<img height="1" width="1" style="border-style: none;" alt="" src="//googleads.g.doubleclick.net/pagead/viewthroughconversion/1064346053/?value=0&amp;guid=ON&amp;script=0">

Carequality Framework for Imaging Data Exchange and Interoperability

person looking at graphs on laptop


Healthcare IT and its standards have often behaved like silos of information, with data extraction and exchange being one of the recurring pain areas of payers and providers, due to disparate information exchange formats & PHI concerns.

Interoperability is essential to guarantee that doctors, surgeons, and other medical providers have the right data at the right time to provide quality care, while also enabling population health and advanced analytics initiatives.

Even CMS and ONC have stepped up their efforts for universal interoperability through their focus on standardized FHIR API based approach for future EHR certifications. But even in the current scenario there are many frameworks and alliance which seek to ensure seamless interoperability, at least amongst their participating members.

These frameworks and associations are endeavoring to increase data exchange for smooth data accessibility. Various trusted health information exchange networks such as Carequality, Qualified Health Information Network (QHIN), Trusted Exchange framework and Common Agreement are evolving. Carequality framework is one of the most established networks trusted by many EHR, Providers, Payers & different other medical health information vendors.

About Carequality

Carequality is non-benefit, autonomous enterprise supported by the Sequoia Project. Its ‘Carequality Interoperability Framework’ considers multiple factors, to provide a practical approach and build a specialized system for – verification and confirmation, vocabulary and message guidelines, delivery conventions, registries and security. The framework allows information exchange between different networks as per query-based document exchange guidelines.


Empower healthcare information exchange between health systems, health IT organizations, payers and providers. The proposed interoperability and information sharing methodology eliminates the need to partner with various networks. Carequality aims to improve scale and efficiency of information exchange by establishing confided exchange guidelines and business rules.


The framework has been established for more than a year and now exchanges healthcare information across different networks. Recently, Carequality has proposed new framework to augment the current query-based document exchange to enable DICOM imaging information exchange over their system. Currently, information sharing between systems occur through query-retrieve functions and plan on enabling information access through HL7 and FHIR.

For query-based image exchange, Carequality relies on IHE XCA and XCA-I profiles. Its imaging data exchange implementation guide explains how it has consolidated various technical solutions to enable sharing of imaging data over the network analogous to document exchange. The implementation guide has adjusted the extra transactions with current norms by posting the imaging exchange endpoints in the Carequality registry. This would enable members to offer imaging datasets who agree to the necessities of the query-based information exchange guidelines.

Key participants

EHR vendors such as EPIC, Surescripts, HIE community, etc. have initiated the exchange of documents by implementing the Carequality framework in their network of healthcare providers, clinics, healthcare delivery providers and Health IT vendors.

One of the key participants is the Commonwell health alliance which permits data exchange between dissimilar IT frameworks and care providers. It has a large network of healthcare providers and vendors such as Cerner, Brightree, Evident, Meditech, etc. which have adopted the framework to exchange about 36 Million+ documents per month.

With 1,700+ Hospitals and 40,000+ clinics in its network, Carequality has provided more and better access to patient records to improve value of care and patient safety.


The Document Exchange Guide for Carequality is live and more use-cases are planned. Carequality framework is aligned with ONC’s goal for Trusted Exchange Framework (TEFCA) and Common Agreement to support nationwide connectivity, availability and scalability.

Carequality will be accepting public comments on their new Imaging Data Exchange Implementation Guide till September 9, 2019. These comments would be shared with the committee for further amendments.


To become part of Carequality network, Health Information Exchange (HIE) networks, payers system and provider organizations need to follow industry principles such as FHIR and IHE profiles for information trade. These associations would profit by associating with Healthcare IT organizations that are equipped for innovation overhauls and have proficiencies in interoperability principles and governing necessities.

The right IT partner should have expertise in interoperability, security, administrative prerequisites, including a wide portfolio of working with HIE networks to effectively conform with the framework. Since the framework is at a nascent stage, the technical requirements necessary to participate would be minimal.

Use cases

For Healthcare Entities

  • Health Information Networks: Connect participants with multiple providers and share patient information on need to know basis.
  • Public Health Organizations and Government Agencies: To access public health records across registries, promote and protect the public health services.
  • Providers and Payers: Individuals, payers, providers, health information organizations and technology developers can become a part of the Carequality to access and exchange health information across networks to provide better care and take informed decisions.
  • Patients: Ability to access their information seamlessly while changing providers, across state boundaries, enabling better care decisions.

For Clinical Workflows

  • Seamless Imaging Workflows: The Imaging Data Exchange would enable vendor neutral network to share and access DICOM data anytime, anywhere. Imaging technology organizations would need to comply with the technical requirements of the framework to enhance the healthcare systems and provide better care.
  • Increased Interoperability: The Carequality framework is the next step in achieving interoperability by collaborating with network of networks at a nationwide level in Healthcare ecosystem. The nation-wide participation of health IT vendors is ensuring the framework’s success and has spread across 40,000+ clinics, managing 36+ Million documents per month.
  • Regulatory Compliance: The framework will also enable health systems to easily attest to the information blocking requirements proposed in the 21st century cures legislation. Other regulations like MACRA and ONC certifications are also increasingly focused towards increasing interoperability and are making seamless data exchange their top focus area.


Related to topics:

Explore other blogs

CMS 21st Century Cures IPA Rule & its Impact on State Health Agencies
CMS 21st Century Cures IPA Rule & its Impact on State Health Agencies
Analytics Opportunities for Payers from CMS Regulations
Analytics Opportunities for Payers from CMS Regulations
Payviders: Enhancing the member experience by creating more personalized digital touchpoints I Part 2 of 2
Payviders: Enhancing the member experience by creating more personalized digital touchpoints I Part 2 of 2


No items currently match your filtering criteria.