Manifest MedEx Now Exchanging Real-time Health Data Under the CalHHS Data Exchange Framework (DxF) for DxF Participants

California’s largest nonprofit Qualified Health Information Organization (QHIO) meets new milestone in advancing secure health data exchange across the state

Emeryville, Calif. – (BUSINESS WIRE) – March 7, 2024 – Manifest MedEx (MX), the largest nonprofit qualified health information organization (QHIO) for the CalHHS Data Exchange Framework (DxF), announced today it is securely exchanging permitted health data in real-time on behalf of DxF participants, including with other QHIOs, marking a new milestone in the implementation of the DxF.

The nearly 200 organizations that selected Manifest MedEx as their data exchange intermediary in the DxF Participant Directory are now successfully meeting their health data sharing obligations under AB 133, state law that requires most health care entities in California to exchange health and social services information beginning this year. The QHIO expects this number to increase substantially as more DxF participants fill out their entries in the newly launched directory.

To help organizations participate in the DxF, Manifest MedEx – the only nonprofit QHIO serving every county in the state – securely shares health data on their behalf as permitted under the Health Insurance Portability and Accountability Act (HIPAA) and as follows:

Requests for Information and Information Delivery 

  • Manifest MedEx supports the DxF's requirements to share clinical data in national and federally adopted standards. These standards include the United States Core Data for Interoperability (USCDI) v2, with data classes and elements related to social drivers of health (SDOH) and sexual orientation and gender identification (SOGI) to support whole person care.
  • In addition to clinical information from providers' electronic health record systems, Manifest Medex shares DxF-required administrative health data from payers, including adjudicated claims and encounters from health insurers and health plans.

Notification of Admission, Discharge, and Transfer (ADT) Events

  • California hospitals are required to send ADT notifications to providers who request them to let them know that their patient has been admitted, discharged, or transferred from the hospital – critical alerts that trigger timely care coordination and reduce readmissions. Skilled nursing facilities (SNFs) may also voluntarily send these alerts.
  • Last month, Manifest MedEx launched the California ADT Network – a no-cost, electronic acute and post-acute ADT notification exchange to help DxF organizations securely and appropriately share ADTs. Eligible California hospitals, health systems, SNFs, and QHIOs can sign on to the California ADT Network to securely send and receive basic ADT notifications for free – without needing to join the broader MX network or access other products and data services from the QHIO, such as longitudinal patient records and claims data.
  • More than 50 California hospitals are already sharing ADTs through this new network to meet their Notice of ADT Event requirement and ensure they are delivered to the requesting care team of a DxF participant.

Individual Access Services 

  • Ensuring all Californians and their care givers have access to their electronic health information is a guiding principle of the DxF.
  • Manifest MedEx has improved and streamlined its Individual Access Services (IAS), enabling secure, electronic patient access to longitudinal health records on behalf of its DxF participants and as authorized to help their patients/members better participate in their own care and ensure the accuracy of their information.

“We have made important investments to expand and scale our capabilities to serve as a QHIO for all DxF participants – regardless of geography, resources, or size,” said Erica Galvez, Chief Executive Officer, Manifest MedEx. “Our goal is to advance a health data safety net for the state by making it as easy as possible for more organizations to participate in the DxF and securely share critical health information needed to improve the health and wellness of all Californians.”

Manifest MedEx has also achieved HITRUST CSF® certification for its fifth consecutive year, demonstrating the highest levels of security in the healthcare industry, and met other financial, governance, and operational requirements under the QHIO program.

“QHIOs, like Manifest MedEx, play a significant role in providing the data infrastructure needed to advance health data exchange across our state, especially for those who may need technical support,” said Assemblymember Jim Wood (D-Healdsburg), past Health Committee Chair and a legislative leader on health care industry reforms, including data sharing. “This is a major milestone in the implementation of the Data Exchange Framework so that all Californians can get the care they deserve.”

As a nonprofit, California primary care providers, specialists, and clinics can join Manifest MedEx for free, and eligible organizations can also participate in the California ADT Network at no cost. Organizations interested in using Manifest MedEx as their DxF intermediary should reach out to Manifest MedEx at and ensure they have updated their organization listing in the DxF Participant Directory.


About Manifest MedEx 

As the largest nonprofit health data network in California, Manifest MedEx (MX) is an integral part of the state’s health data infrastructure, combining and delivering crucial health information for more than 38 million Californians across 125+ hospitals, 16 health plans, and over 1,800 providers. Together, we are transforming health across the state, supporting California as a leader in equitable, affordable, proactive, and compassionate care. For more information, visit and follow us at @ManifestMedEx.

Media Contact 

Sarita Choy

Manifest MedEx