On Friday, the Connecting for Better Health coalition convened several representatives from various health care organizations for a discussion on the need to accelerate the adoption of a statewide health data exchange in California.
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The focus of this conversation was to gain input from these representatives on the implementation of Section 340 of Assembly Bill 133, or the Budget Trailer Bill on Health, that passed in the 2021 legislative session. This legislation requires the California Health & Human Services Agency (CalHHS) to establish the CalHHS Data Exchange Framework by July 1, 2022.
Katie Heidorn, moderator of the conversation and executive director of Insure the Uninsured Project (ITUP), said CalHHS has been working with a great sense of urgency due to its extremely tight timeline. The Data Exchange Stakeholder Advisory Group organized by CalHHS has been meeting regularly, as CalHHS is required to submit an update to the legislature based on input from the stakeholder advisory group no later than April 1, 2022.
As specified in the statute, hospitals, physician organizations, medical groups, labs, skilled nursing facilities, health plans and insurers, and acute psychiatric hospitals will have to implement the data sharing agreement framework by Jan. 31, 2023.
Larger health system participants will be required to exchange health information in real time by Jan. 31, 2024, and smaller health systems will be required to do this by Jan. 31, 2026.
Heidorn said county health, public health, and social services departments would also be encouraged to participate in the framework.
She went on to share numerous benefits that a statewide data exchange would provide the health care landscape in California, as well as the challenges that come along with it.
She said data sharing would enable care coordination among providers for better patient care, the promotion and facilitation of population health management, and the reduction of racial and ethnic health disparities. She added it would also make health care delivery more efficient and reduce medical error, allow patients and providers to access a patient’s full health history, and improve public health emergency responses.
However, Heidorn also mentioned that numerous patient privacy concerns would come up as a result of data sharing, as there are many conflicting state and federal laws and regulations around information sharing.
The law specifies the framework as technology agnostic–it does not mandate what type of technology should be used. The law simply requires that the framework provides for the exchange of health information among health care entities and government agencies in California–regardless of the technology used to do so.
Through this conversation, stakeholders were able to share what they believed should be priorities in the development of the framework, and opportunities they have seen in their own experiences as health care professionals that make the case for statewide data exchange.
Dr. Stanley Frencher, medical director of surgical quality outcomes at Martin Luther King Jr. Community Hospital, said the exchange would affect his work on a daily basis.
“When I see a patient [who I performed a procedure on] show up to the emergency room … the emergency room doctor has no idea what I did for that patient because they don’t have the information readily available at their fingertips. So as a provider, it’s really important for us to think not just of what’s in the health information exchanges, but also how that’s delivered at the point of care for us so that it’s something that appears to be useful and helpful when delivering care to the patient in that moment … So much of the need for us to care effectively depends on all the data that’s been obtained prior to us seeing the patient. Otherwise, that care becomes redundant, duplicative, and typically wasteful.”
Mohit Ghose, senior director of government relations at Anthem, also believed that a data exchange would be significantly beneficial for both the patient and provider communities.
“We want to be able to meet our patients where they want to be met … We really want to be able to create a system where there’s actionable information at the point of service. We find that if you have the right information, and you have the right evidence base to work from, then the care being provided at every level within the system hopefully will get better. And when you look at this through the lens of access, equity, cultural competency–all of those things come into play, but in order to make it work, you actually need to have the data at your fingertips.”
He added that Anthem was interested in working with all of the stakeholders, including those participating in the webinar, and the state itself, to ensure the funding is being used to build a long-term sustainable infrastructure for health information exchange.
Dr. Michael Fu, national director of behavioral health at Hazel Health, saw behavioral health in schools as another opportunity for a health information exchange to aid providers.
“As you can imagine, we’re talking about health care exchange for health systems, so school is not even part of that, but there’s so much potential. You have such tremendous opportunity to inform others, to understand what is going on in that student’s life … to create treatment plans or care plans or to continue them. For us, unfortunately there are barriers to that, and we don’t have a lot of information.”
He said data exchange would also improve experiences for behavioral health patients who are constantly required to communicate their traumas to different providers.
Erin Jackson-Ward, director of the Community Benefit Giving Office at Cedars Sinai Hospital, said data sharing is critical to achieving the goals of CalAIM, particularly related to the social determinants of health.
“In order to address the social determinants of health of [CalAIM] members, a lot of different systems are involved … everything from food services, to housing, to mental and behavioral health care are all on different systems … in order to achieve that first goal of CalAIM … I think that data sharing is critical.”