Carequality

What Carequality does

Carequality is a U.S. 501(c)(3) non-profit founded in 2014 and headquartered in Vienna, Virginia, that operates a nationwide, consensus-built interoperability framework enabling health information exchange between and among health data-sharing networks. Its core product, the Carequality Interoperability Framework, is a collection of legal terms, policy requirements, governance structures, and technical specifications that operationalize trusted national health data exchange across query-based document retrieval, FHIR-based exchange, and push notifications. Carequality maintains a centralized directory of 100,000+ implementer connections and a governance apparatus including a Delegation of Authority policy, a Restricted Participant List, and a formal Dispute Resolution Process to enforce trust and accountability among participants.

Carequality's customer base comprises Implementers—EHR vendors (Epic, athenahealth, eClinicalWorks, NextGen), national and regional HIEs (CommonWell Health Alliance, eHealth Exchange, CRISP), payers (Surescripts), clearinghouses, and emerging health technology firms—who provide connectivity services to provider organizations. End users include 600,000+ physicians, 50,000+ clinics, and 4,200+ hospitals exchanging over 1.5 billion clinical transactions per month. The organization is a subsidiary/affiliate of The Sequoia Project and is governed by a multi-stakeholder Board of Directors and Steering Committee. Revenue is generated through implementer membership/participation fees under a subscription/recurring model; specific pricing is not publicly disclosed.

The company distributes its framework indirectly through its Implementer network rather than via direct enterprise sales, with providers connecting through a single Implementer gateway to access all other participants nationwide. Carequality pursues community engagement via bimonthly informational calls, a joint annual meeting with The Sequoia Project, HIMSS conference participation, public regulatory comments, and content marketing. Recent strategic activity (2025-2026) includes governance modernization (Delegation of Authority, Restricted Participant List, revised Dispute Resolution), a leadership transition to Executive Director Lee Barrett, and deepening alignment with the CMS Digital Health Ecosystem and TEFCA.

Name

Carequality

Legal name

Carequality, Inc.

Website

https://carequality.org

Company type

Private

Founded year

2014

Operating status

Operating

Headcount range

11–50 employees

Short description

Carequality is a U.S. 501(c)(3) non-profit operating a nationwide interoperability framework that enables trusted health information exchange among EHR vendors, HIEs, payers, and providers, connecting 600,000+ physicians across 4,200+ hospitals.

Ownership category

akta.pro rank

Product category

Healthcare Interoperability

NAICS

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518), Health Care and Social Assistance (62)

SIC

Services-Computer Programming, Data Processing, Etc. (7370), Services-Health Services (8000)

akta.pro primary industry

Interoperability Standards, Profiles & Implementation (HL7/FHIR/IHE) (HLACABAA)

akta.pro secondary industries

Data Access, Sharing & Marketplace Platforms (incl. TEFCA/QHIN enablement) (HLACAIAL), Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK), Consent, Authorization & Data Sharing Governance (opt-in/opt-out, DS4P) (HLACABAG)

Keywords

• Health information exchange
• Healthcare interoperability
• Clinical data sharing
• Interoperability framework
• EHR data exchange

Headquarters

HQ city

Vienna

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Implementer Membership/Fees: Carequality generates revenue through fees from Implementers who join and participate in the Carequality Interoperability Framework. Implementers include EHR vendors, HIEs, payers, clearinghouses, and other health IT organizations that provide connectivity services to providers.

Go-to-market motion1 record

Distribution channels3 records

Marketing channels6 records

Core offering

Carequality operates a national-level, consensus-built interoperability framework consisting of legal terms, policy requirements, governance, and technical specifications that enable health information exchange between and among health data-sharing networks. Its offerings include Query-Based Document Exchange, FHIR-Based Exchange, Push Notifications, and governance mechanisms such as the Delegation of Authority Policy, Restricted Participant List, and Dispute Resolution Process, supporting over 1.5 billion monthly transactions across 4,200+ hospitals and 50,000+ clinics.

Product overview

Carequality is a non-profit interoperability framework that provides a national-level, consensus-built common framework enabling health information exchange between and among health data-sharing networks. The Carequality Interoperability Framework consists of legal terms, policy requirements, governance, and technical specifications that operationalize data sharing. Core offerings include Query-Based Document Exchange (supporting over 1.5 billion transactions monthly), FHIR-Based Exchange, and Push Notifications. Trust and governance is maintained through the Delegation of Authority Policy, Dispute Resolution Process, and Restricted Participant List. The framework connects 43+ implementers including major EHR vendors, HIEs, payers, and clearinghouses, enabling exchange across 600,000+ physicians, 50,000+ clinics, and 4,200+ hospitals.

Differentiator

Problem solved

Functional benefit

Products and services

• Carequality Interoperability Framework A national-level, consensus-built, common interoperability framework providing legal terms, policy requirements, governance, and technical specifications for trusted national health data exchange between and among health information networks. Used by EHR vendors, HIEs, payers, clearinghouses, and provider organizations.
• Query-Based Document Exchange

Quantifiable outcome

• 1.5 billion+ monthly transactions
• +4 more outcomes

Named customers5 records

Segments4 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Ten partnerships are on record, tiered core and flagship.

• CMS Digital Health EcosystemcoreStrategic or Co-development Partner · 9 April 2026Carequality supports CMS data network pledgees in the Digital Health Ecosystem. 52% of early CMS data network adopters are Carequality implementers, and more than a quarter of Carequality implementers have taken the CMS data network pledge.
• MyDirectivescoreStrategic or Co-development Partner · 2 December 2025MyDirectives and HIT Commons partnered with Carequality and eHealth Exchange to enable nationwide access to validated Oregon POLST forms through Carequality, integrated within healthcare workflows using Epic EHR.
• EpiccoreTechnology or IntegrationEpic is a major EHR vendor and Carequality Implementer, providing its customers connectivity to the Carequality interoperability network for seamless health data exchange with other participating organizations.
• athenahealthcoreTechnology or Integrationathenahealth serves as a Carequality Implementer, enabling their healthcare provider customers to exchange clinical data with other Carequality participants across the network.
• eClinicalWorkscoreTechnology or IntegrationeClinicalWorks is a Carequality Implementer providing interoperability services to its customers through the Carequality framework.
• CommonWell Health AlliancecoreTechnology or IntegrationCommonWell Health Alliance is a Carequality Implementer and network focused on health data exchange and care coordination.
• eHealth ExchangecoreTechnology or IntegrationeHealth Exchange is a Carequality Implementer enabling nationwide health data exchange across healthcare organizations.
• CRISPcoreTechnology or IntegrationCRISP (Chesapeake Regional Information System for our Patients) serves as a Carequality Implementer, providing HIE connectivity services.
• The Sequoia ProjectflagshipStrategic or Co-development PartnerThe Sequoia Project is the parent organization of Carequality. Both organizations hold joint Annual Meetings and collaborate on interoperability initiatives including TEFCA support. Lee Barrett serves as Executive Director of Carequality while also having previously served on The Sequoia Project board.
• SurescriptscoreTechnology or IntegrationSurescripts is a Carequality Implementer leveraging the network for health data exchange capabilities.

Scale indicators9 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• eHealth Exchange: eHealth Exchange is a nationwide health information exchange network operated as a Carequality Implementer that also functions as a QHIN under TEFCA. It is the most direct peer, providing comparable query-based clinical document exchange across federal, state, and private-sector participants.
• CommonWell Health Alliance: CommonWell Health Alliance is a vendor-led HIE network and Carequality Implementer providing nationwide clinical data exchange across its EHR vendor members. It operates a parallel connectivity framework that competes for the same implementer relationships and provider use cases.
• DirectTrust: DirectTrust is a non-profit industry alliance that establishes trust and accreditation frameworks for directed health information exchange (Direct messaging, identity, certificates). It is directly comparable as a consensus-built, non-profit trust framework serving the same healthcare ecosystem.
• The Sequoia Project: The Sequoia Project is Carequality's parent organization and operates as the Recognized Coordinating Entity (RCE) for TEFCA. It is directly comparable as the umbrella non-profit advancing nationwide interoperability and the formal liaison to federal health IT policy.

Emerging players

• Health Gorilla: Health Gorilla is a Carequality Implementer and QHIN-designated interoperability platform focused on clinical data exchange, FHIR APIs, and lab connectivity. It overlaps with Carequality as an emerging exchange network targeting payers, providers, and digital health developers.
• Redox: Redox is a Carequality Implementer providing API-based healthcare interoperability services. It is an emerging player offering developer-friendly data exchange infrastructure that complements or competes with portions of Carequality's framework depending on use case.
• Kno2: Kno2 is a Carequality Implementer offering cloud-based interoperability for providers, payers, and post-acute care. It is an emerging exchange player focused on smaller providers and behavioral health, overlapping with Carequality's reach into underserved segments.
• Particle Health: Particle Health is a Carequality Implementer providing a clinical data API for payers, digital health, and life sciences. It is comparable as an emerging player monetizing record retrieval on top of Carequality's exchange infrastructure (and was the subject of Carequality's first formal dispute resolution in 2024).

Broad incumbents

• Epic Systems: Epic is both the dominant EHR vendor and a core Carequality Implementer with its own Care Everywhere network. It is a broad incumbent whose interoperability strategy sits on top of and partially competes with Carequality's framework for provider-to-provider exchange.

Regional players

• CRISP (Chesapeake Regional Information System for our Patients): CRISP is a Maryland-based regional HIE and Carequality Implementer providing statewide clinical data exchange. It is comparable as a regional HIE that participates in Carequality while also operating its own connectivity services across the mid-Atlantic.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks7 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/carequality

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Carequality