Ensuring older adults receive coordinated and person-centered care means bridging the longstanding divide between health care and social services. But this is only possible when the right people have the right information at the right time.
The California Data Exchange Framework is central to realizing that vision, because it is prompting providers of all kinds to participate in the seamless, secure, and equitable sharing of health and social service data across all care settings. To provide whole-person care that honors the dignity and complexity of each Californian’s experience, it is critical that hospitals, primary care providers, specialists, aging services organizations, payors, and caregivers can access and exchange timely and accurate information with each other. The framework, known as the DxF, was created by the state to make that happen.
Equally important to person-centered care is making sure people have access to their own data. None of us – especially older adults – should have to act as the historians of our own care, expected to carry all our paperwork from one provider to the next.
A Turning Point
Siloed systems create barriers to care, particularly for those with complex needs. Efforts to break down those barriers by connecting health and social care systems – including CalAIM, the program to transform Medi-Cal – depend on the timely and reliable exchange of patient data. That is why the state created the DxF in 2021 and pushed for its full implementation by last year. It then convened a meeting in Sacramento in February where payors, providers, state officials, and community-based organizations shared their experiences with the emerging system – and agreed it is "riskier" to not share health and social services data.
Why It Matters
Consider Tina, who is 75 years old and navigating a fragmented network of disconnected care systems. She lives alone, manages diabetes and hypertension, and receives in-home support and services from local organizations. But when she was taken to the emergency room one night after experiencing chest pains, the hospital care team didn’t know she recently began a new medication or that she receives daily medically tailored meals and transportation assistance. That lack of information compromised her care, delayed her discharge, and increased her risk of readmission.
Such stories are all too common and reflect the systemic failure the DxF is designed to address. It provides “rules of the road” that providers agree to for sharing health and social service information about their patients in ways that are secure and trustworthy. Its four components are:
- A data sharing agreement under which participants commit to securely providing real-time and appropriate information.
- Policies and procedures governing information exchange, including universal consent guidance.
- Digital identities allowing providers to match shared clients while keeping their identities and records confidential.
- A system allowing providers to access information using either their own technology or an intermediary organization.
This system allows health care providers, social service providers, and community-based organizations to share information confidently, respectfully, and equitably. This is especially important for community-based and aging services organizations, which have been excluded from previous data exchange efforts focused on clinical care providers only.
Closing the Gaps
The DxF won’t succeed unless under-resourced organizations receive the support they need to participate. To that end, Archstone Foundation recently awarded a grant to Connecting for Better Health (C4BH), a statewide coalition advancing data sharing, to bring aging services organizations into the data exchange conversation by providing education, technical assistance, and policy support.
Through training sessions and community design studios, C4BH will help aging service providers understand DxF principles and requirements, implement the necessary technical and workflow changes, and share resources and insights to inform broader policy efforts. The next training session – DxF Bootcamp – is Wednesday, May 7th from 9:00 am to 12:00 pm. Register here.
This work will ensure the benefits of exchanging data will be realized not only by large health systems but also for all organizations supporting older adults and caregivers.
Ultimately, the DxF revolves around trust, collaboration, and the health and dignity of older Californians. Each of us plays a role in building this framework in our communities. With aligned effort, we can turn information sharing into action that improves lives and ensures that people like Tina never have to navigate disconnected systems alone.
Remi Fernandez and Stephanie Thornton of Connecting for Better Health contributed to this post.
