Keep Your Eyes on These Four Health Data Advancements in 2023

By Erica Galvez
CEO
Manifest MedEx

Original Publish Date: December 6, 2022

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 do, is, simply put, not easy. As we look to 2023, here are a few things to watch as we go through our growing pains together:

California’s AB 133 and Data Exchange Framework kick into high gear

California’s new Data Exchange Framework (DxF), a first-ever statewide data-sharing framework, will begin to be implemented in 2023. AB 133 sets up an entirely new trajectory for the future of health data exchange, as most healthcare entities are required to sign California’s Data Sharing Agreement on or before January 31, 2023, and share health data with each other by January 31, 2024.

Signing entities should start thinking about how they will comply with the data-sharing requirements. The DxF is “technology agnostic” and allows Data Sharing Agreement (DSA) signatories to meet data-sharing obligations through their own technology or through choosing an intermediary that provides for data exchange. The state is developing criteria to identify and designate intermediaries known as Qualified Health Information Organizations (QHIOs) so organizations can confidently choose an intermediary that can help meet DSA requirements. The state will accept applications for qualifying HIOs in early 2023.

Keep your eyes on: deadlines and key milestones; QHIO process and outcomes; funding, resources, and technical assistance to onboard to QHIOs, especially for smaller safety-net providers
CalAIM’s new Population Health Management Service goes live

CalAIM, California’s ambitious multiyear plan to transform Medi-Cal, is undergoing a new shift to address population health. With a primary goal of supporting a more responsive, equitable, and outcome-focused Medicaid ecosystem for beneficiaries and the state, one of CalAIM’s initiatives is Population Health Management (PHM). On January 1, 2023, the Department of Health Care Services (DHCS) will be implementing its statewide PHM Service designed to collect and integrate disparate information to support the vision for PHM. Most notably, the PHM Service will provide plans, providers, counties, Medi-Cal members, and other authorized users access to more timely, accurate, and comprehensive data on members’ health history and needs, helping improve care and avoid duplicative processes.

Keep your eyes on: how the PHM Service aligns DxF; advances in policy and standards for sharing behavioral health, social determinants of health, and sexual orientation gender identity (SOGI) data; CalAIM Behavioral Health Quality Improvement Program (BHQIP) that incentivizes data sharing for counties
Modernizing public health data infrastructure for precision public health

The COVID-19 pandemic highlighted that our woefully underfunded public health infrastructure is in desperate need of modernization nationwide, starting with the capacity to collect, exchange, match, aggregate, and analyze health data on the ground in near real time. Public health officials are calling for targeted investment in meaningful health data exchange in preparation for the next pandemic, to combat preventable communicable diseases (like congenital syphilis) and to address health inequities.

As we improve and expand California’s health data infrastructure, identifying and piloting public health use cases will be critical. Already, we are seeing how public health departments can partner with nonprofit health information organizations (HIOs) to use timely, accurate health data to significantly improve community health across a range of communicable conditions, including to reduce cases of congenital syphilis. Investing in modern technology and infrastructure that supports public health’s access to and use of crucial health data for things like electronic case reporting and more complex case management will advance precision public health, which in turn advances the health and well-being of entire communities.

Keep your eyes on: efforts (and funding) for counties and local health jurisdictions to advance health data exchange infrastructure; BHQIP (above); policy guidance for HIO data sharing with public health
Federal impact: Qualified Health Information Networks are on the horizon. What can we expect?

The Office of the National Coordinator for Health Information Technology’s (ONC) Trusted Exchange Framework and Common Agreement (TEFCA) is poised to take nationwide exchange and interoperability to the next level by working with the Sequoia Project (ONC’s Recognized Coordinating Entity or RCE) to designate an initial set of Qualified Health Information Networks (QHINs) in 2023. These QHINs will begin connecting existing and emerging networks for a broader range of health data exchange than the current national networks support. The RCE is expected to announce the first round of QHINs in early 2023, which will expand network-to-network data sharing beyond treatment purposes to individual access and a subset of payment and healthcare operations use cases.

Many healthcare leaders in our space are eagerly awaiting this announcement to see who’s selected, who isn’t, and what it means for the data exchange landscape. While there isn’t yet a mandate for providers, health plans, public health, or community-based organizations to participate in TEFCA, policymakers are already looking at ways that adopting TEFCA in federal, state, and local policy can advance their data sharing and health agendas. Regardless of the strategies that materialize, this new framework will likely impact data sharing in and outside California in years to come.

Keep your eyes on: who becomes a QHIN; implications for DxF

In addition to these key advancements, there are many other unknowns: how much funding will be available for health data infrastructure, impacts of the midterm elections on health policy, and future directions of value-based care arrangements, to name a few. 2023 is shaping up to be another busy year as we work to build California’s health data ecosystem. Whatever pain points may lie ahead, I believe health and policy leaders and community stakeholders across the state will continue working together more than ever to forge a healthier future for all Californians.

Erica Galvez is CEO of Manifest MedEx, California’s leading nonprofit health data network. Before joining MX, Galvez led the HIE efforts at Aledade and also led the Office of the National Coordinator for Health IT’s (ONC’s) Interoperability Portfolio.