shift.
CMS has already made moves toward aligning future federal program participation with TEFCA readiness. As value-based care models evolve, and as CMS looks for ways to standardize how data is accessed across organizations, TEFCA may become the default infrastructure for compliance.
That doesn’t mean it’s required tomorrow. But it does suggest that aligning with a QHIN—or at least building a plan for when and how you will—should be part of your longer-term strategy.
There’s also movement in the private sector. Large payers, ACOs, and national healthcare systems are testing how QHIN connectivity can reduce administrative waste or accelerate risk adjustment work. If your solution plays in those lanes, being “QHIN-aware” will help you show up as credible.
Just keep in mind: QHINs don’t replace the kind of app-level integration work most digital health products still require. Even in a TEFCA world, you’ll need workflow alignment, data normalization, and buyer-specific implementation paths.
What You Can Do Now
If you’re a commercial or product leader trying to land more U.S. healthcare system deals this year, here’s what I’d prioritize:
1. Map your target accounts to existing QHINs.
Several QHINs—like Redox, Health Gorilla, and eHealth Exchange—offer searchable databases or maps of current integrations. Overlay those against your prospect list.
2. Clarify your data exchange posture.
Whether you’re already using FHIR APIs, connecting through an HIE, or working with a partner like Particle, your buyers need to hear a coherent story. Don’t wait for the RFP to get clear.
3. Monitor how procurement language is changing.
Healthcare systems are starting to include “TEFCA-aligned” or “QHIN-supported” as line items in vendor questionnaires. If you don’t know how to respond yet, work with your team now to draft one.
4. Know when to bring in a partner.
Not every product needs direct QHIN access. But if data liquidity is core to your model, and you’re seeing repeat blockers in sales cycles, it may be time to formally align.
5. Don’t assume TEFCA will level the playing field.
QHINs reduce some barriers—but they don’t eliminate the need for integration, implementation, and IT governance. If anything, they raise expectations. Buyers will assume you’re ready.
How I Help
I work with digital health teams selling into U.S. healthcare systems to navigate CIO objections, de-risk integration, and sharpen how they position themselves in enterprise sales cycles.
That usually means:
- Mapping GTM and integration strategies to actual healthcare system buying behavior
- Helping teams evaluate where QHINs and other infrastructure partners fit
- Coaching revenue teams on how to frame value in terms CIOs and procurement leaders care about
The goal isn’t to chase buzzwords. It’s to get to market faster—with fewer surprises and a tighter close rate.
If you’re trying to figure out how QHINs fit into your GTM strategy—or how to build a more defensible sales motion inside U.S. healthcare systems—I can help you work through it. Write to me at astrunk@accretiveedge.com.
