The Santa Barbara County Care Data Exchange: What Happened?

Robert Miller
Bradley Miller


This is archived content; for historical reference only.

The Santa Barbara County Care Data Exchange provides important lessons about the barriers to adoption of health data exchanges to make health information more portable, according to an independent project evaluation funded by the California HealthCare Foundation (CHCF) and published by the journal Health Affairs.

As part of the evaluation, Health Affairs produced a series of Web Exclusive articles commenting on the Santa Barbara County Care Data Exchange by some of the nation’s leading experts on health information technology. Publication of the package was supported by CHCF.

The data exchange, one of the most ambitious and publicized health information exchange projects, ceased operations in December 2006, more than eight years after its inception. According to the Health Affairs article by Miller and Miller, lack of a compelling “value proposition” for potential investors was the main cause of the project’s demise. The authors assert that without a combination of grants, incentives, and mandates, other regional health information organizations (RHIOs) could face the same issue.

The lessons learned from the data exchange and its outcome helped shape nearly every aspect of federal health IT policy, according to an article by former National HIT Coordinator David Brailer, MD, who led the Santa Barbara initiative before being appointed to his federal post.

Noting the legal, technical, and organizational hurdles faced by the data exchange, CHCF coauthors Jonah Frohlich, Sam Karp, Mark Smith, and Walter Sujansky recommend that data exchanges be implemented incrementally and that consumers be engaged from the start to help craft privacy and security policies. They also call for faster development of national health IT standards to help lower the cost of development.

While some consistency is needed to interconnect various health information exchange systems across the nation, a National Health Information Network (NHIN) will be possible only if local data exchanges are allowed flexibility in how they operate, what services they provide, how they deliver those services, and how they pay for those services, writes Marc Overhage, president and CEO of the Indiana Health Information Exchange.

Understanding who benefits from health information exchange is critical to creating a sustainable business model, according to an article by Donald Holmquest, CEO of the California Regional Health Information Organization (CalRHIO). He argues that patients, health care providers, laboratories, pharmacies, hospitals, health plans, and employers are among the many parties who will benefit from data exchange efforts.

The five Web Exclusive articles reporting the evaluation’s findings are available free of charge on the Health Affairs site, listed under External links.

A link to a more detailed evaluation of the data exchange by Robert Miller and Bradley Miller is included under Related CHCF Pages.