The DxF Data Sharing Agreement (DSA) and its Policies and Procedures govern and require the Exchange of Health and Social Services Information under the DxF only among signatories to the DxF DSA. The DxF does not prohibit Exchange among nonsignatories or between signatories and non-signatories, whether or not the Exchange is facilitated by a QHIO. QHIOs and other Intermediaries assisting Participants to meet their DxF requirements should review their Business Associate Agreements (BAAs) and other agreements with their customers, as well as Applicable Law, in determining what Exchange they can facilitate among signatories and non-signatories to the DxF DSA.

The DxF does not prohibit a QHIO who receives an Admission or Discharge Event or Notification of an Admission or Discharge from a DxF signatory from sharing any notification of the Event with a non-signatory, so long as the Exchange is permitted by Applicable Law and relevant BAAs or other agreements the QHIO has with its customers.