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.

About the Authors

HealthTech Solutions (HealthTech) was formed with a vision of supporting federal and state government agencies and health information exchange (HIE) organizations with consulting and technical services to develop and implement state-of-the-art technology solutions and practices. Authors include Sandeep Kapoor, president; JoAnne Hawkins, senior consultant; and Dawn R. Gallagher, senior consultant.

The authors wish to thank the individuals and groups who agreed to participate and be interviewed for this paper, including representatives from the states profiled and California stakeholders who provided valuable insights on the health data exchange environment in California. A complete table of participants is included as Appendix C.