> ## Documentation Index
> Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Promoting Interoperability (MIPS 2026) - Enabling exchange under the Trusted Exchange Framework and Common Agreement (TEFCA)

## Measure Details

This measure is an alternative measure in the Health Information Exchange Objective in the Promoting Interoperability category and is not a required measure. The alternate measures for this are:

* [Sending & Receiving Health Information](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information) (2 measures with performance numerator/denominator metrics)
* [Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2026-Health-Information-Exchange-HIE-Bi-Directional-Exchange) (attestation to engagement of a bidirectional exchange)

## Measure Parameters

The MIPS eligible clinician or group must attest to the following:

* Participating as a signatory to a Framework Agreement (as that term is defined by the Common Agreement for Nationwide Health Information Interoperability as published in the Federal Register and on ONC’s website) in good standing (that is, not suspended) and enabling secure, bi-directional exchange of information to occur, in production, for every patient encounter, transition or referral, and record stored or maintained in the EHR during the performance period, in accordance with applicable law and policy.
* Using the functions of CEHRT to support bi-directional exchange of patient information, in production, under this Framework Agreement.

## Elation Workflows

For 2026, Elation Health offers an [integration with Zus Health](https://partners.elationhealth.com/partners/zus-health) as an additional partner with an associated cost. Zus participates in TEFCA by querying the CommonWell QHIN.

## Related Articles

* [MIPS (2026) Overview](/articles/MIPS-2026-Overview)
* [Promoting Interoperability - Health Information Exchange (Sending & Receiving)](/articles/Promoting-Interoperability-MIPS-HIE-Sending-Receiving-Health-Information)
* [Promoting Interoperability (MIPS 2026) - Health Information Exchange (HIE) - Bi-Directional Exchange](/articles/Promoting-Interoperability-MIPS-2026-Health-Information-Exchange-HIE-Bi-Directional-Exchange)