Don’t believe the naysayers. Many see recent regulatory initiatives at the Federal level as a nail in the coffin for public Health Information Exchanges (HIEs). In particular, the push within the 21stCentury Cures Act to promote interoperability among health IT applications is seen as undermining HIEs. That push is real but looking deeper into Federal policies illustrates that related efforts like TEFCA support more nuanced differences of health data exchange and interoperability that promote a broad ecosystem of solutions - solutions that will be needed to assure we achieve the goals for healthcare transformation framed in the quadruple aims. According to HealthIT.gov, the Trusted Exchange Framework and Common Agreement (TEFCA), released on April 19, 2019, outlines a common set of principles, terms, and conditions to support the development of a Common Agreement that would help enable nationwide exchange of electronic health information (EHI) across disparate health information networks (HINs). The TEFCA is designed to scale EHI exchange nationwide and help ensure that HINs, health care providers, health plans, individuals and many more stakeholders have secure access to their electronic health information when and where it is needed. NextGen Healthcare is in an interesting position as a health IT provider that has both EHR and HIE offerings in the market. We see every day, at the front lines of healthcare, how interoperability and health information exchange add value to the quality and outcomes of care delivered across the country. It is true that advanced interoperability standards emerging through 21st Century Cures will enable clinicians to more easily query information on individual patients in their care to assure they are fully informed about patient’s care history overtime. And we think that is great. These queries are permissible because the provider is actively caring for that individual. They can’t however, query information on individuals not in their care or receive alerts on patients seen elsewhere through the query process.