Reciprocity on National Networks

The national networks run on a give-to-get model. When another organization on CommonWell, Carequality or TEFCA requests records for a patient you've written data for, Zus responds on your behalf. That response is how your organization meets its reciprocity obligations.

This page explains how Zus responds. For what you must contribute and when, see the Clinical Data Contribution Policy.

Which requests Zus answers

Network	Requests Zus responds to
CommonWell	Treatment
Carequality	Treatment
TEFCA	Treatment, and Individual Access Services (IAS): requests from patients for their own records

The requesting organization must match the patient's demographics before Zus returns any data.

What a response contains

Summary document

Zus builds a Continuity of Care Document (CCD) from the data your organization has written to Zus Responses include only the responding Builder's first-party data, not records Zus retrieved from the networks. The CCD incorporates these resource types:

AllergyIntolerance
Appointment
CarePlan
CareTeam
Condition
Consent
Coverage
DeviceUseStatement
DiagnosticReport
DocumentReference (see below)
Encounter
FamilyMemberHistory
Immunization
MedicationAdministration
MedicationDispense
MedicationRequest
MedicationStatement
Observation
Patient
Procedure
QuestionnaireResponse: included in the Social History section as a table of each question, its response and the response date. These are Social History observations, not structured assessment scale observations.

Clinical notes (DocumentReference):

A DocumentReference that references an Encounter in DocumentReference.context is included in the Encounters section. Other notes go in a Notes section.
Write note content as narrative text in DocumentReference.text, as Base64-encoded text in DocumentReference.content.attachment.data, or both.

Documents you've written

PDFs you write to Zus are available to the network by default
CDAs you write or that Zus retrieves from your EMR can be returned to the network in their original form. This functionality is off by default; please contact Support if you are interested in it.

Document titles

Documents Zus generates for these responses, including PDFs, are titled with your organization's name (for example, "Your Organization CDA").

What's never sent

Restricted data. Resources labeled Restricted or Very Restricted are withheld from network responses. See Specially Regulated Data.
Patients who opted out. See Patient Opt Out.

If your EMR responds for you

If your organization uses an initiator-only Delegate listing, your EMR responds to network requests through its own listing, and Zus doesn't respond for you [confirm wording].