California has worked with the federal government for the last 12 years to support the state’s Medicaid providers in adopting and using electronic health record systems (EHRs). As part of this collaboration, the state was required to prepare and deliver a State Medicaid Health Information Technology (IT) Plan, which includes a Health IT Landscape Assessment describing California’s current health IT environment. The assessment reports on the state of health IT adoption and use among stakeholders, past trends in the adoption and use of health IT during the period of federal support, and remaining challenges in achieving full adoption and optimal use of health IT.

The latest version of the California Health IT Landscape Assessment was completed in early 2022 by researchers from the Clinical Informatics Improvement and Research group at the University of California, San Francisco, along with staff at the California Department of Health Care Services (DHCS). This brief is a summary of the assessment’s major findings.

Key Findings

• HITECH Act funding and the “meaningful use” programs significantly helped medical providers to adopt EHRs and gain the capabilities to exchange patient data electronically.
• Although most hospitals and other eligible entities can send patient data electronically, the degree of data sharing and the value of data received can be improved.
• Participation by health care providers in regional and local HIE organizations has grown substantially, but many HIOs face financial sustainability issues and other barriers.
• The electronic exchange of public health data has improved, but provider organizations cite remaining barriers to effective electronic reporting and exchange that will need to be addressed by public health agencies.
• The HITECH funding and meaningful use programs did little to increase EHR adoption and electronic data exchange for skilled nursing facilities, substance use disorder facilities, and nonmedical social service agencies. This leaves a notable gap in achieving the objectives of the CalAIM program, which the state may need to address.
• Further policy measures and changes to regulations are required to facilitate and promote the electronic data exchange needed for state initiatives such as CalAIM.

About the Author

Walter Sujansky, MD, PhD, is the principal consultant at Sujansky & Associates, a California-based consulting firm that specializes in the analysis and design of EHRs, disease registries, and solutions for health information exchange. Sujansky is also an adjunct professor at the Center for Biomedical Informatics Research at the Stanford School of Medicine, and a health IT consultant for litigation involving intellectual property and medical malpractice.