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Are You Ready for the January 2024 CalHHS Data Exchange Framework (DxF) Deadline?

By Bill Barcellona, Executive Vice President of Government Affairs, America's Physician Groups
By Felix Su, Director of Health Policy, Manifest MedEx

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Original Publish Date: December 5, 2023

2024 will undoubtedly be another year focused on advancing health and social services data sharing and connecting the California health ecosystem to transform care delivery in our state. We are already implementing CalAIM, which requires robust data sharing to achieve the goals of providing seamless care coordination for the most vulnerable of our Medi-Cal population. And next year, the state will ramp up its work in implementing the California Health and Human Services Agency (CalHHS) Data Exchange Framework (DxF), which requires most health organizations to sign a single statewide Data Sharing Agreement (DSA) and exchange health data with each other throughout California by January 2024.

The ambitious and inspiring “North Star” for the DxF is that: “Every Californian, no matter where one lives within our state, should be able to walk into a doctor’s office, a county social service agency, or an emergency room and be assured health and social services providers can access the information they need to provide safe, effective, whole-person care—while keeping our data private and secure.” It’s a vision that we can and should all support for a “Healthy California for All.”

These data sharing initiatives will help physician groups and practices provide better and more efficient care for their patients, spending less time and resources on faxing and chasing records, and more time on what’s really important—providing the best care. This is achieved by having secure and permitted access to health information on their patients, such as whether they have been admitted, lab and test results, and discharge summaries. As the proverbial phrase goes, “Knowledge is power,” and physicians and care teams can make better and more timely care decisions with the right information.

While smaller practices have until January 2026 to meet the data sharing deadline, most healthcare organizations will be required to share data by 2024. Are you ready for this upcoming deadline that will help advance data sharing in our state and improve care for all Californians? By law (Assembly Bill 133, signed in 2021), the following entities are required to sign the Data Sharing Agreement (DSA), an agreement to share information quickly, securely, and appropriately while following a common set of terms, conditions, and obligations set forth in the DSA’s Policies and Procedures and share health and social service information by January 31, 2024:

Providers, hospitals, and health plans are required to securely exchange DxF-required clinical data in nationally adopted standards with other DSA signatories for required and permitted uses.

More than 1,900 such organizations have already signed the DSA and are working to meet the DxF requirements. If you are a required entity looking for help to meet the deadline, you can contact one of eight nonprofit DxF Educational Initiative Grantees to learn more about the DxF, and partner with a Qualified Health Information Organization (QHIO) to access the capabilities needed to meet your DxF data sharing requirements. A QHIO is a DxF-designated intermediary that meets the criteria and requirements for secure data exchange. The state has designated nine QHIOs as of October 2023. These intermediaries offer services and functions to support the sharing of health information, assisting health and social services entities as they initiate, receive, and reply to requests for information. For example, a primary care provider or community health center providing Enhanced Care Management under CalAIM could request and receive notifications through a QHIO when a Medi-Cal member is discharged from the hospital. The practice might also leverage a QHIO’s services to electronically exchange information with a social Community Supports provider with proper consent from a patient or client.

QHIOs may be especially beneficial for smaller practices and clinics that may not have a lot of existing resources or technology to easily participate in the DxF. Fortunately, the CalHHS Center for Data Insights and Innovation (CDII), the state entity responsible for overseeing the DxF, is administering the DSA Signatory Grant Program to provide funding that can help cover an organization’s costs of connecting to a QHIO, as well as hiring staff and expertise to optimize the use of data sharing technology for complying with and benefitting from the DxF.

To ensure that all entities have an equal opportunity to receive funding, CDII has opened a third round of grant applications that will be due on December 15, 2023. CDII has indicated this is possibly the final round of funding, and we encourage all DxF participants to apply by the deadline if they qualify.

Health and social services providers are joining the DxF in a shared commitment to providing safe, effective, whole-person care and creating a Healthy California for All. As the year comes to a close, it’s not too late to get ready for the January 2024 deadline, apply for grants, and help advance care for all Californians!

Bill Barcellona is Executive Vice President of Government Affairs for America’s Physician Groups, a DxF Education Initiative Grantee. He can be reached at Felix Su is Director, Health Policy, Manifest MedEx, a designated statewide DxF QHIO that exchanges data for more than 38 million Californians. He can be reached at