Incentive programs and better data collection could help expand statewide health data exchange in California – State of Reform


Last week, the California Health and Human Services Agency (CalHHS) released its highly anticipated Data Sharing Framework, Data Sharing Agreement, and Initial Set of Policies and Proceduresin accordance with Assembly Bill 133 terms.

Along with the legal requirement to publish the Data Sharing Framework, Data Sharing Agreement, and Policies and Procedures by July 1, the agency used advice from the Framework’s Stakeholder Advisory Group CalHHS data exchange to publish a set of policy recommendations that the state can use as a roadmap for implementing a robust and effective statewide health information exchange system. These include establishing incentive programs for healthcare organizations and strict standards for the collection and use of demographic and social determinants of health (DSD) data.

Some key recommendations are listed below.

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Establish an electronic health record (EHR) incentive program

This incentive program would encourage the adoption of certified EHR technologies and clinical documentation technologies among healthcare organizations, as many health and human services organizations in California do not have the resources to invest in systems. of digital records necessary for the effective exchange of health information.

Establish a data exchange intermediary technical assistance and integration program

Many health and social service organizations will encounter technical, operational and financial barriers to establishing connections with data exchange intermediaries. This program would provide funding, incentives and technical assistance to help these organizations connect to a qualified data exchange intermediary.

Expand existing event notification requirements

Event notifications about changes in a person’s condition (such as admission, discharge, or transfer to a health care facility) for the primary care practitioner or care team of a person can be used to support the coordination and delivery of care. However, these notifications are often limited to a narrow set of participants and circumstances. CalHHS recommends that the state establish policies to expand the scope of existing event notification requirements to include additional health and human service organizations and notification types.

Upgrading California County’s Health Information Technology (HIT) Infrastructure

California health, public health, and human services agencies have various capabilities to electronically exchange meaningful information with other health and human services organizations. CalHHS recommends that the state expand federally funded programs to upgrade state and local health, public health, and social services information technology infrastructure so that these entities can more easily participate in the exchange of health information.

Establish demographic and SDOH data collection and use standards, requirements and incentives

Standardized demographic and SDOH data in California remains inconsistent and often incomplete. CalHHS recommends that the state establish demographic and SDOH data standards, requirements, and incentives to encourage the collection, sharing, and use of data among health and human services organizations in California. CalHHS also recommends that the state improve demographic and SDOH data sharing among state agencies, as well as send recommendations to the federal government to improve national standards for SDOH and demographic data sharing.

Establish a directory of suppliers and requirements for data reporting

Solid provider information, such as name, practice locations, and affiliated organizations, is not always available or accessible to all state health and human services organizations. CalHHS recommends that the state establish a statewide provider directory and require data sharing agreement signatories to provide data to promote provider communication and information sharing. about health.

Establish policies to ensure individuals have access to their longitudinal health information and policies to build trust among individuals sharing data

Individuals often face challenges when trying to access their health and social services records in a convenient way. CalHHS recommends that the state establish policies to ensure that individuals have timely and convenient access to their health information at all health and human services organizations that are under the data sharing agreement. Having constant access to this information will enable Californians to make informed decisions about their health care.

Establish a “universal” information release authorization form, implement electronic consent management, and promote alignment of federal and state regulations

CalHHS recommends that the state establish a “universal” information release consent form to enable standardized data exchange, as well as an electronic consent management service that will allow individuals to digitally manage their consents to share their information on health and social services. CalHHS also says the state should make efforts to align federal and state information-sharing requirements.

Leverage government, private and philanthropic funding sources

Many health and social service organizations face significant financial barriers to making the necessary investments in health information exchange. CalHHS recommends that the state identify and pursue federal, state, private, and philanthropic funding opportunities to fund data exchange efforts, such as CMS Medicaid Enterprise Systems Enhanced Funding, CMS Medicaid Matching Funds, CMS Waivers Medicaid and state taxes.

CalHHS and the Association of California Counties are required to encourage as many health, public health, and human service providers as possible to participate in the data exchange framework by January 31, 2023. Many entities, including gGeneral 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 psychiatric hospitals Treble will also be required to sign the data sharing agreement by January 31. , 2023.

The full implementation date is January 31, 2024, the date by which, according to CalHHS, all participating entities will exchange health information or provide access to health information to and from all other entities in real time for healthcare treatment, payment or operations.


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