Stakeholders call for closing key gaps in Data Sharing Agreement and Policies: Health Information Organization (HIO) funding, proactive data sharing, and process to qualify HIOs
At the eighth meeting of the Data Exchange Framework (DxF) Stakeholder Advisory Group, members discussed the latest draft of the Data Sharing Agreement (DSA) and initial policies and procedures (P&Ps) from the California Health and Human Services Agency (CalHHS). CalHHS also presented an update on proposed funding related to health data sharing in the May Revision to the Governor’s Budget.
Funding for data infrastructure is still missing
Stakeholders raised the disconnect between the state’s aspirations and resource commitments. California’s ambitious health goals cannot be achieved without investment in our HIO data infrastructure:
“It’s great to see the DSA recognizes HIO infrastructure as the backbone for data sharing in California. To meet the requirements of the DSA and CalAIM and to support equity initiatives, it’s essential to allocate funds in the budget to maintain HIO infrastructure.”
— Ali Modaressi, CEO, LANES
“As others have pointed out, funding to support regional HIE infrastructure is a gap which the [May Revise] proposals do not address.”
— Linnea Koopmans, CEO, Local Health Plans of California
“I’m trying to understand how public health activities are defined in this context. I don’t feel like the infrastructure is being built and invested in to really do this.”
— Michelle Gibbons, Executive Director, County Health Executives Association of California
It is imperative that California provide sustainable public funding to support the critical data infrastructure provided by our state’s HIOs. Manifest MedEx (MX) has joined the EQUITY coalition of more than 25 provider, health plan, and health information organizations requesting $95 million in 2022-23, and ongoing funding after, for data sharing incentives and HIO data infrastructure. We hope the Final Budget passed by the Governor includes this funding which is urgently needed to support California’s goals of improving equity and transforming Medi-Cal through whole person care.
A vetting process for qualified intermediaries needs to be defined
MX is encouraged that the revised DSA recognizes the crucial role of Qualified HIOs in supporting provider and health plan compliance with data sharing requirements. Now CalHHS must rapidly establish the process and requirements for qualifying HIOs. It is critical to identify Qualified HIOs as soon as possible so that providers and health plans can select a partner and execute an agreement well in advance of deadlines.
Critical proactive data sharing requirements remain absent
The DSA does not require hospitals to proactively share encounter alerts and discharge summaries with primary care providers and other care team members when patients are admitted, discharged, or seen in the emergency department. This is a big gap. Participants should be required to share data proactively and in real-time, not just in response to queries, in specific circumstances where timely and proactive data sharing is needed to support care coordination and public health.
CalHHS adopted Guiding Principles to shape the development of the Data Exchange Framework. Guiding Principle 3 states that the Data Exchange Framework will support whole person care, including health information exchange and use to:
“Identify and manage population health; improve transitions of care; track and report quality; improve health equity; and coordinate care and services.”
Proactive data sharing by hospitals when patients are hospitalized is the most basic and essential way to improve transitions of care and support care coordination through information exchange.
As state lawmakers negotiate the Final Budget over the next several weeks, the EQUITY coalition will redouble its push for HIO infrastructure funding. Our joint advocacy was on display through public comments made by the Riverside County Medical Association, America’s Physician Groups, SacValley MedShare, and the Los Angeles Network for Enhanced Services (LANES).
The final DxF Advisory Group meeting will take place on June 23. We invite you to follow @ManifestMedEx on Twitter for live tweets and share your thoughts with us at https://www.manifestmedex.org/contact/. Stay tuned for more updates!
For a recap of past meetings, please check out News and Perspectives on our website.