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Data Exchange Framework (DxF)

DxF 2025 Implementation

DSA Signing Portal and Participant Directory

CDII has made enhancements to the Data Sharing Agreement (DSA) Signing Portal, which includes the Participant Directory web-based application. If you have not yet signed the DSA, do so today.

DSA Signing Portal

Participant Directory

All Participants are obligated by the Participant Directory Policy and Procedure to enter the Intermediaries or technologies they choose to exchange health and social services information under the DxF. For more information on both the DSA Signing Portal and the Participant Directory web-based application, see resources below.

Implementation Resources and FAQs

DxF Roadmap (2025-2027)

The DxF Roadmap describes how the state and stakeholders can work together through 2027 to collectively invest in data exchange efforts that advance whole person care, leveraging efforts across the health and human service ecosystems, inside and outside of government. CDII collaborated with the DxF Implementation Advisory Committee (IAC), CalHHS state departments, and other subject matter experts and stakeholders to develop the DxF Roadmap. Feedback received during a public comment period in Fall 2024 also informed the Roadmap’s final recommendations.
Through implementation of the DxF Roadmap, CDII will advance CalHHS’ vision for data exchange, in alignment with the guiding principles of the DxF and CalHHS.

Feedback

DxF Feedback

Click the link below to share feedback with the CDII on the exchange of health and social services information under the DxF.

If you experience technical issues accessing or completing the form, please email dxf@chhs.ca.gov and a CDII team member will respond with assistance.

DxF Feedback Form

DxF Feedback Resources

Implementation Advisory Committee (IAC)

IAC Meeting Materials

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting (May 15, 2025, 9:00 AM – 11:30 AM PT)

  • To join by smart phone, tablet or computer, join by Zoom
    To call in (listen only): 669 254 5252 (Toll Free)
    Webinar ID: 161 360 3986

IAC Members

Chair

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

Members

  • Dan Chavez, Serving Communities Health Information Organization
  • Joe Diaz, California Association of Health Facilities
  • David Ford, California Medical Association
  • Aaron Goodale, MedPoint Management
  • Brian Henricksen, California Ambulance Association
  • Cameron Kaiser, County of Solano
  • Troy Kaji, Contra Costa Regional Medical Center and Health Centers
  • Andrew Kiefer, Blue Shield of California
  • Mark Knee, Office of the National Coordinator for Health IT
  • Matt Lege, SEIU California
  • Carol Leveroni, California Association of Health Information Exchanges
  • Pam Martinez, Ontario Fire Department
  • Amie Miller, California Mental Health Services Authority
  • Ali Modaressi, Los Angeles Network for Enhanced Services
  • Lucy Saenz, California Primary Care Association
  • Kiran Savage-Sangwan, California Pan-Ethnic Health Network
  • Felix Su, Manifest MedEx
  • Jim Willis, CommonSpirit Health

IAC Past Meeting Materials

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting (February 13, 2025, 9:00 AM – 11:30 AM PT)

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting (November 7, 2024, 12:30 PM – 3:00 PM)

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting (September 17, 2024, 1:00 PM – 2:15 PM)

Implementation Advisory Committee Meeting (May 22, 2024, 12:00 PM – 2:00 PM)

Implementation Advisory Committee Meeting (March 19, 2024, 12:00 PM – 2:30 PM)

Joint Implementation Advisory Committee and Data Sharing Agreement (DSA) Policy and Procedure (P&P) Subcommittee Meeting (January 24, 2024, 9:00 AM – 11:00 AM)

Joint Implementation Advisory Committee and Data Sharing Agreement (DSA) Policies and Procedures (P&P) Subcommittee Meeting (December 19, 2023, 2:00pm – 3:45pm)

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

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 Subcommittee)

DSA P&P Subcommittee Meeting Materials

This section will be updated for future meetings.

DSA P&P Subcommittee Members

Chair

  • DeeAnne McCallin, Deputy Director, CDII

Members

  • 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
  • Diana Kaempfer-Tong, CA Dept. of Public Health
  • Mark Knee, Office of the National Coordinator for Health IT
  • Steven Lane, Health Gorilla
  • Kelby Lind, Planned Parenthood Affiliates of California
  • Sunny Lowell, CA Dept. of State Hospitals
  • Belinda Luu, Kaiser Permanente
  • Deven McGraw, Ciitizen
  • Jackie Nordhoff, PointClickCare
  • Margaret Porto, CA Dept. of Health Care Services
  • Mark Savage, Savage & Savage LLC
  • Tom Schwaninger, LA Care
  • Elizabeth Steffen, Plumas District Hospital
  • Lee Tien, Electronic Frontier Foundation
  • Belinda Waltman, Los Angeles County Department of Health Services

DSA P&P Subcommittee Past Meeting Materials

Joint Implementation Advisory Committee and Data Sharing Agreement Policies and Procedures Subcommittee Meeting (November 7, 2024, 12:30 PM – 3:00 PM)

  • Please refer to the Implementation Advisory Committee Section for meeting materials.

Joint Implementation Advisory Committee and Data Sharing Agreement (DSA) Policies and Procedures (P&P) Subcommittee Meeting (September 17, 2024, 1:00 PM – 2:15 PM)

  • Please refer to the Implementation Advisory Committee section for meeting details.

Data Sharing Agreement (DSA) Policies and Procedures (P&P) Subcommittee Meeting (April 10, 2024, 1:30 PM – 3:30 PM)

Data Sharing Agreement (DSA) Policies and Procedures (P&P) Subcommittee Meeting (March 6, 2024, 1:30 PM – 4:00 PM)

Joint Implementation Advisory Committee and Data Sharing Agreement (DSA) Policies and Procedures (P&P) Subcommittee Meeting (January 24, 2024, 9:00 AM – 11:00 AM)

  • Please reference the Implementation Advisory Committee Section for 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.

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)

Technical Advisory Subcommittee (TASC)

TASC Meeting Materials

Focus Group 1 – Social Data Exchange

Focus Group 2 – Consent Management

  • Consent Management Meeting 2A: May 29, 2025, 12:00 PM – 1:00 PM PT
  • Consent Management Meeting 2B: June 12, 2025, 12:00 PM – 1:00 PM PT
  • Consent Management Meeting 2C: June 26, 2025, 12:00 PM – 1:00 PM PT
  • Consent Management Meeting 2D: July 10, 2025, 12:00 PM – 1:00 PM PT

Focus Group 3 – Event Notification Architecture

  • Event Notification Architecture Meeting 3A: July 31, 2025, 12:00 PM – 1:00 PM PT
  • Event Notification Architecture Meeting 3B: August 14, 2025, 12:00 PM – 1:00 PM PT
  • Event Notification Architecture Meeting 3C: August 28, 2025, 12:00 PM – 1:00 PM PT
  • Event Notification Architecture Meeting 3D: September 11, 2025, 12:00 PM – 1:00 PM PT

Focus Group 4 – Identity Management

  • Identity Management Meeting 4A: October 9, 2025, 12:00 PM – 1:00 PM PT
  • Identity Management Meeting 4B: October 23, 2025, 12:00 PM – 1:00 PM PT
  • Identity Management Meeting 4C: November 6, 2025, 12:00 PM – 1:00 PM PT
  • Identity Management Meeting 4D: November 20, 2025, 12:00 PM – 1:00 PM PT

TASC Members

Chair

  • Rim Cothren, Independent HIE Consultant, CDII

Members

  • Social Data Exchange Architecture Focus Group Membership
    • Irene Lintag Alvarez, Aliados Health
    • Harman Basra, Sonoma Community Action Network
    • Hans J Buitendijk, Electronic Health Record Association (EHRA)
    • Gabriel Cate, WellSky
    • Michael Deering, LANES
    • Alexis Fernández Garcia, CA Dept of Social Services
    • Eric Jahn, Bitfocus, Inc.
    • Alana G Kalinowski, 211 San Diego
    • Michael Marchant, Sutter Health
    • Benjamin R. Martin,  JD, Project Angel Food
    • Eric Nielson, California Welfare Director’s Association – CWDA
    • Aparna Ramesh, CA Dept of Social Services
    • Ken Riomales, CalMHSA
    • James Shalaby, Elimu Informatics, Inc
    • Ambrish Sharma, Interface Children & Family Services
    • Julie Silas, Homebase
    • Corey Smith, Gravity Project
    • Dr. Brian Thomas, The County of Alameda
    • Chris Ticknor, Orange County United Way
    • Lee Tien, Electronic Frontier Foundation
    • Anwar Zoueihid, Partners in Care Foundation

TASC Past Meeting Materials

Social Data Exchange Meeting 1B: April 10, 2025, 12:00 PM – 1:00 PM PT

Social Data Exchange Architecture Meeting 1A: March 27, 2025, 12:00 PM – 1:00 PM PT

Technical Advisory Subcommittee (TASC) Meeting #4B (November 19, 2024, 2:00 PM – 3:00 PM)

Technical Advisory Subcommittee (TASC) Meeting #4A (November 8, 2024, 1:00 PM – 2:00 PM)

Technical Advisory Subcommittee (TASC) Meeting #3B (September 4, 2024, 1:00 PM – 2:00 PM)

Technical Advisory Subcommittee (TASC) Meeting #3A (August 21, 2024, 1:00 PM – 2:00 PM)

Technical Advisory Subcommittee (TASC) Meeting #2D (June 4, 2024, 2:00 PM – 3:00 PM)

Technical Advisory Subcommittee (TASC) Meeting #2C (May 21, 2024, 2:00 PM – 3:00 PM)

Technical Advisory Subcommittee (TASC) Meeting #2B (May 7, 2024, 2:00 PM – 3:00 PM)

Technical Advisory Subcommittee (TASC) Meeting #2A (April 23, 2024, 1:30 PM – 3:00 PM)

Technical Advisory Subcommittee (TASC) Meeting #1B (March 20, 2024, 1:30 PM – 2:30 PM)

Technical Advisory Subcommittee (TASC) Meeting #1A (March 5, 2024, 2:00 PM – 3:00 PM)

2024 Standards Committee

2024 Standards Committee Info

Technical Standards Advancement Process Update – June 28, 2024

2024 Standards Committee Meeting Materials

Please monitor this section for updates on upcoming Standards Committee meeting schedules.

2024 Standards Committee Members

Chair

  • Rim Cothren, Independent HIE Consultant, CDII

Members

  • Ray Duncan, Cedars-Sinai Health System
  • Jonathon Feit, Beyond Lucid Technologies, Inc.
  • Danielle Friend, EHRA
  • Evelyn Gallego, EMI Advisors
  • Dave Green, PointClickCare
  • John Helvey, SacValley MedShare
  • Sheljina Ibrahim Kutty, Elevance Health
  • Mani Nair, Blue Shield of California
  • Tim Polsinelli, Manifest MedEx
  • Ken Riomales, CalMHSA

2024 Standards Committee Past Meeting Materials

2024 Standards Committee Meeting #5 (Monday, December 2, 2024, 12:00 PM – 1:00 PM PT)

2024 DxF Standards Committee Meeting #4 (Thursday, November 21, 2024, 12:00 PM – 1:00 PM PT)

2024 DxF Standards Committee Meeting #3 (Monday, October 28, 2024, 12:00 PM – 1:00 PM PT)

2024 DxF Standards Committee Meeting #2 (Friday, October 18, 2024, 1:00 PM – 2:00 PM PT)

2024 DxF Standards Committee Meeting #1 (Friday, September 27, 2024, 1:00 PM – 2:00 PM PT)

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.

 

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.

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 (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

Strategy for Digital Identities

DxF Grant Program

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. Grantees can download the DSA Signatory Grants Management Guide to learn more about the Grant Program, and how to manage their respective Grant awards.

The DxF Grant Portal is closed for the DSA Signatory Grants Round 3.

CDII has designated Public Consulting Group LLC (PCG) as the third-party administrator (TPA) to administer DSA Signatory Grants and the DxF Grant 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.

DSA Signatory Grantee Webinar (February 29, 2024, 11:00 AM – 12:00 PM)

Resources

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 (DSA, P&Ps and Glossary)

Data Sharing Agreement

Policies and Procedures

Glossary of Defined Terms

Public Comment

Nothing is currently open for public input

Notice of Intended Administrative Changes to P&Ps

Nothing is currently open for public input

Data Exchange Framework Public Webinars

DxF Public Webinar Materials

Please monitor this section for information about future DxF Webinar dates.

Past DxF Webinar Materials

DxF Participant Directory Walkthrough (2/7/2024, 2:30 PM – 3:30 PM PT)

DxF Year End Review and Look Ahead (12/13/2023, 1:00 PM – 2:00 PM PT)

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)

The Qualified HIO Program

Understanding California’s QHIOs

Last Updated June 4, 2024

Below is information for DxF  Participants seeking assistance in meeting their DxF requirements. This material will provide information on what a QHIO is, what DxF related services they offer, and how to find the right QHIO for your organization.

Resources

For more information, please see the QHIO website: 

Program Requirements

Last Updated October 18, 2024

The QHIO Program Guide provides an overview of the QHIO program and describes the requirements that an organization must meet to become qualified and maintain qualified status thereafter.

While the application window to become a QHIO has closed, the 2023 application and supporting material may be found below for prospective applicants to reference.

Application Resources

For more information regarding the QHIO program and process to become a QHIO, please see the past meeting materials in the archived section below or email dxf@chhs.ca.gov.

Program Oversight

Last updated October 18, 2024

The QHIO Program Guide (“the Guide”) contains a section entitled “Collaboration with CDII and Communication Practices.” In that section, the following requirement is provided:

  • Comply with CDII’s requests for information, compliance reviews, corrective action plans, and other CDII oversight efforts as found in The Qualified HIO Program section of CDII’s DxF webpage. 

The Maintaining Qualified Status document details the processes that CalHHS Center for Data Insights and Innovation (CDII) will follow to conduct compliance reviews, issue corrective action plans, remove QHIO qualification, and manage appeals.

Change Management

Last updated October 18, 2024

The QHIO Program Guide (“the Guide”) contains a section on Change Management which includes the following statement:

  • The DxF and the QHIO program are expected to evolve over time. The requirements outlined in this document are subject to change. Changes to the program will follow change management processes as found in The Qualified HIO Program section of CDII’s DxF webpage. 

The Change Management Process  document details the change management processes referenced by the Guide.

Archive

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