California Health and Human Services

Link to California State Web Portal
Link to the California Web State Portal

What is the Data Exchange Framework?

Every Californian, no matter where we live, should be able to walk into a doctor’s office, a pharmacy, 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.

In the News

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

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.

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.

Public Comment

 

On May 18th, 2022, CalHHS released drafts of the Data Exchange Framework (DxF), Data Sharing Agreement (DSA) and Policies & Procedures (P&Ps) for public comment. The documents can be found in the respective tabs of this section. Please note that the documents released for public comment are the same versions previously shared with Stakeholder Advisory Group and DSA Subcommittee members on May 12th, 2022. Public comment for the DxF, DSA, and P&Ps will be received through Wednesday, June 1, 2022. The DxF Comment Template is preferred, but optional, method for the creation and submission of your comments. Additional details with guidance on how to prepare and transmit comments are provided below.

In addition, on May 26, 2022, CalHHS released the draft of the Strategy for Digital Identities for public comment. The document can be found in the respective tabs of this section. Public comments for the Strategy for Digital Identities will be received through Thursday, June 9, 2022. The Strategy for Digital Identities Comment Template  is preferred, but optional, method for the creation and submission of your comments. Additional details with guidance on how to prepare and transmit comments are provided below.

Public Comment Guidance

The comment templates include “locked” cells shaded in grey with instructions and “open” cells shaded in green for your comments. Additional information on the worksheets and their contents are provided below.

  1. “Commenter Information” Worksheet: This worksheet includes “open” cells shaded in green for: your name, your organization, the date you prepared your comments, and the name of the file. The “Commenter Information” worksheet also includes a helpful table that tracks the presence of comments on the DxF documents contained in subsequent worksheets.

Please note that you don’t need to fill out each worksheet in the Template. You only need to complete the worksheets for the documents upon which you wish to comment. For example, if you want to comment on the DxF DSA and the P&P on Breach Notification, you would only need to complete worksheet “DxF 1. DSA” and “DxF 5. P&P-Breach Notification”.

  1.  “DxF Components” Worksheet: This worksheet includes “open” cells shaded in green to enumerate and track your specific comments on the DxF component documents. To aid us in tracking your comments, the worksheet includes:
    an “open” cell in column A for you to enumerate your specific comment
    a drop-down menu in column B (shaded in yellow) for the applicable document version
    a drop-down menu in column C (shaded in yellow) that allows you to identify the applicable DxF document upon which you are commenting. Please note that we included a “general” option if you have a comment applicable to multiple sections.
    an “open” cell in column D for you to paste the relevant document text
    an “open” cell in column E for you to identify the relevant page number(s)
    an “open” cell in column F for you to provide a brief title or high-level summary of your specific comment
    an “open” cell in column G for you to provide the full text of your comment
  2.  “DxF_1. DSA” Worksheet: This worksheet includes “open” cells shaded in green to enumerate and track your specific comments on the DxF Data Sharing Agreement. To aid us in tracking your comments, the worksheet includes:
    an “open” cell in column A for you to enumerate your specific comment
    a drop-down menu in column B (shaded in yellow) for the applicable document version applicable document version
    a drop-down menu in column C (shaded in yellow) that allows you to identify the applicable section of the DxF DSA for your specific comment. Please note that we included a “general” option if you have a comment applicable to multiple sections.
    an “open” cell in column D for you to paste the relevant document text
    an “open” cell in column E for you to identify the relevant page number(s)
    an “open” cell in column F for you to provide a brief title or high-level summary of your specific comment
    an “open” cell in column G for you to provide the full text of your comment
  3.  “DxF 2. P&P-Amending DSA” through “DxF 9. P&P-Indiv Access” Worksheets: These eight worksheets include “open” cells shaded in green to enumerate and track your specific comments on the DxF Policies and Procedures (P&Ps) documents. To aid us in tracking your comments, the worksheet includes:
    an “open” cell in column A for you to enumerate your specific comment
    a drop-down menu in column B (shaded in yellow) for the applicable document version.
    an “open” cell in column C for you to paste the relevant document text
    an “open” cell in column D for you to identify the relevant page number(s)
    an “open” cell in column E for you to provide a brief title or high-level summary of your specific comment
    an “open” cell in column F for you to provide the full text of your comment

Transmission of Your Comments to CDII
To assist us with processing of your comments, please name your completed comment file as follows: [Your Organization Name]_[Your Last Name]_[Date Prepared] and transmit the file attached in an email to CDII@chhs.ca.gov.

CDII asks that comments delivered in alternative formats meet Web Content Accessibility Guidelines. The California Department of Rehabilitation has created Web Accessibility Toolkit to serve as a resource for meeting these guidelines. Thank you.

Strategy for Digital Identities 

  1. DxF Strategy for Digital Identities 

 

Stakeholder Advisory Group Meeting Information

 

2022 Meeting Dates

Beginning April 2022, all public meetings supporting DxF development (including AG, DSA Subcommittee, and Digital Identities Focus Group meetings) will transition to a hybrid in-person structure.

  • June 23, 2022 Data Exchange Framework Stakeholder Advisory Group Meeting #9 10:00am – 1:00pm 

    Clifford L. Allenby Building, 1215 O Street, Sacramento, CA 95814
    California 110A Conference Room
    Zoom meeting
    Join by smart phone, tablet or computer 
    To call in (listen only): 888 788 0099 (Toll Free)
    Webinar ID: 979 4305 1559

Data Exchange Framework Stakeholder Advisory Group Meeting #9

Data Exchange Framework Stakeholder Advisory Group Meeting #8

Data Exchange Framework Stakeholder Advisory Group Meeting #7

Data Exchange Framework Stakeholder Advisory Group Meeting #6 

Data Exchange Framework Stakeholder Advisory Group Meeting #5 

Data Exchange Framework Stakeholder Advisory Group Meeting #4

Data Exchange Framework Stakeholder Advisory Group Meeting #3

Data Exchange Framework Stakeholder Advisory Group Meeting #2

Data Exchange Framework Stakeholder Advisory Group Meeting #1

Chair

  • Mark Ghaly, MD, MPH. Secretary of the California Health & Human Services Agency

Stakeholder Organizations

  • Jamie Almanza, Bay Area Community Services
  • Charles Bacchi, California Association of Health Plans
  • Andrew Bindman (delegate for Greg A. Adams), Kaiser Permanente
  • Michelle Doty Cabrera, County Behavioral Health Directors Association of California
  • Carmela Coyle, California Hospital Association
  • Joe Diaz (delegate for Craig Cornett), California Association of Health Facilities
  • Rahul Dhawan (delegate for Don Crane), MedPoint Management (representing America’s Physician Groups)
  • David Ford (delegate for Dustin Corcoran), California Medical Association
  • Liz Gibboney, Partnership HealthPlan of California
  • Michelle Gibbons (delegate for Colleen Chawla), County Health Executives Association of California
  • Lori Hack, California Association of Health Information Exchanges
  • Sandra Hernández, California Health Care Foundation
  • Cameron Kaiser (delegate for Karen Relucio), County of San Diego (representing the California Conference of Local Health Officers)
  • Andrew Kiefer (delegate for Paul Markovich), Blue Shield of California
  • Linnea Koopmans, Local Health Plans of California
  • Matt Legé (delegate for Tia Orr), Service Employees International Union California
  • David Lindeman, UC Center for Information Technology Research in the Interest of Society
  • Eduardo Martinez (delegate for Art Pulaski), California Labor Federation
  • Amanda McAllister-Wallner (delegate for Anthony E. Wright), Health Access California
  • DeeAnne McCallin (delegate for Robert Beaudry), California Primary Care Association
  • Ali Modaressi, Los Angeles Network for Enhanced Services
  • Erica Murray, California Association of Public Hospitals and Health Systems
  • Mark Savage, Savage & Savage LLC
  • Kiran Savage-Sangwan, California Pan-Ethnic Health Network
  • Cathy Senderling-McDonald, County Welfare Directors Association
  • Claudia Williams, Manifest MedEx
  • William York, 211 San Diego/Community Information Exchange

State Departments

  • Ashrith Amarnath, California Health Benefit Exchange
  • Mark Beckley, Department of Aging
  • Scott Christman, Department of Health Care Access and Information
  • David Cowling, California Public Employees’ Retirement System
  • Kayte Fisher, Department of Insurance
  • Brent Houser, California Department of State Hospitals
  • Cheryl Larson (delegate for Diana Toche), Department of Corrections and Rehabilitation
  • Julie Lo, Business, Consumer Services & Housing Agency
  • Dana E. Moore, Department of Public Health
  • Nathan Nau, Department of Managed Health Care
  • Linette Scott, Department of Health Care Services
  • Jim Switzgable (delegate for Nancy Bargmann), Department of Developmental Services
  • Julianna Vignalats, Department of Social Services
  • Leslie Witten-Rood, Emergency Medical Services Authority

To learn more about the advisory group members, read their biographies.

Data Sharing Agreement Subcommittee Meeting Information

 

Data Sharing Agreement Subcommittee Meeting #6

Data Sharing Agreement Subcommittee Meeting #5

Data Sharing Agreement Subcommittee Meeting #4

Data Sharing Agreement Subcommittee Meeting #3

Data Sharing Agreement Subcommittee Meeting #2

Data Sharing Agreement Subcommittee Meeting #1

Chair

  • John Ohanian, California Health & Human Services Agency

Members

  • Ashish Atreja, UC Davis Health
  • William (Bill) Barcellona, America’s Physician Groups
  • Jenn Behrens, Los Angeles Network for Enhanced Services (LANES)
  • Michelle (Shelly) Brown, Private Practice
  • Louis Cretaro, California Welfare Directors Association of California
  • Elaine Ekpo, California Department of State Hospitals
  • Sanjay Jain, Health Net
  • Diana Kaempfer-Tong, California Department of Public Health
  • Elizabeth Killingsworth, Manifest Medex
  • Helen Kim, Kaiser Permanente
  • Patrick Kurlej, Health Net
  • Carrie M. Kurtural, California Department of Developmental Services
  • Steven Lane, Sutter Health | Palo Alto Medical Foundation
  • Lisa Matsubara, Planned Parenthood Affiliates of California
  • Deven McGraw, Invitae
  • Eric Raffin, San Francisco Department of Public Health
  • Morgan Staines, California Department of Health Care Services
  • Ryan Stewart, CommonSpirit Health
  • Lee Tien, Electronic Frontier Foundation
  • Belinda Waltman, Los Angeles County Department of Health Services
  • Terry Wilcox, Health Center Partners

To learn more, read the subcommittee members biographies.

Digital Identity Focus Group Meeting Information

 

Digital Identity Social Service Organizations Focus Group Meeting #2

Digital Identity Health Plans Focus Group Meeting #2

Digital Identity Consumer Privacy Focus Group Meeting #2

Digital Identity Social Services Organizations Focus Group Meeting #1

Digital Identity Health Plans Focus Group Meeting #1

Digital Identity Consumer Privacy Focus Group Meeting #1

Digital Identity Health Care Providers Focus Group Meeting #2

Digital Identity Health Information Organizations Focus Group Meeting #2

Digital Identity Health Care Providers Focus Group Meeting #1

Digital Identity Health Information Organizations Focus Group Meeting #1

Health Information Organizations

  • Aadli Abdul-Kareem, Coalition of Orange County Community Health Centers
  • Bill Beighe, Santa Cruz Health Information Organization
  • Jamie Franklin, Central Valley Health Information Exchange
  • Lori Hack, California Association of Health Information Exchanges
  • John Helvey, SacValley MedShare
  • Kate Horle, formerly CORHIO
  • Alex Horowitz, Intrepid Ascent
  • James Kirkwood, Statewide Health Information Network of New York (SHIN-NY)
  • Leo Pak, Los Angeles Network for Enhanced Services (LANES)
  • Ako Quammie, Contexture

Health Care Providers

  • Ashish Atreja, UC Davis Health
  • Nate Carroll, Ventura County Healthcare Agency
  • Guillermo Diaz, LA County Department of Health Services
  • Matthew Eisenberg, Stanford Health Care
  • Christopher Longhurst, UC San Diego Health
  • David Lown, California Association of Public Hospitals and Health Systems
  • Stephanie Pruett, HCA Healthcare
  • Griff Sahlin, Cottage Health
  • Gil Shlamovitz, University of Southern California
  • Vincent Vinh, California Medical Association
  • Belinda Waltman, LA County’s Whole Person Care
  • Katherine Williamson, Children’s Hospital of Orange County

Consumer Privacy

  • Becca Cramer-Mowder, American Civil Liberties Union of California
  • Pam Dixon, World Privacy Forum
  • Anne Donnelly, San Francisco AIDS Foundation
  • Adrian Gropper, Patient Privacy Rights
  • Lucy Johns
  • Craig Pulsipher, APLA Health
  • Mark Savage, Savage & Savage LLC
  • Lee Tien, Electronic Frontier Foundation

Health Plans

  • Sanjay Jain, Health Net
  • Mani Nair, Blue Shield of California
  • Rajiv Pramanik, Contra Costa Health Services
  • Eben Yong, Health Plan of San Mateo

Social Services Organizations

  • Peter Battistel, CIE San Diego
  • Allen Noriega, LA County Department of Health Services
  • Jonathan Russell, Bay Area Community Services (BACS)
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