CDII will assess any organization, including a Trusted Exchange Framework Qualified Health Information Network (QHIN) or nationwide network or framework if it applies to become a QHIO. Only organizations that apply for QHIO status during the open application period will be granted QHIO status. The QHIO application period may be offered by CDII annually, but not more often than once a year.

DxF Participants are not required to use a QHIO, and may use “any health information exchange network, health information organization, or technology that adheres to [DxF] standards and policies” as stated in HSC 130290(a)(2). According to the QHIO P&P, CDII will create a QHIO Program as an option that may help a Participant meet all of their DxF obligations. If a Participant chooses an option other than a QHIO, it is up to the Participant to ensure that the health information exchange network, health information organization, or technology they select adheres to DxF standards and policies