Data Exchange
Framework
Technical Advisory Subcommittee (TASC)
Meeting #2D
Members are strongly encouraged to
enable their video to foster increased
interaction and discussion.
Tuesday, June 4, 2024
2:00 PM – 3:00 PM PT
1
The Vision for Data Exchange in California
2
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.
Agenda
3
2:00 PM
Welcome and Roll Call
2:
05 PM
ADT Event Notification Strategy
Recommendations
2:50 PM
Public Comment
2:55 PM
Next Steps and Closing Remarks
TASC Members
Members are strongly encouraged to enable
their video to foster increased interaction and
discussion.
4
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
Kameron Mims-
Jones
Nourish California
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
Public Comment Opportunities
5
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 DxF@chhs.ca.gov
.
What We Heard on May 21, 2024
6
• There are challenges with managing content of rosters.
• Many entities participating in the DxF, especially social service organizations, may have limited
resources to implement the strategies the TASC is considering and may benefit from ongoing
resource support.
• The DxF should consider establishing a certification process to build trust among DxF Participants
and ensure that all Participants have the appropriate privacy and security capabilities in place.
• The ADT notification approach under the DxF should be flexible enough to allow different providers using
different technologies to incorporate it into their operational workflows.
• QHIOs might be one way to support ADT event notification delivery.
• The strategy for ADT event notifications should be informed by privacy considerations related to
sharing of sensitive data across platforms that may not be compliant.
• The DxF strategy should consider the need for individuals to consent to notifications
• If there is flexibility, DxF could direct ADTs using four methods: rosters, patient’s expressed
preferences (conditions for participation in CMS rule), where the individual has previously been
seen, or geography.
Reminder: Today’s Objective
Make recommendations to CDII to improve the event notification strategy
under the DxF that might include:
• new requirements for technical infrastructure,
• technical delivery and content standards, and
• the roles of various DxF Participants
considering the current California landscape, DxF requirements, and
nationwide initiatives.
7
ADT Event Notification Strategy
Recommendations
8
ADT Event Notification Strategy Survey
On Friday, May 24, 2024, CDII administered an 11-question survey to TASC members.
The survey asked TASC Members to weigh-in on the following topics for discussion at today’s meeting:
• Architecture: Currently, DxF allows hospitals, EDs, and SNFs to use any intermediary or technology to send notifications of
admissions and discharges. Should DxF utilize a single, centralized service, a small number of collaborating and cooperating
intermediaries (such as QHIOs), or any intermediary or technology to collect admission and discharge events, collect
requests for notifications of those events, and send notifications to DxF Participants?
• Requests for Notifications: Currently, DxF requires participants to submit a roster of patients if they wish to receive
admission and discharge notifications for these individuals. Should DxF send notifications for patients found on rosters
submitted by DxF participants, to participants identified by the patient, to participants/intermediaries near the address
supplied by the patient, or to participants that have care or payer relationship with the patient as determined by some
means other than a roster or patient request?
• Transport Methods: Currently, DxF does not specify a standard for sending an admission or discharge event to a QHIO or
other intermediary. DxF also does not specify a standard for the notification sent to a DxF participant. Should DxF specify
technical standards for how events are sent to a notification service or intermediary (e.g, HL7 v2.5.1 message) or specify
technical standards for how notifications are sent to DxF participants (e.g. DIRECT secure message)?
• Content Standards: Currently, DxF provides high-level guidance on what must be contained in an event message or
notification. Should DxF specify content standards for events sent to a notification service or intermediary (e.g., the elements
in an HL7 v2.5.1 message that must contain data), or specify content standards for notifications sent to a DxF Participant (e.g.,
data that must be included in a DIRECT secure message)?
9
*Note: Subsequent slides display survey results and analysis.
Survey Results: Requests for Notifications
Respondents recommend that multiple methods of identifying individuals should be available.
10
Question:
Currently, DxF requires participants to submit a roster of patients if they wish to receive admission and
discharge notifications for these individuals. Rate your recommendation for how these notifications should be sent.
Patients Identified
Use
Exclusively
As One
Option
Do Not
Use
DxF should send notifications for patients found on rosters submitted by DxF
Participants.
2
5 0
DxF Should send notifications to participants identified by the patient. 0
6 1
DxF should send notifications to participants/intermediaries near the address
identified with the patient.
1
4 2
DxF should send notifications to participants that have care or payer relationship
with the patient as determined by some means other than a roster or patient
request.
0
6 1
Do you agree with the approach suggested by the survey findings?
Survey Results: Transport Methods
11
Survey respondents recommend specifying a standard but allowing for other options.
Question:
Currently, DxF does not specify a standard for sending an admission or discharge event to a QHIO or other
intermediary. DxF also does not specify a standard for the notification sent to a DxF participant. Rate your
recommendation on standards for sending and receiving events and notifications.
Technical Standards
Specify a
Single
Standard
Specify at
Least One
Standard But
Keep Options
Do Not
Specify
DxF should specify technical standards for how events are sent to a
notification service or intermediary (e.g. HL7 v2.5.1 message)
1
6 0
DxF should specify technical standards for how notifications are sent to
DxF Participants (e.g., DIRECT secure message).
2
5 0
Do you agree with the approach suggested by the survey findings?
Survey Results: Content Standards
Survey respondents recommend a single content standard for events and notifications.
12
Question:
Currently, DxF provides high-level guidance on what must be contained in an event message or
notification. Rate your recommendations on standardizing the content of event messages and notifications.
Content Standards
Require A
Spec
High Level
Guidance
Do Not Specify
DxF should specify content standards for events sent to a notification
service or intermediary (e.g., the elements in an HL7 v2.5.1 message that
must contain data)
5 2 0
DxF should specify content standards for events sent to a DxF
participant (e.g., data that must be included in a DIRECT secure
message)
4 3 0
Do you agree with the approach suggested by the survey findings?
Survey Results: Architecture
There was no consensus recommendation.
13
Question:
Currently, DxF allows hospitals, EDs, and SNFs to use any intermediary or technology to send notifications of
admissions and discharges. Rank your preference among differing architectural choices.
Approaches
Ranking by Respondent
Avg
DxF should utilize a single, centralized service to collect admission and
discharge events, collect requests for notifications of those events, and send
notifications to DxF participants.
1, 1
2, 2
3, 3, 3
2.1
DxF should utilize a small number of collaborating and cooperating
intermediaries,
such as QHIOs, to collect admission and discharge events,
collect requests for notifications of those events, and send notifications
to DxF participants.
1, 1, 1,
2,
3, 3, 3
2.0
DxF should allow hospitals, EDs, and SNFs to use any intermediary or
technology
they choose to collect admission and dischargeevents, collect
requests for notifications of those events, and send
notifications to DxF participants.
1, 1,
2, 2, 2, 2
3
1.9
Is there a recommendation we are prepared to make?
Public Comment
14
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”.
Next Steps
15
CDII to:
• Document the discussions and recommendations of the TASC
and consider next actions.
Upcoming Meetings
• CDII is scheduling TASC Series 3, which will be focused on technical strategies
for Social Services data exchange.
• Meeting information will be posted to the CDII
DxF webpage once confirmed.
