FAQs About NC HealthConnex Participation

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The participation agreement is the legal contract that governs data sharing between the health care provider and N.C. Health Information Exchange Authority. This agreement can be found on the NC HealthConnex website with instructions for completion.

The full participation agreement, which is aligned with the eHealth Exchange Data Use and Reciprocal Support Agreement, allows providers full use of current and future NC HealthConnex value-added features and satisfies the state requirement to submit, at a minimum, clinical and demographic data for the provision of health care services paid by state funds. Organizations with a full participation agreement may submit data to NC HealthConnex either through a unidirectional connection or a bidirectional data connection. Full participants with a unidirectional connection can access patient data using the NC HealthConnex clinical portal. Bidirectional or electronic health records-integrated participants view NC HealthConnex clinical data within their EHR.

The submission-only participation agreement enables a provider to submit the clinical and demographic data required by law in a unidirectional technical connection to be in compliance with the Health Information Exchange Act. However, this agreement prohibits all other data exchange services, including HIE data query and response of patient records, clinical and event notifications and public health registries. Participants with a submission-only agreement should consult with legal counsel prior to sending data that does not pertain to health care services paid for with state funds pursuant to the HIE Act. Being able to only submit state-funded data also depends on the technical capability of your EHR vendor to implement data filtering.

Note: Providers may use either agreement to submit state-required data. The primary difference between the two agreements is whether or not the health care provider wants to be able to view longitudinal patient records and utilize the additional services offered by NC HIEA. If so, providers should sign the full agreement.

The health care entity signs the participation agreement on behalf of the practice or facility. Individual providers who are part of a health care system or larger practice should ensure that their organization is a participant. Find a complete list of participants.

There are two primary differences between the submission-only and the full participation agreement.

  • The submission-only participation agreement does not include a business associate agreement, so providers are neither able to access to patient longitudinal health records nor can they utilize any services provided by NC HealthConnex. Some of these services include NC*Notify, an event notification service, as well as participation in registries to meet meaningful use and promoting interoperability requirements. The submission-only agreement also requires that the EHR have the technical capability to implement data filtering, which may come at a cost to participants. Participants with a submission-only agreement should consult with legal counsel before sending data not pertaining to health care services paid for with state funds pursuant to the Health Information Exchange Act (e.g., Medicaid, N.C. State Health Plan, N.C. Grant Funding).
  • The full participation agreement provides for a business associate relationship between the N.C. Health Information Exchange Authority and the provider organization. With this agreement, providers* can query and access patients’ longitudinal records and utilize all NC HealthConnex services at no additional fee. They may also send all patient data to support whole-person care or choose to send only state-required data. Note: A bidirectional interface is not required with this agreement.

Note: Some mental health provider organizations’ service offerings may be limited due to 42 CFR Part 2 regulations. The NC HIEA provider relations team can answer more specific questions if you fall under 42 CFR Part 2.

Participating entities are organizations that a participant controls, that are under common control with a participant or that share information or electronic health records systems with a participant and who the main participant organization will submit patient data to NC HealthConnex on behalf of.

A participating entity may also be a natural person or business entity with whom the participant has a direct or indirect business or employment relationship, including any person or entity provided a license or right to access and use any of a participant’s EHR product, software and services. Participating entities may elect to submit health information exchange data to NC HealthConnex under a single participant or as multiple separate participants.

For instance, an integrated health system may own or license EHR software to several hospitals, ambulatory clinics and residential facilities within its organization. The larger health system organization could be considered the participant organization, while the other facilities it owns or has a business relationship with would be the participating entities.

It is very important that each organization lists all its participating entities in its participation agreement to mark each facility as compliant with NC HealthConnex, better inform our outreach team about who is not yet connected to NC HealthConnex yet and help add more details about where patients were seen when submitting data.

The participant account administrator serves as the organization’s main contact to receive questions and communications from the N.C. Health Information Exchange Authority. The participant account administrator works with the NC HIEA Help Desk to manage the creation and deactivation of user accounts for the NC HealthConnex portal and direct secure messaging accounts and acts as the organization’s point person for questions and training on NC HealthConnex. This person must be a staff member of your organization.

A staff member who has the authority to sign contractual agreements on behalf of the practice, facility or organization can sign the participation agreement.

The participation agreement includes instructions on where the signatory must sign. The participation agreement is the legal document governing data use between the health care organization and N.C. Health Information Exchange Authority. Electronic health records vendors or business associates are not approved to sign agreements on behalf of their customers.

The participation agreement is an editable pdf document with form fields where information from your organization is needed. N.C. Health Information Exchange Authority prefers for this agreement to be both completed and submitted electronically to hiea@nc.gov. Note: If a provider chooses to use the form fill functionality, they must save the document before emailing it to hiea@nc.gov.

A participant may also decide to send the entire completed and signed participation agreement in a hard copy to the address below. However, email is preferred. NC HIEA does not require two copies.

The physical mailing address is:

N.C. Health Information Exchange Authority
Re: N.C. HIEA Participation Agreement
Mail Service Center 4101
Raleigh, NC 27699-4101

If the facility does not have an organization ID, our technical team, SAS, will provide one during development. A facility does not have to acquire one before onboarding.