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Data Exchange Framework

DxF Updates – Grants Round 3 Closes December 15, 2023

Note that the Data Sharing Agreement (DSA) Signatory Grants Round 3 application cycle will close to new application submissions on Friday, December 15, 2023 by 11:59 pm. CDII highly encourages anyone with a health information technology (HIT) need to exchange per the standards, terms, and conditions of the DSA to apply today. See detailed information in the DxF Grant Program section under the Data Exchange Framework Details menu within this webpage below.

What is the Data Exchange Framework?

Every Californian, no matter where we live, should be able to walk into a doctor’s office, a county social service agency, or an emergency room and be assured health and human services providers can access the information they need to provide safe, effective, whole person care—while keeping our data private and secure.

This is the goal of California’s Health and Human Services Data Exchange Framework, a first-ever, statewide data sharing agreement that will accelerate and expand the exchange of health information among health care entities, government agencies, and social service programs beginning in 2024.

The data exchange framework is not a new technology or centralized data repository; instead, it’s an agreement across health and human services systems and providers to share information safely. That means every health care provider can access the information they need to treat you quickly and safely; health care, behavioral health and social services agencies can connect to each other to deliver what Californians need to be healthy; and our public health system can better assess how to address the needs of all communities.

Hundreds of experts and members of the public have spent the last year shaping a framework that delivers on these principles. On this website, learn more about the progress toward seamless data exchange that will improve Californians’ experience of health care, support California’s whole-person care transformation, and put consumers in the drivers’ seat with our health data.

Data Exchange Framework Guiding Principles
To receive updates on the Data Exchange Framework, email CDII@chhs.ca.gov.

In July 2022, CalHHS released the Data Exchange Framework, Data Sharing Agreement, and initial set of Policies and Procedures. Please see the Data Exchange Framework section for more information. View the Executive Summary.

Take Action

The Data Exchange Framework includes a single data sharing agreement and common set of policies and procedures that will govern and require the exchange of health information among health care entities and government entities in California.

The CalHHS Data Sharing Agreement (DSA) Signing Portal is now open for providers and healthcare entities to take the first step for better health information exchange. The DSA is a mandated agreement between hospitals, physician organizations and medical groups, skilled nursing facilities, health plans and disability insurers, clinical laboratories, and acute psychiatric hospitals to share patient information safely.

California Health and Safety code section 130290 requires most providers and healthcare entities to sign the DSA by January 31, 2023.

Take the first step today. Visit the CalHHS Data Sharing Agreement Signing Portal to sign the DSA.

 

Register for Data Exchange Framework

Implementation Advisory Committee

IAC Meeting Materials

Implementation Advisory Committee Meeting #11 (November 16, 2023, 9:00am – 11:00am)

Joint Implementation Advisory Committee and Data Sharing Agreement (DSA) Policies and Procedures (P&P) Subcommittee Meeting #12 (December 19, 2023, 2:00pm – 4:30pm)

To join by smart phone, tablet or computer, click this link: Zoom
To call in (listen only): 888 788 0099 (Toll Free)
Webinar ID: 979 4305 1559

IAC Members

Chair

  • John Ohanian, Chief Data Officer, CalHHS and Director, CDII

Members

  • Andrew Bindman, Kaiser Permanente
  • Eileen Cubanski, County Welfare Directors Association
  • Joe Diaz, California Association of Health Facilities
  • David Ford, California Medical Association
  • Michelle Gibbons, County Health Executives Association of California
  • Aaron Goodale, MedPoint Management
  • Lori Hack, California Association of Health Information Exchanges
  • Cameron Kaiser, County of Solano
  • Troy Kaji, Contra Costa Regional Medical Center and Health Centers
  • Cindy Keltner, California Primary Care Association
  • Andrew Kiefer, Blue Shield of California
  • Paul Kimsey, California Department of Public Health
  • Linnea Koopmans, Local Health Plans of California
  • Matt Legé, Service Employees International Union California
  • Amie Miller, California Mental Health Services Authority
  • Ali Modaressi, Los Angeles Network for Enhanced Services
  • Jonathan Russell, Bay Area Community Services
  • Kiran Savage-Sangwan, California Pan-Ethnic Health Network
  • Felix Su, Manifest MedEx
  • Jim Willis, Common Spirit Health

Past Meeting Materials

Implementation Advisory Committee Meeting #10 (October 10, 2023, 10:00am – 12:00pm)

Implementation Advisory Committee Meeting #9 (8/28/2023, 1:00pm – 2:00pm)

Implementation Advisory Committee Meeting #8 (7/20/2023, 9:30am – 11:00am)

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting #7 (6/5/2023, 10:30am – 1:00pm)

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting #6 (4/24/2023, 10:30am – 12:30pm)

Joint Implementation Advisory Committee and Data Sharing Agreement and Policies & Procedures Subcommittee Meeting (3/21/2023, 12:00 pm – 2:30 pm)

Implementation Advisory Committee Meeting #4 (2/2/2023, 9:00 am – 11:30 am)

Implementation Advisory Committee Meeting #3B (1/10/2023, 11:00 am – 2:00 pm)

Implementation Advisory Committee Meeting #3A (12/20/2022, 10:00 am – 12:30 pm)

Implementation Advisory Committee Meeting #2 (11/3/2022, 10:00 am – 1:00 pm)

Implementation Advisory Committee Meeting #1 (9/21/2022, 10:00 am – 1:00 pm)

Data Sharing Agreement and Policies & Procedures Subcommittee

DSA P&P SC Meeting Materials

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting #12 (December 19, 2023, 2:00pm – 4:30pm)

  • Please reference the Implementation Advisory Committee Section for meeting materials.

Subcommittee Members

Chair

  • DeeAnne McCallin, Deputy Director, CDII

Members

  • Ashish Atreja, UC Davis Health
  • William (Bill) Barcellona, America’s Physician Groups
  • Michelle (Shelley) Brown, Private Practice
  • Jason Buckner, Manifest MedEx
  • Louis Cretaro, County Welfare Directors Association of California
  • Matthew Eisenberg, Stanford Health
  • John Helvey, SacValley MedShare
  • Sanjay Jain, Health Net
  • Bryan Johnson, CA Dept. of Developmental Services
  • Diana Kaempfer-Tong, CA Dept. of Public Health
  • Justin Kaltenbach, Los Angeles Network for Enhanced Services
  • Helen Kim, Kaiser Permanente
  • Steven Lane, Health Gorilla
  • Sunny Lowell, CA Dept. of State Hospitals
  • Lisa Matsubara, Planned Parenthood Affiliates of California
  • Deven McGraw, Invitae
  • Jackie Nordhoff, PointClickCare
  • Eric Raffin, San Francisco Department of Public Health
  • Mark Savage, Savage & Savage LLC
  • Tom Schwaninger, LA Care
  • Morgan Staines, CA Dept. of Health Care Services
  • Elizabeth Steffen, Plumas District Hospital
  • Lee Tien, Electronic Frontier Foundation
  • Belinda Waltman, Los Angeles County Department of Health Services
  • Terry Wilcox, Health Center Partners

Past Meeting Materials

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #10 (October 31, 2023, 9:00am – 11:00am)

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #9 (September 27, 2023, 1:00pm – 3:00pm)

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #8 (6/27/2023, 10:00 AM – 12:30 PM)

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting #7 (6/5/2023, 10:30am – 1:00pm)

  • Please reference the Implementation Advisory Committee Section for meeting materials.

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting #6 (4/24/2023, 10:30 AM – 12:30 PM)

  • Please reference the Implementation Advisory Committee Section for meeting materials.

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting (3/21/2023, 12:00 pm – 2:30 pm)

  • Please reference the Implementation Advisory Committee Section for post-meeting materials.

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #4 (1/26/2023, 9:00 am – 10:30 am)

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #3 (12/15/2022, 9:00 am – 11:30 am)

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #2 (10/25/2022, 10:00 am – 12:30 pm)

Data Sharing Agreement Policies and Procedures Subcommittee Meeting #1 (9/23/2022, 9:30 am – 12:00 pm)

Did you know? California's new Data Exchange Framework won’t replace the many Health Information Exchange systems already up and running across our state California's progress on our bold vision of equitable, affordable, and whole person care will depend on seamless data exchange. Making life-saving information available to health care providers when and where you need it is just one goal of California's #DataExchangeFramework

Timeline

Initial Data Exchange Framework

By July 1, 2022, the state will establish a single Data Sharing Agreement and common set of policies and procedures that will govern and require the exchange of health information among health care entities and government agencies in California. This effort will be guided by a Stakeholder Advisory Group, which will provide information and advice to CalHHS.

Public health/social services integration

CalHHS and the California State Association of Counties will encourage as many county health, public health, and social services providers to connect to the Data Exchange Framework—with all state and local public health agencies exchanging health information in real time with participating health care entities.

Data Sharing Agreement

By January, 31, 2023, the Data Exchange Framework data sharing agreement will be executed by the following entity types: General acute care hospitals, physician organizations and medical groups, skilled nursing facilities, health service plans and disability insurers, Medi-Cal managed care plans, clinical laboratories, and acute psychiatric hospitals.

Full implementation

On or before January 31, 2024, most required signatories of the DSA shall exchange health information or provide access to health information as specified by CalHHS’s Data Sharing Agreement for treatment, payment, or health care operations.

Data Exchange Framework Details

Background

On July 5, 2022, CalHHS released the Data Exchange Framework, Data Sharing Agreement, and initial set of Policies and Procedures. Documents can be found in the respective tabs of this section. More information for signatories of the Data Sharing Agreement, including information on agreement execution, will be available on this webpage later this year (2022).

Context

While parts of California’s health care system rely on coordinated, interoperable electronic systems, other parts rely on decentralized, manual, and siloed systems of clinical and administrative data exchange that is voluntary in many situations. This voluntary patchwork imposes burdens on providers and patients, limits the health care ecosystem from making material advances in equity and quality, and functionally inhibits patient access to personalized, longitudinal health records. Further, a lack of clear policies and requirements to share data between payers, providers, hospitals, and public health systems is a significant hindrance to addressing public health crises, as demonstrated by challenges inherent to the COVID-19 pandemic.

Despite the widespread availability of secure electronic data transfer, a small but important minority of Californians’ medical information is stored or shared on paper. When that medical information is shared between providers, much of it happens by mail, fax, or, most likely, by the patients themselves, who frequently carry their records from appointment to appointment. While electronic health information exchange cannot replace provider-patient communication, it can greatly improve the completeness of patient records, which has a significant effect on health and wellness outcomes, as past history, current medications, and other information are jointly reviewed during appointments.

Social and economic factors distinct from medical care are powerful predictors of health outcomes and disease burden throughout a person’s life. From a population health perspective, this means that evidence-based policies that affect the broader conditions in which people are born, grow, and live can exert a powerful influence on health and well-being. From an operational perspective, data-driven efforts to better coordinate human and social supports with the medical and health care sectors provide opportunities to deliver services that are more client centered, efficient, effective, and tailored.

Data Exchange Framework (DxF)

  1. DxF Development Process_Final_July 2022
  2. DxF Guiding Principles_Final_July 2022
  3. CA Data Exchange Landscape_Final_July 2022
  4. Data Exchange Scenarios_Final_July 2022
  5. DxF Governance_Final_July 2022
  6. CA Data Exchange Gaps and Opportunities_Final_July 2022

Data Sharing Agreement

Policies and Procedures

A second draft P&P has been released for public comment. Please refer to the Public Comment section below for draft materials and instructions. The public comment period will close at 8:00 AM PT on Monday, December 18, 2023.

A draft P&P on fees has been released for public comment. Please refer to the Public Comment section below for draft materials and instructions. The public comment period will close at 8:00 AM PT on Thursday, December 21, 2023.

Strategy for Digital Identities

DxF Grant Program

The DxF Grant Portal is open for Round 3 applications. See further below for more detailed information on the DxF Grants Program.

Understand the funding opportunity: Read the DSA Signatory Grant Guidance Document for detailed information on eligibility, funding parameters, and the application process.

Get started on the application:

  • For Technical Assistance (TA) Grant Applications: Begin your application in the DxF Grant Portal, hosted on Public Consulting Group’s GrantsConnect portal.*
  • For QHIO Onboarding Grant Applications: Email grantsupport@cahie.org to begin the process today. The California Association of Health Information Exchanges (CAHIE) is a contractor to CDII’s DxF team, providing application support for all QHIO Onboarding Grant Applications.

Informational Webinar and Office Hours: To receive direct Round 3 application support and information, CDII encourages interested applicants to register and participate in one of the upcoming Informational Webinar and virtual Office Hours sessions offered below:

DSA Signatory Grants Round 3 Informational Webinar

October 24, 2023
9:00 am – 10:00 am
Register for 10/24/23 (advanced registration required)

DSA Signatory Grants Round 3 Office Hours

Round 3 Office Hours #3
November 29, 2023
12:00 pm – 1:00 pm
Register for 11/29/23

Resources

DxF Grants Program

The Data Exchange Framework (DxF) Grant Program launched in October 2022 to help health and social services providers and other health care entities understand and implement DxF requirements. There are two core grant opportunities to address areas where resources are required to support broad DxF implementation: the DSA Signatory Grants and the DxF Educational Initiative Grant Programs.

DSA Signatory Grants

CDII has allocated up to $47 million for DSA Signatory Grants that provide support to DSA Signatories to subsidize their efforts to implement the DxF. The program includes two grant options for Signatories: QHIO Onboarding Grants and Technical Assistance (TA) Grants. Download the DSA Signatory Grants Application Guidance Document to learn more.

The DxF Grant Portal is now accepting Round 3 applications for the DSA Signatory Grant.

  1. Understand the DSA Signatory Grant opportunity: Read the DSA Signatory Grant Guidance Document for detailed information on eligibility, funding parameters, and the application process.
  2. Get started on the application:

CDII has designated Public Consulting Group LLC (PCG) as the third-party administrator (TPA) to administer DSA Signatory Grants and the GrantsConnect portal. PCG is acting solely as a TPA on behalf of CDII and is not liable or responsible for CDII decisions, payment delays, or actions.

APPLICATION: For detailed information on the application, read the DSA Signatory Application Template that details all content in the DxF Grant Portal application.

  • For TA Grant Applications: Begin your application in the DxF Grant Portal, hosted on Public Consulting Group’s GrantsConnect portal. Contact DSAGrants@pcgus.com or call (866)698-6525 with any portal questions or questions about the TA grant application.
  • For QHIO Onboarding Grant Applications: Email grantsupport@cahie.org to begin the application process today. Applicants in this domain must work with the California Association of Health Information Exchanges, CAHIE, to complete their application and should not start an application on the grant portal.

APPLICATION DEADLINE: Round 3 applications are due Friday, December 15, 2023, by 11:59pm PT. DSA Signatories who demonstrate a HIT need, in order to meet DxF requirements, may submit an application in Round 3 regardless as to whether they are required or voluntary signatories to the DSA.

Requests for DSA Signatory Grant funding must be submitted through the DxF Grant Portal, hosted on PCG’s GrantsConnect portal, during the open application windows starting in May 2023. All applications submitted will be reviewed by CDII.

DxF Educational Initiative Grant Program

In December 2022, CDII selected eight associations to provide education and outreach about the DxF across the state throughout 2023. The list of grantees and their contact information can be found in the DxF FAQ document, question 16.

Archives

Data Sharing Agreement

Policies and Procedures

Public Comment

Participant Directory P&P (Closing on December 18, 2023, 8am PT)

Background and Instructions

The CalHHS Center for Data Insights and Innovation (CDII) has released a draft of the following Policy and Procedure (P&P) for the Data Exchange Framework’s (DxF) Data Sharing Agreement (DSA) for public comment:

CDII is soliciting public comment on the draft through 8:00 AM PT on Monday, December 18, 2023. Additional details with guidance on how to prepare and transmit comments are provided below.

============================================

Guidance on Comment Preparation and Transmission

The DxF Comment Template is CDII’s preferred method for the creation and submission of your comments.

1. Structure of the Comment Template 
The DxF Comment Template for Draft P&Ps contains two worksheets that include “locked” cells shaded in grey with instructions and “open” cells shaded in green for your comments.
Each worksheet has a header row with instructions and examples in the third row shaded in grey. Additional information on the worksheets and their contents is provided below.

  • “Commenter Information” Worksheet: This worksheet includes “open” cells shaded in green for: your name, your organization, the date you prepared your comments, and the name of the file.
  • Worksheet for the draft P&P released for public comment: This worksheet includes “open” cells shaded in light green to enumerate and track your specific comments for each section of the draft P&P. To aid us in tracking your comments, the worksheet includes:
    • an “open” cell in column A for you to enumerate your specific comment
    • an “open” cell in column B for you to identify the relevant section from the P&P being commented on
    • an “open” cell in column C for you to paste the applicable text from the P&P being commented on
    • an “open” cell in column D for you to identify the relevant page number(s)
    • an “open” cell in column E for you to provide a brief title or high-level summary of your specific comment
    • an “open” cell in column F for you to provide the full text of your comment

2. Transmission of the Comment Template 
To assist us with processing of your comments, please name your completed Excel file as follows:
[Your Organization Name]_[Your Last Name]_[Date Prepared] and transmit the file attached in an email to CDII@chhs.ca.gov with the subject line ‘DxF P&P: Participant Directory Public Comment’.

CDII asks that comments delivered in alternative formats meet Web Content Accessibility Guidelines. Specifically, CDII requests that commenters refrain from submitting comments in tracked-changes format or as a document with in-text comments. The California Department of Rehabilitation has created a Web Accessibility Toolkit to serve as a resource for meeting accessibility guidelines.

Comments Received

Fees P&P (Closing on December 21, 2023, 8am PT)

Background and Instructions

The CalHHS Center for Data Insights and Innovation (CDII) has released a draft of the following Policy and Procedure (P&P) for the Data Exchange Framework’s (DxF) Data Sharing Agreement (DSA) for public comment:

CDII is additionally releasing a list of questions for public input to accompany the release of the P&P for public comment. CDII seeks public input on the listed questions to inform future version(s) of the P&P. Please note that CDII appreciates all comments and recommendations and invites comments on other components of the P&Ps not addressed by the questions listed in this document.

CDII is soliciting public comment on the draft through 8:00 AM PT on Thursday, December 21, 2023. Additional details with guidance on how to prepare and transmit comments are provided below.

============================================

Guidance on Comment Preparation and Transmission

The DxF Comment Template is CDII’s preferred method for the creation and submission of your comments.

1. Structure of the Comment Template
The DxF Comment Template for Draft P&Ps contains two worksheets that include “locked” cells shaded in grey with instructions and “open” cells shaded in green for your comments.
Each worksheet has a header row with instructions and examples in the third row shaded in grey. Additional information on the worksheets and their contents is provided below.

  • “Commenter Information” Worksheet: This worksheet includes “open” cells shaded in green for: your name, your organization, the date you prepared your comments, and the name of the file.
  • Worksheet for the draft P&P released for public comment: This worksheet includes “open” cells shaded in light green to enumerate and track your specific comments for each section of the draft P&P. To aid us in tracking your comments, the worksheet includes:
    • an “open” cell in column A for you to enumerate your specific comment
    • an “open” cell in column B for you to identify the relevant section from the P&P being commented on
    • an “open” cell in column C for you to paste the applicable text from the P&P being commented on
    • an “open” cell in column D for you to identify the relevant page number(s)
    • an “open” cell in column E for you to provide a brief title or high-level summary of your specific comment
    • an “open” cell in column F for you to provide the full text of your comment

2. Transmission of the Comment Template 
To assist us with processing of your comments, please name your completed Excel file as follows:
[Your Organization Name]  [Your Last Name]_[Date Prepared] and transmit the file attached in an email to CDII@chhs.ca.gov with the subject line ‘DxF P&P: Fees Public Comment’.

CDII asks that comments delivered in alternative formats meet Web Content Accessibility Guidelines. Specifically, CDII requests that commenters refrain from submitting comments in tracked-changes format or as a document with in-text comments. The California Department of Rehabilitation has created a Web Accessibility Toolkit to serve as a resource for meeting accessibility guidelines.

Comments Received

Data Exchange Framework Public Webinars

DxF Public Webinar Materials

DxF Webinar 14 (12/13/2023, 1:00 PM – 2:00 PM PT)

Past DxF Webinar Materials

QHIO Program Launch and Grant Opportunities (11/7/2023, 2:00 PM – 3:00 PM PT)

DxF Round 3 Grants and DxF Exchange Scenario (10/16/2023, 10:30 AM – 11:30 AM PT)

Demystifying the DxF: Real World Exchange Scenarios (8/24/2023, 1:30 PM – 2:30 PM PT)

Demystifying DxF Exchange Scenarios (7/25/2023, 10:00 AM – 11:00 AM PT)

Data Sharing Agreement (DSA) Signatory Grants Town Hall (5/16/2023, 10:00 AM – 12:00 PM PT)

Applying for Data Exchange Framework (DxF) Grants and Other DxF Program Updates (4/18/2023, 10:00 AM – 11:00 AM PT)

How the DxF Supports CalAIM & Other DxF Program Updates (3/23/2023, 9:30 AM – 10:30 AM PT)

DxF Data Sharing Agreement Fact vs. Fiction, DxF Grant Applications, & QHIO Applications (2/21/2023, 10:00 AM – 11:00 AM PT)

The Impact of Data Exchange Under the DxF & Key Program Update (1/19/2023, 9:00 AM – 10:00 AM PT)

DxF DSA Signing Portal Town Hall (1/6/2023)

What is a QHIO? How do I sign the DSA? And other DxF Program Updates (12/13/2022, 2:00 PM – 3:00 PM PT)

DxF Grant Program Overview & DSA Signature Portal Demonstration (11/22/2022, 11:30 AM – 12:30 PM PT)

The DxF DSA and P&Ps: An Overview (10/24/2022, 2:00 PM – 3:00 PM PT)

What is the Data Exchange Framework? (9/13/2022)

 

Qualified Health Information Organization Program

QHIO

QHIO Application

The 2023 Qualified Health Information Organization (QHIO) Application window has closed. For reference, the application, guide and FAQ are available below along with materials and recordings from the related informational webinars.

CDII hosted two informational webinars to address questions from prospective applicants. Post meeting materials and recordings can be found in the “Past Meeting Materials” tab.

  • Please submit any QHIO Application questions to the CDII inbox at CDII@chhs.ca.gov.

Past Meeting Materials

Qualified Health Information Organization (QHIO) Application Question and Answer (Q&A) Session (9/11/2023, 11:00 AM – 12:00 PM)

Qualified Health Information Organization (QHIO) Application Question and Answer (Q&A) Session (9/8/2023, 10:00 AM – 11:00 AM)

Qualified Health Information Organization Town Hall (2/9/2023, 9:00 am – 10:30am PT)

View the Draft QHIO 2023 Application and the 2023 Application Criteria that was discussed in the 2/9/2023 Town Hall.

Archived DxF Materials

More Information

Center for Data Insights and Innovation
1215 O Street
Sacramento, CA 95814