Data Exchange
Framework
Technical Advisory Subcommittee (TASC)
Meeting #2B
Tuesday, May 7, 2024
2:00 PM – 3:00 PM PT
Members are strongly encouraged to
enable their video to foster increased
interaction and discussion.
1
The Vision for Data Exchange in California
The Data Exchange Framework (DxF)
creates new connections and efficiencies
between health and social services providers,
improving whole-person care.
The DxF is California’s first-ever statewide
Data Sharing Agreement (DSA) that requires
the secure and appropriate exchange of
health and human services information to
enable providers to work together and
improve an individual’s health and wellbeing.
2
Agenda
2:00 PM
Welcome and Roll Call
2:05 PM
Thoughts on Presentations at the
April 23, 2024, Meeting on ADT
Event Notification Strategy
2:20 PM
Current DxF Requirements
2:25 PM
Strategy for ADT Event
Notifications on the DxF
2:50 PM
Public Comment
2:55 PM
Next Steps and Closing Remarks
3
TASC Members
Members are strongly encouraged to enable
their video to foster increased interaction and
discussion.
Name
Organization
Rim Cothren (Chair)
Center for Data Insights and Innovation
Cindy Bero Manatt Health Strategies
Hans Buitendijk
Oracle (EHRA)
Cassie-Ann Bush
Adventist Health
Sarah DeSilvey
Gravity Project
Mohit Ghose
Anthem Blue Cross
Prashant Gupta
LabCorp
John Helvey
SacValley Medshare
Name
Organization
Kimberly Krause
Providence Administrative Consulting Services
Michael Marchant
UC Davis
Chris Muir
Office of the National Coordinator for Health IT
Ken Riomales
CalMHSA
Jess Sanford
California Department of Public Health
Hanan Scrapper
People Assisting the Homeless (PATH)
Joe Sullivan
California EMS Authority
Brian Thomas
Alameda County
4
Public Comment Opportunities
Public comment will be taken during the meeting at the
approximate time listed on the agenda and limited to the total
amount of time allocated for public comment.
Members of the public may also use the Zoom’s Q&A feature to ask
questions or make comments during the meeting, or can email
their questions or comments to [email protected].
5
What We Heard on April 23, 2024
• Event Notification Services in Massachusetts (presented by Mass General Brigham) describing outbound
notifications using HL7 ADT messages and inbound notifications via Direct secure messaging using many
payload types to be processed and inserted into the EHR, with some payloads that could not be processed;
• Patient Centered Data Home® (PCDH) describing a network that forwards HL7 ADT messages to HIEs serving
a
patient’s ZIP code which might be followed by a request for information to learn more;
• An implementation guide for event notifications developed by D
irectTrust describing a technical content
specification for notifications not dependent upon Direct secure messaging for transport;
• Bamboo Health event notification services describing a robust process for managing patient rosters and
AD
T messages and the lessons learned from the experience with many organizations; and
• Learnings from the ADT notifications use case from the DxF Sandbox describing a model implementation
a
nd the need for content standards for HL7 ADT messages and flexibility in the standards used to send
notifications to those that request them.
Which aspects of the guest presentations did you find appealing or lacking, and which
aspects should we consider applying to notifications on the DxF?
6
Strategy for ADT Event
Notifications on the DxF
7
Current DxF Requirements
Technical Requirements for Exchange P&P
The Technical Requirement for Exchange P&P establishes the obligations of DxF Participants pertaining to ADTs.
• Notifications of admissions and discharges are required of hospitals and emergency
departments (EDs), the intermediaries they use including all QHIOs, and are encouraged for
skilled nursing facilities (SNFs).
• Any DxF participant may request notifications by submitting a roster of individuals for whom
n
otifications are desired compliant with person matching standards.
• Hospitals, EDs, and SNFs are not required to use to any specific network or technology, but
ma
y use their own technology, QHIO, other intermediary, or nationwide network that supports
notifications.
• Hospitals, EDs, and SNFs are not required to follow any specific technical s
tandard, but may
use any secure method and payload compliant with DxF security requirements and
acceptable to the requesting participant.
Adapted from ADT section of Technical Requirements for Exchange P&P
8
Current DxF Requirements
QHIO ADT Event Notification Service
The 2023 QHIO Application outlined the ADT service requirements of QHIOs.
QHIOs must receive, process, and forward admission and discharge notifications from hospitals,
EDs, and SNFs with capabilities introduced over time:
Each QHIO must:
1. Receive HL7 version v2.5.1 ADT messages from their participating hospitals, EDs, and SNFs.
2. Receive and maintain a roster of persons from DxF participants who seek to monitor
a
dmissions and discharges for these persons.
3. Securely share rosters with other QHIOs so that these other QHIOs can also monitor for
e
vents on these individuals.
4. Match incoming events to persons found on rosters from their participants or a QHIO.
5. Notify requesting participants or QHIOs when an event matches a person listed their roster.
Summarized from 2023 QHIO Application
9
Discussion Questions
1. Is use of a common technology, network, or hub required to make
notifications effective or efficient?
2. Should notifications be sent based on a roster of individuals or
some other mechanism like that used by PCDH?
3. Should there be specific requirements or technical standards for
the content of notifications? What should they be?
4. Should there be specific requirements or technical standards for
how notifications are delivered? What should they be?
5. Is there a role for ambulatory providers or other DxF participants in
sending notifications of other events such as encounters?
10
Public Comment
Members of the public must “raise their
hand” and Zoom facilitators will unmute
each member of the public for them to
share comments.
The Chair will call on individuals in the order
in which their hands were raised.
Individuals will be recognized for up to two
minutes and are asked to state their name
and organizational affiliation at the start of
their remarks.
If you logged on via Zoom interface
Press “Raise Hand” in the “Reactions” button on
the screen
If selected to share your comment, you will
receive a request to “unmute;” please ensure you
accept before speaking
If you logged on via phone-only
Press “*9” on your phone to “raise your hand”.
Listen for your phone number
to be called by the
moderator.
If selected to share your comment, please
ensure you are “unmuted’ on your phone by
pressing “*6”.
11
Next Steps
Members to:
• Think on what technical or operational standards need to be identified and
adopted to make notifications effective.
• Try sketching a picture of how the best parts of California and other
initiatives might be combined into a better model for DxF.
Upcoming Meetings
TASC Meeting Series Date
Meeting #2C:
ADT Notification Strategy
Developing a Straw Model
May 21, 2024, 2:00 PM – 3:00 PM
Meeting #2D:
ADT Notification Strategy
Final Recommendation
June 4, 2024, 2:00 PM – 3:00 PM
Note: Additional TASC meetings are being scheduled.
Meeting information will be posted to the CDII
DxF webpage once confirmed.
12
