The overall goal for the Trusted Exchange Framework and Common Agreement (TEFCA) is to establish a floor of universal interoperability across the country. The Common Agreement will establish the infrastructure model and the governing approach for users in different networks to securely share basic clinical information with each other—all under commonly agreed-to expectations and rules and regardless of which network they happen to be in.
https://www.healthit.gov/topic/interoperability/trusted-exchange-framework-and-common-agreement