Each Wonks’ Corner, a member of Blue Shield’s government affairs team dives into a current policy topic. See our previous Wonks’ Corner blogs here.
Sharing clinical data is essential for the health and social services systems in California to work effectively. For health plans like Blue Shield of California, we rely on our provider and hospital partners to share important clinical data. This data helps us manage member care after they leave the hospital, collect information to measure quality performance, and allow members to access their health information through the Member Health Record. Data sharing ensures that providers have their patients’ records, and that Emergency Department teams can pull a patient’s health history to provide the most appropriate and efficacious treatment possible.
California has made great strides to advance data sharing across the health care system. The landmark California Health and Human Services Data Exchange Framework, creating a single Data Sharing Agreement and a common set of policies and procedures. These policies and procedures standardize and govern the exchange of health information among health care entities and government agencies in California. Importantly, once fully implemented, this will force a siloed and fragmented system to speak the same language and finally allow consumers’ health care data to work for them to improve their outcomes.
However, there is still work to be done to fully realize the benefits of this framework. Many required health care entities have not signed the Data Sharing Agreement nor are they faithfully executing it, as required. This recalcitrance is harming consumers and perpetuating the status quo where the health care system remains highly manual, inefficient, and difficult to navigate. To address this, greater oversight by existing regulators is needed. Today, hospitals, health plans, most providers and health system must comply and their licensing entities should hold them accountable. Additionally, the State needs to develop strong governance and enforcement mechanisms to address compliance issues with the Data Sharing Agreement.
To this end, Senate Bill (S.B.) 660, authored by Senate Health Committee Chair Caroline Menjivar, would address gaps in state law related to the California Health and Human Services Data Exchange Framework. S.B. 660 will ensure that the Data Exchange Framework is successful in achieving the exchange of information so that California can reach its goals on health care access, equity, affordability, public health, and quality of care. Specifically, the bill will:
- Grant the State’s Center for Data Insights and Innovation the authority to set a Data Exchange Framework governing board and continue to refine the Data Sharing Agreement and its policies and procedures.
- Allow the Center for Data Insights and Innovation to investigate potential violations of the Data Sharing Agreement and report them to state licensing entities.
- Require compliance with signing the data sharing agreement as a condition of contracting with CalPERS, Covered California, and the Department of Health Care Services.
Blue Shield of California was supportive of the creation of the Data Exchange Framework and advocated for the passage of prior legislation that sought to implement the same policy provisions now contained in S.B. 660. As S.B. 660 moves through the legislative process, stakeholders will have to reconcile differing views on what necessary and effective accountability and governance entails. However, the most salient messaging point should remain: Californians deserve access to quality care in a timely manner, and state policy should ensure all required organizations fully participate in the Data Exchange Framework to deliver on that promise.
