The DURSA is a comprehensive, multi-party trust agreement that is entered into voluntarily by public and private organizations (eHealth Exchange Participants) that desire to engage in electronic health information exchange with each other as part of the eHealth Exchange.

The DURSA builds upon the various legal requirements that Participants are already subject to and describes the mutual responsibilities, obligations and expectations of all Participants under the Agreement. All of these responsibilities, obligations and expectations created a framework for safe and secure health information exchange, and are designed to promote trust among Participants and protect the privacy, confidentiality and security of the health data that is shared.

The DURSA is based upon the existing body of law (Federal, state, local) applicable to the privacy and security of health information and is supportive of the current policy framework for health information exchange. The DURSA is intended to be a legally enforceable contract that represents a framework for broad-based information exchange among a set of trusted entities. The Agreement reflects consensus among the state-level, federal and private entities who were involved in the development of the DURSA regarding the following issues:

  1. Multi-Party Agreement
  2. Participants Actively Engaged in Health Information Exchange
  3. Privacy and Security Obligations
  4. Requests for Information Based on a Permitted Purpose
  5. Duty to Respond
  6. Future Use of Data Received from Another Participant
  7. Respective Duties of Submitting and Receiving Participants
  8. Autonomy Principle for Access
  9. Use of Authorizations to Support Requests for Data
  10. Participant Breach Notification
  11. Mandatory Non-Binding Dispute Resolution
  12. Allocation of Liability Risk


Current eHealth Exchange DURSA:

Current DURSA Version (dated 9/30/2014)

DURSA Policy Assumptions

The eHealth Exchange DURSA is currently going through the Amendment Process.  Please note that the Coordinating Committee has changed the Target Effective Date.  The New Target Effective Date is: October 1, 2018.  We will provide additional updates to the community in the coming weeks.

The following Redline Drafts are provided for review:

2018 DURSA Amendment Redline – APPROVED DRAFT – DOC (May 2018)

All Participant Call / DURSA Amendment Summary Presentation – APPROVED DRAFT – PDF (May 2018)

All Participant Call / DURSA Amendment Summary Presentation – Webinar Recording (Mar 2018)


Previous DURSA Versions and Webinars 

Previous Version (dated May 2011, sunset as of 9/29/2014)

Previous Version (dated November 2009, sunset as of 11/14/2011)

Overview of Changes: Redline version – Final Amended DURSA (dated May 2011) Presentation

DURSA Policy Assumptions Summary (dated May 2011)

DURSA Overview Webinar Presentation – PDF (2017)

DURSA Overview Webinar Recording – Video (2017)