There is some major news in the world of California health information exchange initiatives. 

Governor Newsom recently signed AB 133 into law which lays the groundwork for building a single data sharing agreement that governs the exchange of health information in California. A new Stakeholder Advisory Group will assist the California Health and Human Services (CHHS) develop an initial Framework by June 2022 with an initial deadline for full participation from health providers in the exchange of data in January 2024. 

AB 133 provides CHHS with the authority to establish a data exchange framework with the goal of improving health information sharing across both the health and social service systems. These data-sharing initiatives aim to improve care delivery, protecting public health, and guiding policy, and promoting equity. 

 Secretary Ghaly commented on the significance of the framework announcement:

“The COVID-19 pandemic has made clear to Californians how important it is for health data to be quickly and seamlessly shared among health professionals and institutions. The exchange of health information will be even more critical as the state moves forward with efforts to provide ‘whole person care’ through CalAIM, major new homelessness initiatives, and other programs aimed at connecting health and social services — from Cradle-to-Career to the Master Plan for Aging.”

“To improve health outcomes for all Californians, all health care providers and government and social service providers need to be able to safely and securely share health information. That is the goal of the Data Exchange Framework, and we will need all of the expertise of our stakeholders from across the state’s health care and human services systems to build it.”

“I appreciate the members of the Stakeholder Advisory Group for their willingness to provide their assistance — and put California on a path to sharing data that will build a healthy California for all.”¹

There is an upcoming stakeholder advisory group meeting scheduled for August 31st, 2021 at 9:30 AM PST. You can find the full meeting agenda here, and to listen in, you can join the meeting directly via Zoom meeting link here. 

Timeline:

Initial Data Exchange Framework

By July 1, 2022, the state will establish a single data sharing agreement and common set of policies and procedures that will govern and require the exchange of health information among health care entities and government agencies in California. This effort will be guided by a Stakeholder Advisory Group, which will provide information and advice to CHHS.

Public health/social services integration

By January 31, 2023, CHHS and the California State Association of Counties will encourage as many county health, public health, and social services providers to connect to the Data Exchange Framework—with all state and local public health agencies exchanging health information in real time with participating health care entities.

Data sharing agreement

By January 31, 2023, the Data Exchange Framework data sharing agreement will be executed by the following entities: General acute care hospitals, physician organizations and medical groups, skilled nursing facilities, health service plans and disability insurers, Medi-Cal managed care plans, clinical laboratories, and acute psychiatric hospitals.

Full implementation

By January 31, 2024, all participating entities will exchange health information or provide access to health information to and from every other entity in real time for treatment, payment, or health care operations. 

Stakeholder Advisory Group Members:

• Mark Ghaly (Chair), California Health and Human Services Agency
• Greg A. Adams, Kaiser Permanente
• Jamie Almanza, Bay Area Community Services
• Charles Bacchi, California Association of Health Plans
• Robert Beaudry, California Primary Care Association
• Michelle Doty Cabrera, County Behavioral Health Directors Association of California
• Colleen Chawla, County Health Executives Association of California
• Dustin Corcoran, California Medical Association
• Craig Cornett, California Association of Health Facilities
• Carmela Coyle, California Hospital Association
• Don Crane, Americas Physician Groups
• Liz Gibboney, Partnership HealthPlan of California
• Lori Hack, California Association of Health Information Exchanges
• Alma Hernández, SEIU California
• David Lindeman, UC Center for Information Technology Research in the Interest of Society
• Paul Markovich, Blue Shield of California
• Erica Murray, California Association of Public Hospitals and Health Systems
• Art Pulaski, California Labor Federation
• Karen Relucio, California Conference of Local Health Officers
• Mark Savage, Savage Consulting
• Kiran Savage-Sangwan, California Pan-Ethnic Health Network
• Cathy Senderling-McDonald, County Welfare Directors Association
• Claudia Williams, Manifest MedEx
• Anthony E. Wright, Health Access California
• William York, San Diego Community Information Exchange

State Agency Partners

In addition to the new Stakeholder Advisory Group, CHHS will also collaborate closely and bring to bear the expertise of a number of other state agencies, whose work will be critical to the success of the Data Exchange Framework:

• California Business, Consumer Services and Housing Agency
• California Health Benefit Exchange
• California Public Employees’ Retirement System
• Department of Corrections and Rehabilitation
• Department of Health Care Access and Information
• Department of Health Care Services
• Department of Insurance
• Department of Managed Health Care
• Department of Public Health
• Department of Social Services
• Emergency Medical Services Authority

Context from the CHHS

While parts of California’s health care system rely on coordinated, interoperable electronic systems, other parts rely on decentralized, manual, and siloed systems of clinical and administrative data exchange that is voluntary in many situations. This voluntary patchwork imposes burdens on providers and patients, limits the health care ecosystem from making material advances in equity and quality, and functionally inhibits patient access to personalized, longitudinal health records. Further, a lack of clear policies and requirements to share data between payers, providers, hospitals, and public health systems is a significant hindrance to addressing public health crises, as demonstrated by challenges inherent to the COVID-19 pandemic.

Despite the widespread availability of secure electronic data transfer, a small but important minority of Californians’ medical information is stored or shared on paper. When that medical information is shared between providers, much of it happens by mail, fax, or, most likely, by the patients themselves, who frequently carry their records from appointment to appointment. While electronic health information exchange cannot replace provider-patient communication, it can greatly improve the completeness of patient records, which has a significant effect on health and wellness outcomes, as past history, current medications, and other information are jointly reviewed during appointments.

Social and economic factors distinct from medical care are powerful predictors of health outcomes and disease burden throughout a person’s life. From a population health perspective, this means that evidence-based policies that affect the broader conditions in which people are born, grow, and live can exert a powerful influence on health and well-being. From an operational perspective, data-driven efforts to better coordinate human and social supports with the medical and health care sectors provide opportunities to deliver services that are more client centered, efficient, effective, and tailored.²

Zen’s Perspective on the Significance

Zen is extremely pleased that there is finally some movement in CA to drive more data exchange in our state. Zen President, Marilee Benson, participated in brainstorming sessions (prior to the pandemic) with key stakeholders in CA to identify potential HIE drivers and it’s very exciting to finally see some progress. Certainly COVID-19 has validated the critical role Health Information Exchanges play in public health and hopefully has helped remove some final barriers to statewide cooperation around health information exchange.

We know first hand the value of these state level frameworks and data sharing initiatives as we have seen the direct results of similar initiatives in other states in improving the quality of care and supporting public health initiatives.

We look forward to helping California based organizations implement data sharing in conjunction with the new framework as that comes into focus.

If you would like to speak with our team of interoperability experts to discuss how you can best prepare for the future requirements, please click the link below or you can email us directly at info@consultzen.com.

Reference Articles: 

https://www.chhs.ca.gov/blog/2021/08/20/data-exchange-framework/¹

https://www.chhs.ca.gov/data-exchange-framework/²