The COVID-19 pandemic has brought into stark relief the need for high-quality health data about everyone in the state. Creating and exchanging data more efficiently 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 do 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 (HIOs) and private health care networks. And 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. Overcoming these shortcomings would reduce health care disparities, improve patient safety and public health, and reduce wasteful spending, poor coordination, and reactive care. This report explores what is working in four states that have successfully implemented statewide health data networks. The report broadly defines a statewide health data network as a state’s approach to data exchange that allows all health care providers, institutions, and agencies across a state to appropriately access and securely share patient health information electronically. Further, the term is more expansively defined in this report to address the direction in which many statewide health data networks are moving, which is to also connect clinical and claims records, as well as data about behavioral health care and social determinants of health (SDoH) to enable “whole-person care.” Each state in this report may brand its system differently, calling its statewide health data networks health information exchanges (HIEs) or health information networks (HINs), and may have followed a slightly different path to development over time, but all have important features in common. 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.
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