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What is the Data Exchange Framework?

Every Californian, no matter where we live, should be able to walk into a doctor’s office, a county social service agency, or an emergency room and be assured health and human services providers can access the information they need to provide safe, effective, whole person care—while keeping our data private and secure. 

This is the goal of California’s Health and Human Services Data Exchange Framework, a first-ever, statewide data sharing agreement that will accelerate and expand the exchange of health information among health care entities, government agencies, and social service programs beginning in 2024.

The data exchange framework is not a new technology or centralized data repository; instead, it’s an agreement across health and human services systems and providers to share information safely. That means every health care provider can access the information they need to treat you quickly and safely; health care, behavioral health and social services agencies can connect to each other to deliver what Californians need to be healthy; and our public health system can better assess how to address the needs of all communities.

Hundreds of experts and members of the public have spent the last year shaping a framework that delivers on these principles. On this website, learn more about the progress toward seamless data exchange that will improve Californians’ experience of health care, support California’s whole-person care transformation, and put consumers in the drivers’ seat with our health data.

On July 5, 2022, CalHHS released the Data Exchange Framework, Data Sharing Agreement, and initial set of Policies and Procedures. Please see the Data Exchange Framework section for more information. View the Executive Summary.

Take Action

The Data Exchange Framework (DxF) is an opportunity to create equitable and affordable health information exchange, so that patients, providers, and other healthcare entities can access the health information they need, wherever they are and whenever they need it.

The DxF DSA Signing Portal is now open for providers and healthcare entities to take the first step for better health information exchange. The DSA is a signed agreement between hospitals, physician organizations and medical groups, skilled nursing facilities, health plans and disability insurers, clinical laboratories, and acute psychiatric hospitals to share patient information safely.

California Health and Safety code requires most providers and healthcare entities to sign the DSA by January 31, 2023.

Take the first step today. Visit the CalHHS Data Sharing Agreement Signing Portal to sign the DSA. 

Data Exchange Framework registration button

In the News

Health facilities to start sharing patient data with each other

  • Hospitals, public health agencies and other providers have no systematic way to share patient data among themselves, limiting their ability to monitor trends and work efficiently. Under the state’s new data-sharing requirement, a doctor or case worker could get immediate access to a patient’s full medical history, and patients could view their own records easily. Read more in this article from CalMatters.

A secure, trusted system of data exchange

  • “California has long been a leader in transforming health care, expanding coverage and improving access to care and social services for its residents. But to be successful, all of these initiatives require a reliable, secure, trusted system of data exchange so patients and providers can access the health information they need, wherever they are and whenever they need it.” Read more in this San Francisco Chronicle op-ed from Dr. Sandra Hernádez, CEO of the California Health Care foundation and HHS Data Exchange Framework Stakeholder Advisory Group Member.

Supporting whole-person care, health equity 

  • At the core of the data exchange vision is an “emphasis on health equity and center our health information efforts on the needs of Californians.” Read more in this California Health Care Foundation blog from John Ohanian, chief data officer and director for the Center for Data Insights and Innovation Office.
  • “This framework will be a pillar of support to our health system’s transition to providing whole-person care that addresses social determinants of health. It will be essential to the success of the state’s expansion of integrated care in Medi-Cal, to our major new homelessness initiatives, and to dozens of programs aimed at connecting health and social services, from the Cradle-to-Career California Data System to the Master Plan for Aging.” – Read more in this California Health Care Foundation blog from John Ohanian, chief data officer and director for the Center for Data Insights and Innovation Office.

Expert stakeholder advisory group 

  • News release announcing the formation of the Data Exchange Framework Stakeholder Advisory Group
Did you know? California's new Data Exchange Framework won’t replace the many Health Information Exchange systems already up and running across our state
California's progress on our bold vision of equitable, affordable, and whole person care will depend on seamless data exchange.
Making life-saving information available to health care providers when and where you need it is just one goal of California's #DataExchangeFramework

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 CalHHS.

Public health/social services integration

By January 31, 2023, CalHHS 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.

Data Exchange Framework Grant Program

The Data Exchange Framework (DxF) Grant Program launched in October 2022 to help health and human services providers and other healthcare entities understand and implement DxF requirements. There are three core grant opportunities to address areas where resources are required to support broad DxF implementation.

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.

Context

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.

Data Exchange Framework

 
Background
Data Exchange Framework (DxF)
DxF Data Sharing Agreement and Policies & Procedures
Strategy for Digital Identities
DxF Grant Program
Archive

On July 5, 2022, CalHHS released the Data Exchange Framework, Data Sharing Agreement, and initial set of Policies and Procedures. Documents can be found in the respective tabs of this section. More information for signatories of the Data Sharing Agreement, including information on agreement execution, will be available on this webpage later this year (2022).

 

The Data Exchange Framework (DxF) Grant Program launched in October 2022 to help health and human services providers and other healthcare entities understand and implement DxF requirements. There are three core grant opportunities to address areas where resources are required to support broad DxF implementation.

Public Comment

 
Background and Instructions
Materials for Public Comment
Received Comments

The CalHHS Center for Data Insights and Innovation (CDII) has released four new draft Policies and Procedures (P&Ps) and one modified P&P for the Data Exchange Framework’s (DxF) Data Sharing Agreement (DSA) for public comment:

  • [New] California Information Blocking Prohibitions
  • [New] Technical Requirements for Exchange
  • [New] Real-Time Exchange
  • [New] Early Exchange
  • [Amended] Privacy Standards and Security Safeguards

Earlier drafts of these P&Ps were discussed at CalHHS DxF Implementation Advisory Committee (IAC) and DSA P&P Subcommittee meetings, where feedback was received and incorporated from committee members and the public.

The public comment period closed on Tuesday, February 14, 2023.

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Implementation Advisory Committee

 
IAC Meeting Materials
IAC Members
Past Meeting Materials

Joint Implementation Advisory Committee and Data Sharing Agreement and Policies & Procedures Subcommittee Meeting (3/21/2023, 12:00pm – 2:30pm)

Clifford L. Allenby Building, 1215 O Street, Sacramento, CA 95814
California 110A and 110B Conference Room

Join by smart phone, tablet or computer

To call in (listen only): 888 788 0099 (Toll Free)
Webinar ID: 979 4305 1559

Implementation Advisory Committee Meeting #6 (4/24/2023, 10:30am – 1:00pm)

Implementation Advisory Committee Meeting #7 (6/5/2023, 10:30am – 1:00pm)

Implementation Advisory Committee Meeting #8 (7/20/2023, 9:30am – 12:00pm) (Tentative)

Implementation Advisory Committee Meeting #9 (8/28/2023, 1:00pm – 3:30pm) (Tentative)

      • Chair
        • John Ohanian, Chief Data Officer, CalHHS and Director, CDII
      • Members
        • Norlyn Asprec, County Health Executives Association of California
        • Andrew Bindman, Kaiser Permanente
        • Joe Diaz, California Association of Health Facilities
        • David Ford, California Medical Association
        • Aaron Goodale, MedPoint Management
        • Lori Hack, California Association of Health Information Exchanges
        • Cameron Kaiser, County of San Diego
        • Troy Kaji, Contra Costa Regional Medical Center and Health Centers
        • Cindy Keltner, California Primary Care Association
        • Andrew Kiefer, Blue Shield of California
        • Paul Kimsey, California Department of Public Health
        • Linnea Koopmans, Local Health Plans of California
        • Matt Legé, Service Employees International Union California
        • Amie Miller, California Mental Health Services Authority
        • Ali Modaressi, Los Angeles Network for Enhanced Services
        • Jonathan Russell, Bay Area Community Services
        • Cathy Senderling-McDonald, County Welfare Directors Association
        • Kiran Savage-Sangwan, California Pan-Ethnic Health Network
        • Ryan Sommers, Common Spirit Health
        • Felix Su, Manifest MedEx

Implementation Advisory Committee Meeting #4 (2/2/2023, 9:00 am – 11:30 am)

Implementation Advisory Committee Meeting #3B (1/10/2023, 11:00 am – 2:00 pm)

Implementation Advisory Committee Meeting #3A (12/20/2022, 10:00 am – 12:30 pm)

Implementation Advisory Committee Meeting #2 (11/3/2022, 10:00 am – 1:00 pm)

Implementation Advisory Committee Meeting #1 (9/21/2022, 10:00 am – 1:00 pm)

Data Sharing Agreement and Policies & Procedures Subcommittee

 
DSA P&P SC Meeting Materials
Subcommittee Members
Past Meeting Materials

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting (3/21/2023, 12:00 pm – 2:30 pm)

Please reference the Implementation Advisory Committee section for meeting attendance options and meeting materials.

 

 Data Sharing Agreement Policies and Procedures Subcommittee Meeting #6 (4/18/2023, 12:00 PM – 2:30 PM)


Data Sharing Agreement Policies and Procedures Subcommittee Meeting #7 (5/25/2023, 9:30 AM – 12:00 PM)

 

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #8 (6/27/2023, 10:00 AM – 12:30 PM) (Tentative)

 

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #9 (8/17/2023, 9:30 AM – 12:00 PM) (Tentative)

 

    • Chair
      • Courtney Hansen, Assistant Chief Counsel, CDII
    • Members
      • Ashish Atreja, UC Davis Health
      • William (Bill) Barcellona, America’s Physician Groups
      • Michelle (Shelley) Brown, Private Practice
      • Jason Buckner, Manifest MedEx
      • Jackie Nordhoff, PointClickCare
      • Louis Cretaro, County Welfare Directors Association of California
      • Matthew Eisenberg, Stanford Health
      • Elaine Ekpo, CA Dept. of State Hospitals
      • Sarah Hartmann, CDCR
      • John Helvey, SacValley MedShare
      • Sanjay Jain, Health Net
      • Bryan Johnson, CA Dept. of Developmental Services
      • Diana Kaempfer-Tong, CA Dept. of Public Health
      • Helen Kim, Kaiser Permanente
      • Steven Lane, Health Gorilla
      • Lisa Matsubara, Planned Parenthood Affiliates of California
      • Deven McGraw, Invitae
      • Justin Kaltenbach, Los Angeles Network for Enhanced Services
      • Eric Raffin, San Francisco Department of Public Health
      • Mark Savage, Savage & Savage LLC
      • Tom Schwaninger, LA Care
      • Morgan Staines, CA Dept. of Health Care Services
      • Elizabeth Steffen, Plumas District Hospital
      • Lee Tien, Electronic Frontier Foundation
      • Belinda Waltman, Los Angeles County Department of Health Services
      • Terry Wilcox, Health Center Partners
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Data Sharing Agreement Policies and Procedures Subcommittee Meeting #4 (1/26/2023, 9:00 am – 10:30 am)

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #3 (12/15/2022, 9:00 am – 11:30 am)

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #2 (10/25/2022, 10:00 am – 12:30 pm)

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #1 (9/23/2022, 9:30 am – 12:00 pm)

Data Exchange Framework Grants Listening Sessions

The DxF Grants Listening Sessions were offered twice – once on October 4th, and once on October 17th – and were designed to gather input from participants on DxF implementation challenges, technical assistance opportunities to address those challenges, and the administration of the grant program. During the sessions, participants had the opportunity to provide feedback in writing and verbally.

Organizations that will sign the DSA were encouraged to participate in one of these Listening Sessions.

DxF Grants Listening Session #1 (10/4/2022, 9:30 am – 11:00 am) 

DxF Grants Listening Session #2 (10/17/2022, 3:30 pm – 5:00 pm) 

Data Exchange Framework Public Webinars

 
DxF Public Webinar Materials
Past DxF Webinar Materials

DxF Webinar 7 (3/23/2023, 9:30 AM – 10:30 AM PT)

DxF Webinar 8 (4/18/2023, 10:00 AM – 11:00 AM PT)

DxF Webinar 9 (5/16/2023, 10:00 AM – 11:00 AM PT)

DxF Webinar 10 (6/22/2023, 1:00 PM – 2:00 PM PT)

DxF Webinar 11 (7/25/2023, 10:00 AM – 11:00 AM PT)

DxF Webinar 12 (8/24/2023, 1:30 PM – 2:30 PM PT)

DxF Data Sharing Agreement Fact vs. Fiction, DxF Grant Applications, & QHIO Applications (2/21/2023, 10:00 AM – 11:00 AM PT)

 

The Impact of Data Exchange Under the DxF & Key Program Update (1/19/2023, 9:00 AM – 10:00 AM PT)

DxF DSA Signing Portal Town Hall (1/6/2023)

What is a QHIO? How do I sign the DSA? And other DxF Program Updates (12/13/2022, 2:00 PM – 3:00 PM PT)

DxF Grant Program Overview & DSA Signature Portal Demonstration (11/22/2022, 11:30 AM – 12:30 PM PT)

The DxF DSA and P&Ps: An Overview (10/24/2022, 2:00 PM – 3:00 PM PT)

 What is the Data Exchange Framework? (9/13/2022)

Qualified Health Information Organization Program

 
Past Meeting Materials
QHIO Application

Qualified Health Information Organization Town Hall (2/9/2023, 9:00 am – 10:30am PT)

View the Draft QHIO 2023 Application and the application criteria that was discussed in the 2/9 Town hall. 

The final QHIO 2023 Application will be posted in the coming weeks.

Archived Meeting Information and Materials

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