Participants may comply with the DxF by participating in and sharing information with a QHIO. However, just signing up to use a QHIO does not guarantee compliance with the DxF DSA and all of its P&P requirements. QHIOs offer access to critical services compliant with DxF technical standards requirements and have established critical connectivity that may help Participants comply with their obligations to provide Access to or Exchange of Health and Social Services Information (HSSI). It remains the responsibility of each Participant to ensure that they comply with requirements of the DxF DSA and its P&Ps beyond the technical standards enabled by using a QHIO by reviewing and complying with P&Ps including but not limited to: 
The Permitted, Required, and Prohibited Purposes Policy and Procedure for the purposes for which the Participant may and must share HSSI,  

• The Privacy Standards and Security Safeguards Policy and Procedure for information on privacy and security standards the Participant’s Systems must meet,  

• The Data Elements to Be Exchanged Policy and Procedure for information on data elements the Participant must make available,  

• The Technical Requirements for Exchange Policy and Procedure for the types of Exchange a Participant must enable, and  

• The Real-Time Exchange Policy and Procedure for information on the requirements for timely information sharing. 

All P&Ps listed above can be found on the Policies and Procedures section of the DxF website.