New research analyzing the impact of health data sharing is revealing its powerful impact on patient outcomes and health care affordability, with health information exchange (HIE) contributing to thousands of dollars saved per patient.
Since efforts to drive and streamline statewide interoperability went into effect under the state’s Data Exchange Framework (DxF) in January 2024, more than 4,400 health care entities, social service providers, and government agencies have reported they are now sharing clinically relevant data.
While more are in the process of joining, early research and use case tracking reveal that data sharing is not only a vital part of improving patient care and outcomes but also holds the power to bend the health care cost curve dramatically.
Understanding data sharing in California
The California DxF is a statewide initiative that aims to improve the secure and appropriate exchange of health and social services information. At its core is a Data Sharing Agreement (DSA) that requires health care entities and government agencies to share health and social services data. The DxF, led by the California Department of Health Care Access and Information (HCAI), is the central underpinning of California's broader effort to transform health care, expand coverage, advance equity, and improve connections between health and social services. As part of this effort, California Health and Human Services (CalHHS) designated nine Qualified Health Information Organizations (QHIOs), which are exchanges that meet strict requirements to facilitate connections between DxF participants through the secure sharing of health and social services information.
Collaboration drives innovation
Many of the QHIOs have become the linchpins for innovative practices across California through high-impact use cases. For instance, a Federally Qualified Health Center (FQHC) in Los Angeles worked with QHIO LANES to embed real-time admission, discharge, and transfer (ADT) alerts into clinical workflows. As a result, the FQHC saw a significant improvement in care coordination and fewer unnecessary hospital visits. Over six months, unnecessary emergency department visits for patients with diabetes dropped by more than 85%, and hospitalizations for this group declined by 68%. Among adults with asthma, unnecessary emergency department visits fell by 82%. This effort demonstrates how integrating real-time data into primary care workflows drives better outcomes.
Data sharing is also enabling greater efficiency by freeing up valuable time. QHIO Manifest MedEx worked with a large California health plan to reduce outbound calls to hospitals for chart retrieval, resulting in an estimated 9.7 hours of staff time saved daily. This streamlined process contributes to more staff capacity for higher-value work, such as patient care.
Connecting for Better Health (C4BH), a nonprofit coalition focused on improving the state’s data-sharing infrastructure with a goal of transforming health and social outcomes for all Californians, is another example of innovation in action. Through its DxF Community Sandbox, a real-world testing environment for California DxF Participants, C4BH has democratized access to a space where workflows and strategies can be identified, tested, and validated. Onerecent use case, executed through C4BH’s DxF Community Design Studio human-centered design approach, brought together Managed Care Plans (MCPs), a large hospital system, housing community based organizations (CBOs), a housing technology vendor, a 2-1-1 agency, and a Continuum of Care (CoC) organization to improve housing referrals by assessing and streamlining data exchange practices and processes.
Here at Blue Shield, we have begun receiving data from other DSA signatories via our QHIO partners. By obtaining data in this manner, providers avoid the need to build a custom data exchange solution for Blue Shield and can instead use technology and an intermediary of their choosing.
Driving affordability at scale
As these use cases continue to grow in number and complexity, providers across California will benefit from shared intelligence and resources that drive increasingly effective health outcomes while improving affordability. A recent brief from California Health Care Foundation (CHCF) shares that a study published in JAMA found that 20% to 25% of national health spending is wasteful. When applied to California, this accounts for “$58 billion to $73 billion in wasteful spending annually.”
Excitingly, new research published by the California Health Care Foundation (CHCF) shows electronic health information exchange has demonstrated the ability to reduce wasteful spending by reducing administrative burdens and duplicative testing. For example, in emergency departments, access to a patient’s history can reduce unnecessary CT scans, X-rays, and ultrasound imaging by up to 25%. CHCF also found that “HIE use was also associated with cost savings of nearly $2,000 per patient, largely due to a reduction in unnecessary testing and hospital admissions.”
What’s next
The evidence is clear: statewide data sharing has a significant impact. By continuing to invest in health data sharing, Californians will benefit from coordinated, high-quality care and lower health care costs. Blue Shield of California advocated for the creation of the statewide data sharing mandate and is committed to supporting the success of California’s DxF. While there has been considerable momentum in organizations signing the DSA, the next step is ensuring health care entities are actively complying and that patients are having their care informed by their own health information in real time. Implementing policies for effective accountability and governance will help move us closer to our goal. Californians deserve access to high-quality, affordable care. Let’s work together to make it a reality by supporting the DxF and its mission to deliver on that promise.
