Perspectives

Looking at California’s headwinds and tailwinds can help other states as they build out their data sharing infrastructure Following a year marked by notable regulatory changes and new frameworks on health data sharing across the U.S., California has implemented major initiatives, including the California Data Exchange Framework (DxF) and California Advancing and Innovating Medi-Cal (CalAIM)….

2024 will undoubtedly be another year focused on advancing health and social services data sharing and connecting the California health ecosystem to transform care delivery in our state. We are already implementing CalAIM, which requires robust data sharing to achieve the goals of providing seamless care coordination for the most vulnerable of our Medi-Cal population….

Lessons from Meaningful Use on achieving digital equity for all providers This year has felt like the start of another seismic shift in healthcare infrastructure. 

The Trusted Exchange Framework and Common Agreement (TEFCA) is advancing nationwide exchange and interoperability by designating an initial set of Qualified Health Information Networks (QHINs) to connect existing and emerging…

On May 16 the CalHHS Center for Data Insights and Innovation (CDII) opened the first round of applications for the DSA Signatory Grant Program through the Data Exchange Framework (DxF) Grant Portal. This first round runs through June 17 and is limited to required DSA signatories who are mandated to begin exchanging or making health information available by…

Among the thousands of patients Dr. Donald Rebhun has seen at his primary care practice in the San Fernando Valley, stories that stand out in his memory include cases where he was able to make a timely impact on patients because of a simple electronic alert sent by the hospital, letting him know his patient…

With the transformation of health care through the Data Exchange Framework and Ab133 occurs across the state of California, the Trusted Exchange Framework and Common Agreement (TEFCA) published by the Office of the National Coordinator for Health Information Technology (ONC) is transforming the health care ecosystem nationwide. TEFCA, also referred to as “the Common Agreement,”…

The CalHHS Center for Data Insights and Innovation (CDII) devoted the April installment of its “Information is Power” webinar series to the imminent launch of the DSA Signatory Grant Program. CDII will make available up to $47 million in state funds to support investments that healthcare entities may need to achieve their Data Exchange Framework (DxF)…

As healthcare systems attempt to keep pace with the transformation of the digital age, lapses in data collection create additional challenges for patients and providers in California. Erica Galvez, CEO of Manifest MedEx—California’s largest nonprofit health information organization—highlighted the need for providers to access ADT (admission, discharge, and transfer) data regarding patients. Galvez wove her way…

On March 21, Manifest MedEx joined other key voices in Sacramento to advise and advocate on crucial DSA decisions that are set to be finalized by the CalHHS Center for Data Insights and Innovation (CDII). In a joint meeting of its stakeholder advisory committees, CDII outlined its proposed responses to public comments on draft DSA…

This month, the CalHHS Center for Data Insights and Innovation (CDII) held two online events highlighting its upcoming release of applications for organizations to become QHIOs. QHIOs will be designated by the State as having demonstrated their ability to meet Data Exchange Framework (DxF) requirements and help all signatories of the Data Sharing Agreement (DSA)—including providers, health plans, social service…

CalHHS announced last week that more than 1,400 organizations have joined the Data Exchange Framework (DxF), represented by nearly 1,000 entities that signed the Data Sharing Agreement (DSA)! Organizations that sign the DSA are signaling their commitment to a healthy California for all. The full list of the current CalHHS DSA signatories is available here….

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 DxF’s Data Sharing Agreement (DSA) for public comment. The draft P&Ps include important new requirements for hospitals to proactively send ADT event notifications. Earlier drafts of these new P&Ps were discussed at the…

With this grant funding, these recipients will do important work in informing and training signatories across the state about the Data Exchange Framework in 2023, providing valuable resources for their members.  This will help signatories know and understand what will come next with the CalHHS DxF. It’s important to stay updated as the rollout of…

California is at a moment of opportunity with ambitious goals to improve health equity and achieve “A Healthy California for All” — goals that will require robust health data infrastructure and will fundamentally change the way healthcare is delivered in our state. This kind of infrastructure transformation, while desperately needed and the right thing to…

California has made progress building health data networks across the state for years now — data systems that securely deliver information on your medications, health history, and hospitalizations in real time between your different healthcare providers (imagine never having to fill out that clipboard before your medical appointment again!). While those technology systems are significantly…

The development of safe, effective, lifesaving vaccines is complex scientific work. But the job does not end there. As we’ve seen with COVID-19—and now with monkeypox, polio, measles and other serious public health issues—there is also a science to the process of connecting with the community and getting the vaccines actually administered. Aggregating health data…

As we work to advance interoperability and data sharing across the nation, we should remember that our ultimate goal is to help people live healthier lives This has been another important year in the work of building health data networks in the U.S. as the urgency of the pandemic has carried us more swiftly to…

Those on the ground caring for Medi-Cal patients—the small health care practices, behavioral health and safety net clinics, skilled nursing facilities, county health and human services, and hospitals that form the safety net—need help sharing meaningful patient information to improve health and reduce health disparities. Because of a lack of resources, however, only a small…

On July 5th, the California Health and Human Services Agency (CalHHS) released the final Data Exchange Framework, associated Data Sharing Agreement (DSA), and the initial set of Policies and Procedures (P&Ps). This is the culmination of over nine months of stakeholder discussions and recommendations to CalHHS, including consistent input from MX, that we have chronicled through our News…

Dear Friends,   As my time wraps up at Manifest MedEx, I’ve been reflecting on all that we’ve accomplished and the opportunities that lie ahead. You’re in wonderful hands with Erica Galvez as interim CEO, and I have deep confidence in the amazing Manifest MedEx team.   My career has focused on building transformative systems for healthcare…

The Data Exchange Framework (DxF) Stakeholder Advisory Group closed with its last meeting on June 23. The California Health and Human Services Agency (CalHHS) team previewed its final changes to the DxF, Data Sharing Agreement (DSA), and initial policies and procedures (P&Ps). These incorporate the Agency’s review of public comments on the latest draft documents…

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)…

On April 21, 2022, John Ohanian, Chief Data Officer and Director of the Center for Data Insights and Innovation, released the first draft of the Data Sharing Agreement (DSA) and related Policies on behalf of the California Health and Human Services Agency (CalHHS). Manifest MedEx has reviewed the documents and provided recommended edits to ensure…

Different views on Data Exchange Framework (DxF) governance… In the most recent DxF Stakeholder Advisory Group meeting earlier this month, members of the DxF Stakeholder Advisory Group discussed California Health and Human Services Agency’s (CalHHS) proposal to delegate DxF oversight, enforcement, and/or rulemaking authority to a separately appointed “HIE Policy Board” that would not include…

“Do’s and Don’ts” to advance data sharing in California   At the March meeting of the Data Exchange Framework (DxF) Stakeholder Advisory Group, the California Health and Humans Services Agency (CalHHS) presented a proposed governance model for overseeing DxF implementation. Manifest MedEx joined other Advisory Group members urging clarity on the data sharing agreement (DSA) and…

In response to the Data Sharing Agreement draft shared by the California Health and Human Services Agency, Manifest MedEx has identified missing key components needed to effectively implement the data sharing mandates enacted in AB 133. We also strongly recommend that the full draft agreement and related binding policies be shared with and reviewed by…

Save the date for our upcoming webinar on Thursday, March 31 from 12 pm – 1 pm PDT. With all eyes on CalAIM and California’s pressing public health and health equity challenges, learn how Inland Empire Health Plan (IEHP) and other Inland Empire stakeholders are preparing to seize this opportunity for healthcare transformation, where there…

California has set the right goals for the years ahead, including initiatives focused on reducing health disparities, effectively delivering care for our most vulnerable residents, and improving mental health services. As one of the nation’s most populous states, with a history of leading innovation and rapidly growing Medicaid enrollment, all eyes are on us to…

Manifest MedEx is a proud member of a widespread coalition that is requesting that the 2022 California state budget include funding to accelerate Medi-Cal provider data sharing and build the data infrastructure needed to support CalAIM and meet AB 133 requirements. Coalition members include: Read the coalition’s letter to Governor Newsom requesting funding for performance…

“…and then there’s the all-important question: How are you going to pay for it?”  — David Ford, Vice President of Health Information Technology, California Medical Association (CMA)  Here are our two main takeaways from the January meeting of the Data Exchange Framework (DxF) Stakeholder Advisory Group:  Where’s the money?  The most interesting and pointed exchange…

Through its California Advancing and Innovating Medi-Cal (CalAIM) program, one of California’s goals is to “improve quality outcomes, reduce health disparities, and transform the delivery system through value‑based initiatives, modernization, and payment reform” for its Medicaid program (known as Medi-Cal). California is not the only state coming out of the COVID-19 pandemic with substantial plans to…

Funding and incentives to increase data exchange among top areas of discussion “Systems are not enough. We’ve got to make it a requirement to have incentive programs to support, not just adopt, actual data exchange.” – Jonah Frohlich, Manatt Health This week, the California Health and Human Services Agency (CalHHS) held their fourth Data Exchange…

It’s a match that works. Like peanut butter and chocolate or Batman and Robin, some things just belong together. Health plans and health information exchanges (HIEs) are quickly becoming one of the most dynamic duos in the healthcare landscape. Like many great partnerships, there was a bit of a will-they or won’t-they history to the…

Urgency and ability to operationalize are two key areas of concern “My worst fear is that we create a really nice report that doesn’t achieve exchange and doesn’t reach the goals we’ve indicated.”  – Claudia Williams, Chief Executive Officer, Manifest MedEx  As John Ohanian, Chief Data Officer, California Health and Human Services Agency (CalHHS) kicked off the third Stakeholder Advisory…

The kids are not all right. The more dangerous Delta COVID variant is far from the only health crisis our children are facing. Reports are showing that children are struggling with mental health, food insecurity, and obesity and backsliding on routine vaccinations. In California, we likely don’t know today the full extent of the pediatric health crisis because so…

Scenario Development and Data Exchange Issue Identification Last week, the Data Exchange Framework Stakeholder Advisory Group convened to continue its important work to develop recommendations for the California Health and Human Services (CHHS) Data Exchange Framework (DxF). The DxF will govern the required exchange of health information by 2024 – impacting hospitals, providers, health plans, and Californians across the state. This was the second of nine scheduled meetings; a recap of the inaugural meeting can be found on our website.  The Advisory Group reviewed the…

The big summer health care budget news was the passage of Assembly Bill 133, which expands Medi-Cal eligibility, improves behavioral health access and requires providers, hospitals and health plans to share complete health records by 2024. The bill underscores the importance of transparency and data. Embedded in this legislation is a new $315 million population health…

Key priorities emerge around ensuring equity and access for all Californians, building on existing infrastructure, and addressing patient privacy and security concerns  This week, the Stakeholder Advisory Group launched its work on the California Health and Human Services (CHHS) Data Exchange Framework pursuant to AB 133, the health trailer bill signed by Governor Newsom in July 2021. The legislation calls for…

One of the lessons from Covid-19 is the dangerous risk for our nation created by the gaping divide between public health and clinical care. With little information about their patients’ vaccination status, how can primary care providers help patients overcome hesitancy or find a place to get vaccinated? With no ability to track post-vaccination health,…

On July 27, 2021, Governor Gavin Newsom signed into law health care trailer bill AB 133 which aims to transform healthcare for Californians by expanding Medi-Cal eligibility, investing in behavioral health initiatives, and requiring providers and health plans to share data with each other by 2024. AB 133 also requires the creation of a framework…

Since its inception in 2004, the Office of the National Coordinator for Health Information Technology (ONC) has delivered outsized results for its size. This subdivision of the U.S. Department of Health and Human Services (HHS) has a budget of around $60 million and a team of approximately 150 people — small by federal standards —…

How did the COVID-19 pandemic impact the health of Californians beyond the virus? What will be the impact of missed medical and preventive care in 2020? How can we catch up quickly? Manifest MedEx, California’s largest nonprofit health information network, completed an analysis of the impact of COVID-19 on healthcare utilization in California in 2020…

As California reopens, ambulatory medical practices across the state are gearing up for the surge of catch-up care with their patients. There’s a lot of work to do: Californians fell as much as 50% behind on medical care during the 2020 pandemic, with the volume of preventive services, such as cancer screenings, falling between 20%-40%,…

By Claudia Williams, Special to CalMatters Claudia Williams is CEO of Manifest MedEx, a nonprofit health data network, Claudia.williams@manifestmedex.org. Disrupting the health care status quo takes courage. Recently, Assemblymember Jim Wood, who chairs the Health Committee, stood up boldly for a statewide infrastructure for sharing health data to strengthen public health, improve equity, transform Medi-Cal, and…

Take an academic, a technologist, a doctor, and a nonprofit leader and what do you get? Agreement that 2021 could be the breakthrough year for interoperability in healthcare. In a lively conversation at the end of last year for the Fierce Health IT Virtual Series, “The future of interoperability—will we ever get there?”, we were…

We are so excited to be welcoming Adam Harrison as Manifest MedEx’s first Chief Growth Officer. An athenahealth alum, he brings more than 18 years of experience in leading high-performing sales teams. Adam’s role includes adding new California provider and health plan participants to receive clinical and claims data across MX’s network of more than…

The Covid-19 pandemic has proven the dire need for the health-care industry to share health-care data in a secure, private way. Health information exchanges help providers move past their data sharing fears and toward interoperability, says Deven McGraw, co-founder of Ciitizen and a former HHS health information privacy official. This global pandemic is one more…

American healthcare has so many advantages: cutting-edge vaccine development, global experts in public health, massive gains in our technology and interoperability, while at the same time, Americans are suffering and dying because of a crisis of trust. The devastating health outcomes of distrust and a broken health contract this year have been made even clearer…

Too many Californians have learned first-hand that one of the most frightening things about COVID-19 is how it robs you of your ability to breathe — let alone speak. In a medical emergency, every second counts and every bit of information matters. But what happens when we can’t communicate because we’re unconscious and gasping for…

With COVID-19 cases on the rise and hospitals again overwhelmed, recent good news about three vaccine candidates provides a welcome light at the end of a long tunnel and is a stunning scientific achievement. “This will go down in history as one of science and medical research’s greatest achievements. Perhaps the most impressive,” said Scripps…

When doctors know their patients have been to the hospital, they can act fast to provide needed support. Widespread use of hospital event notifications is associated with all kinds of health benefits, including a 10 percent decrease in readmissions for Medicare beneficiaries. These event notifications are one of the simplest, easiest (most-bipartisan!), and most impactful changes we can…

California has had strong leadership in the COVID-19 pandemic. But, like other states, we are struggling to get COVID-19 data right. Between the disclosure of a missing backlog of a quarter of a million lab results and announcement of a $15.3 million six-month contract with Optum to fix COVID-19 data, California is reckoning with health information issues. With decisive…

Driving from California to Vermont, as I did this summer, offers time to think and plenty to look at. The vast interstate highway system that I followed for much of my journey, championed by President Dwight D. Eisenhower, was created in large part by the Federal-Aid Highway Act in 1956, which declared that building this highway system…

We got the call. Riverside County, one of the most active regions in our health data network, was asking for help with identifying people in their community who most critically need help during the COVID-19 pandemic. From my time at the Office of the National Coordinator to Aledade to the past three years at Manifest…

I was relieved when HIMSS was canceled. We had already made the decision to withdraw to protect our team and so we can focus on continuing to help on the front lines of California healthcare as the statewide health data network. As public health leaders, it is our responsibility to make this kind of difficult…

What do we want from our healthcare system? What do we need from it? And what is the role of technology in helping us feel better? There are so many ways that healthcare technology has advanced to help people live better lives in the last few decades: pacemakers, CT scans, interventional radiology, insulin pumps, digital records, genome…

Anybody who has had a loved one with an acute hospitalization or a chronic illness will have experienced some of the many ways in which healthcare systems fail to live up to the values and ideals of the people who have chosen healthcare as a calling. Healthcare is complicated indeed, but there are rare instances…

“Data is the new oil,” British data scientist Clive Humby once said. “It’s valuable, but if unrefined it cannot really be used.” I thought about that line recently when I met with the chief medical officer of a large health system. “I don’t want more data,” she told me, “we are already drowning in it.”…

In the middle of California’s fire season, it’s hard not to think about the role healthcare organizations can and must play when it comes to providing and coordinating care for patients during a natural disaster. These events will become more frequent and intense as the impacts of climate change increase. Natural disasters like the fires…

The path to value-based care is arduous. For health plans, their ability to manage care, assess quality, lower costs, and streamline reporting is directly impacted by access to clinical data. For providers, the same can be said due to their lack of access to claims data. Providers and health plans are increasingly demanding integrated claims…

Robust exchange of health information is absolutely critical to improving health care quality and lowering costs. In the last few months, government leaders at the US Department of Health and Human Services (HHS) have advanced ambitious policies to make interoperability a reality. Overall, this is a great thing. However, there are places where DC regulators need help…

On a cold January day high above Rockefeller Plaza a small group of technology pioneers coined the term Blue Button – denoting giving patients easy access to their own electronic health records. It’s a simple and transformative concept, central to our vision of patient-centered healthcare. It was an honor to be there that day. And…

What do we want from our healthcare system? What do we need from it? And what is the role of technology in helping us feel better? There are so many ways that healthcare technology has advanced to help people live better lives in the last few decades: pacemakers, CT scans, interventional radiology, insulin pumps, digital records, genome…

It still seems magical that Spotify creates a personalized music track for my life. Similarly, I now get personalized suggestions of what books to read, what recipes to cook, and even where to travel. This is the way we’re living our lives except for healthcare. It represents almost 20 percent of the U.S. economy and…