California's Path to Better Healthcare: Understanding the CA Data Exchange Framework (DxF)

The CA DxF allows Participants to provide access to, or exchange information through, any health information exchange network, health information organization, or technology that adheres to the DSA and Policies and Procedures. This includes the potential to use (or continue to use) national data exchange networks such as eHealth Exchange or Carequality, and soon, TEFCA. Zen provides direct access to these nationwide data exchange networks via our Stargate Gateway, and will support access to TEFCA designated QHINs as needed by our clients.The California Health & Human Services Agency (CalHHS) has just made a groundbreaking announcement, designating nine entities as Qualified Health Information Organizations (QHIOs) under the new Data Exchange Framework (DxF). This exciting development is set to revolutionize the state’s healthcare system by bridging the gaps in data exchange infrastructure.

What is the California Data Exchange Framework (DxF)?

DxF is a California data sharing initiative aimed at creating a seamless and secure path for health and social services entities to exchange vital patient health information. It’s a game-changer for California’s healthcare landscape, allowing organizations to share actionable data efficiently.

Who must sign the California DxF Data Sharing Agreement (DSA)?

Under the CA DxF – many healthcare providers in California are required to sign the data sharing agreement (DSA). For a detailed review of who is required to sign the DSA in California, here is a FAQ: https://www.cdii.ca.gov/wp-content/uploads/2023/07/Data-Exchange-Framework-FAQ-2023-7-13-011.pdf

At a high level, the mandate includes Acute Care Hospitals, Physician Organizations, Skilled Nursing Facilities, Health Plans, Clinical Laboratories, and Acute Psychiatric Hospitals.

Per the FAQ document:

“Under AB 133, all mandatory signatories must sign the DSA by January 31, 2023. Some of these organizations, such as smaller physician practices and clinics, rehabilitation, long-term acute care, psychiatric, and critical access hospitals, and smaller rural acute care hospitals, will have until January 31, 2026, to fully implement the Data Exchange Framework even though they signed the agreement in January 2023.”

Once our organization signs the DSA, what are our responsibilities?

Per the FAQ document:

“After signing, DxF DSA signatories will be required to exchange health and social services information or provide access to health information to and from every other signatory in real time as specified in the DSA and its Policies and Procedures (P&Ps).”

What are Qualified Health Information Organizations QHIOs?

Qualified Health Information Organizations (QHIOs) will play a pivotal role in the transformation as envisioned by AB 133. These organizations will provide data exchange capabilities, especially for those serving underserved communities. They will act as intermediaries, connecting healthcare organizations that might not have the means to exchange data on their own. The goal is to ensure better-informed and coordinated care across the state.

Who are the current nine organizations that have been designated as QHIOs?

1. Applied Research Works, Inc.
2. Health Gorilla Inc.
3. Long Health Inc.
4. Los Angeles Network for Enhanced Services (LANES)
5. Manifest MedEx
6. Orange County Partners in Health-Health Information Exchange (OCPH-HIE)
7. SacValley MedShare
8. San Diego Health Connect
9. Serving Communities Health Information Organization (SCHIO)

Announced at the Sequoia/Carequality Annual Meeting. Updated as of 11/20/23:

10. Surescripts
11. Velatura

How will Zen play a role in supporting CA based healthcare organizations to meet the requirements of the CA DxF?

The CA DxF allows Participants to provide access to, or exchange information through, any health information exchange network, health information organization, or technology that adheres to the DSA and Policies and Procedures. This includes the potential to use (or continue to use) national data exchange networks such as eHealth Exchange or Carequality, and soon, TEFCA. Zen provides direct access to these nationwide data exchange networks via our Stargate Gateway, and will support access to TEFCA designated QHINs as needed by our clients.

In addition, Zen’s Gemini Integration as a Service platform is “network” agnostic, and can help your organization bridge technology gaps in order to connect with any of the newly announced QHIOs listed above.

What are four things I can do now to get ready:

1. Visit the CA.gov website and learn more: https://www.cdii.ca.gov/committees-and-advisory-groups/data-exchange-framework/
2. Join our President Marilee Benson at her Interoperability Office Hours held most Friday’s at 2 pm Central. To gain access to the Zoom Link, visit her Office Hours Space at: https://zen-healthcare-it.dealpad.io/marilees-interoperability/sO
3. Visit the Connecting for Better Health website. They are providing excellent education and support for CA organizations needing more assistance with CA DxF and hold meetings several times a month. https://connectingforbetterhealth.com/
4. Contact Zen directly to begin addressing any interoperability technology gaps that you may be concerned about. Schedule a Free Interoperability Call

To sum it all up:

California naming the first nine QHIOs under the CA Data Exchange Framework (DxF) is an important step toward a better, more connected healthcare system. It’s not just news; it’s a commitment to improve healthcare for everyone. Zen is here to support you in this journey, enabling your organization to meet both state and federal healthcare data exchange initiatives and mandates.