TEFCA IAS

Nationwide exchanges

One identity verification finds a person’s records across facilities on the TEFCA network. Flexpa is an Individual Access Services provider through two QHINs, Kno2 and CommonWell.

Read the docs Markdown for agents

For people and teams

People rarely remember every place that holds their records. Through TEFCA, they verify who they are once, and Flexpa searches participating facilities for them. Flexpa has matched patients at more than 88,000 distinct facilities in live production.

What comes back

Clinical documents from each matching facility, such as care summaries, discharge summaries, and clinical notes.
Lab and imaging results, and unstructured notes.
Conditions, medications, allergies, immunizations, and procedures, converted from those documents into structured FHIR.

How people connect

Review and accept the TEFCA consent.
Verify identity with CLEAR, ID.me, or Persona, using a government-issued photo ID. This takes under a minute with an existing account, or 3 to 7 minutes to create one.
Flexpa searches the network and retrieves records from matching facilities. A facility that answers over a FHIR API asks for its own sign-in.

Good to know

Flexpa starts retrieving records within minutes of the patient finishing consent. Separately, a new record can take about 24 to 72 hours to become available at the source facility or network, so a very recent visit may not appear until the source makes it available.
A connection can finish with no records found. It keeps refreshing, so records from future visits appear without signing in again.
When the search finds an Epic organization, a patient who signs in there with their Epic ID may also share the other Epic organizations linked to their MyChart Central account.
The patient verifies their own identity. There is no guardian or proxy path through TEFCA.
TEFCA is enabled per application. Contact partnerships@flexpa.com to turn it on.

For agents

Read as markdown

Source: TEFCA Individual Access Services, through the Kno2 and CommonWell QHINs
Patient sign-in: IAL2 identity verification with CLEAR, ID.me, or Persona
Launch: Flexpa Consent authorization URL with flexpa_ial2_mode=true. It cannot be combined with flexpa_endpoint_id. In the Node SDK, flow: { type: 'ial2' }.
FHIR R4: DocumentReference wrapping each C-CDA (base64 in content[0].attachment.data, facility in custodian), plus converted Condition, MedicationRequest, Observation, and more, each linked to its source by Provenance
Standards: XCPD (ITI-55) patient discovery; XCA (ITI-18, ITI-43) document query and retrieve
Timing: Retrieval starts within minutes of consent. The 24 to 72 hours is source-side: a new record can take that long to become available at the facility or network, so a recent visit may be missing until the source has it. It is not Flexpa processing time.

Records tools

After the patient authorizes through Flexpa Consent, at https://api.flexpa.com/mcp/consent. They need a patient access token.

get_documents The C-CDA documents found for the patient
get_document_content The narrative text of one C-CDA
get_problems Conditions converted from the documents
get_medications Medications converted from the documents

Notes for agents

With offline_access in scope, authorizations verified with CLEAR or ID.me refresh automatically.
GET /rest/consent/:consentId?include=tefcaOutcomes summarizes the latest sync: patients found, facilities queried, and documents retrieved.
An empty result means no matching facility was found, not an error.

Scale and context

How a TEFCA request reaches a facility

TEFCA is a network of networks. Flexpa sends Individual Access Services requests through two QHINs, which reach the participants and subparticipants connected across all QHINs.

Recognized Coordinating Entity
The Sequoia Project
Selected by ONC to maintain the Common Agreement and oversee the QHINs.
Designated QHINs
11
Qualified Health Information Networks that connect directly to each other, as of August 17, 2026.
Organizations live on TEFCA
24,500+
QHINs, participants, and subparticipants, representing 107,000+ unique connections to clinicians, hospitals, clinics, and more, as of October 20, 2026.
Flexpa
IAS Provider
Connected through two QHINs, Kno2 and CommonWell. Flexpa has matched patients at 88,000+ distinct facilities in live production (88,897 as of August 25, 2026).

The RCE counts cover every TEFCA exchange purpose, not Individual Access Services alone.
Flexpa’s facility count is facilities where it has matched at least one patient. It is a different unit from the RCE’s organizations and connections, not a share of them.

Sources: RCE informational call, “TEFCA by the Numbers” (October 20, 2026); RCE announcement, “ONC Increases Funding for TEFCA RCE in New Contract Year” (August 17, 2026); Flexpa network docs (August 25, 2026).

In the docs

Other networks

All three work together in one Flexpa integration and return the same FHIR R4 API.

CMS-9115
Health insurers
Claims, coverage, and clinical history from health insurers, shared by the member through the Patient Access APIs required by CMS-9115.
Sign-in: The member’s own health plan account
ONC (g)(10)
Medical record systems
Clinical records from the EHRs at hospitals and practices, shared by the patient through ONC (g)(10) certified Patient Access APIs, now with Epic MyChart Central sign-in across linked Epic organizations.
Sign-in: The patient portal account at each facility, such as MyChart

Bring patient-consented records into your app or agent.

Try the demo to see the consent flow and the records it returns.

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