JUNE 2021 At a Glance Why California Needs a Statewide Health Data Network (and How to Get There) Key Elements of a Statewide Health Filling that leadership void is the first and most impor- tant step California should take. All successful state Data Network data exchanges have strong leadership to oversee their California needs a statewide health data network to data health networks. Strong leadership should have a protect public health, respond to emergencies, and governance structure with the authority to manage par- improve care delivery - while maintaining patient ticipation, data privacy, and financing. privacy. This will allow those making critical health care decisions to have the information they need to see the The new data system should meet three main conditions: whole picture for their patients, make smart and timely decisions, and save lives. A Health care data should link to public health data, so the state has the information it needs to address Statewide health data networks have been adopted in public health emergencies. many other states. Case studies in Maryland, Michigan, A Allphysical health data should link to behavioral Nebraska, and New York show shared digital infrastruc- health and social services data. That way, Medi-Cal ture can take different forms and be managed differently. and other important programs can provide care and They all have in common that the state government plays support to the whole person. a leadership role and has the ultimate responsibility for ensuring that this infrastructure exists, includes everyone, A A statewide health data network needs to include and addresses the state's most important health needs. all Californians. Right now, too many Californians are left behind because their care teams do not have the right information at the right time. How Health Information Exchange (HIE) Works (and Doesn't Work) Today While other states have built coordinated health information networks with single user interfaces and sustained funding, California has a decentralized system. $ Most data exchange occurs through privately managed hospital-based electronic medical record (EMR) systems that exclude underresourced behavioral health and social services providers. $ More than 200 of the state's 350 hospitals do not participate in health information exchange organizations (HIOs), non- profit organizations built to share data among health care plans and providers outside of those EMR-based networks. The Result: A Fragmented, Siloed, Inefficient System $ Providers can access some information through their electronic health record-based exchanges, but often that informa- tion can be overwhelming or incomplete, hindering the provider's ability to use the data. $ When providers are able to retrieve the data, they must create the capacity to clean, duplicate, match, normalize, at- tribute, store, and secure data from many sources. $ This system is inefficient, costly for patients, and contributes to poor health outcomes. A Key Question for California: What Data Model? For More Information California needs to choose a model - and embrace it. CHCF is committed to ensuring the state has the The challenge for California leaders is deciding how to information it needs to make these decisions - create a health information exchange system that works commissioning research on what other states have done and on a range of possible use cases. The foun- for the whole state - collecting patient data in a single dation is also providing additional resources to help unified manner, while also making this information acces- the state answer questions about its HIE needs. sible to health providers timely and securely. Three reports published by CHCF have helped further clarify the choices involved: Two strategic options. California's new digital infra- structure should serve as a "superhighway" for health $ Why California Needs Better Data Exchange: Challenges, Impacts, and Policy Options for a information. This infrastructure would bypass roadblocks 21st Century Health System between providers to connect communities across the $ Designing a Statewide Health Data Network: state and allow those making critical health care deci- What California Can Learn from Other States sions to have the information they need to see the whole $ Expanding Payer and Provider Participation in picture for their patients. Data Exchange A A single highway. In some states, a single highway has been built over the years from the ground up - with all information stored in one place and on-ramps and off-ramps entering different communities. About the Foundation A Digitalbridges between regions. In other states, The California Health Care Foundation is dedicated to existing networks have been connected through a advancing meaningful, measurable improvements in the state hub that digitally bridges different regions and way the health care delivery system provides care to the forms of HIE. people of California, particularly those with low incomes and those whose needs are not well served by the status California's system does not do either of these quo. We work to ensure that people have access to the well - yet. But with California's effort to improve the care they need, when they need it, at a price they can coordination of care for Medi-Cal enrollees through afford. California Advancing and Innovating Medi-Cal (CalAIM), the time has come for a statewide health data network. CHCF informs policymakers and industry leaders, invests This critical infrastructure will link the state's disparate, in ideas and innovations, and connects with changemak- fragmented information systems, enabling the right ers to create a more responsive, patient-centered health access to health information at the right time - saving care system. public resources, saving time, and saving lives. SNAPSHOT Why California Needs a Better Data Exchange System A Medi-Cal enrollee with complex physical or behavioral health needs typically must navigate a minimum of five different systems that currently do not share health data. $ County social services $ Health plan $ Dental plan $ County behavioral health plan $ Substance use disorder provider $ Supplemental nutrition programs (SNAP and WIC)