Designing a Statewide Health Data Network: What California Can Learn from Other States

The COVID-19 pandemic has brought into stark relief the need for high-quality health data that serves all Californians. Having a more efficient structure for exchanging data could allow health care payers, providers, and public health agencies to accurately target high-priority populations in need of vaccinations, allow contact tracers to quickly reach patients with positive test results, assist local governments and public health agencies in spotting early signs of outbreaks, and help researchers learn which treatments are working.

Even though millions of patient health records are shared electronically in California each day, health data does not flow across large areas of California, and access is limited in the areas that do share patient records. A highly fragmented system confines most data exchange to regional, community-based health information organizations and private health care networks. Many kinds of health care records are likely left out, including those from behavioral health providers, social service organizations, and nursing homes, as well as those from out-of-state care providers.

This report looks at four states — Maryland, Michigan, Nebraska, and New York — that have successfully implemented statewide health data networks, which allow all health care providers, institutions, and agencies to appropriately access and securely share patient health information electronically. Each of these networks is nationally known to have achieved robust statewide electronic access, in a timely and secure manner, to a patient’s nearly complete health data when and where needed.

The “framework for success” that these four states have forged offers lessons for California in how to institute new technology and expand data exchange statewide.

This report is the first in a series sponsored by the California Health Care Foundation to help inform decisionmakers in California about why better health data exchange is important, what efforts and infrastructure for the sharing of health data are in place in California, and what models for statewide health data networks exist and could be viable in the state.