A resurgence of demand for health information exchange (HIE) is underway in California. The COVID19 pandemic has exposed fissures in our health data infrastructure, with dangerous gaps between public health and clinical care systems. Increasing focus on health equity has highlighted the lack of data available to support behavioral health and whole-person care, including addressing social needs. And sustained momentum toward value-based payment continues to focus both commercial and government payers’ attention on the need for data exchange as a foundational requirement for integrated systems of care. Shared understanding of the current data exchange landscape in California can inform key decisions shaping this landscape. This report builds on that companion issue brief to describe how these different forms of HIE play out regionally. Given California’s enormous size and diversity, variation in data-sharing activity at the regional level is to be expected. Such variation has significant implications for California’s long-term approach to enhancing data exchange across the state over time. To explore the dynamic interaction and regional variation across these four HIE types, the authors surveyed publicly available information and conducted 20 interviews with statewide and regional leaders. Four regions were selected for this issue brief: Los Angeles County, Fresno and environs, the Sacramento metropolitan area, and Humboldt County. The regions represent a range of characteristics, such as urban and rural; they also align with the regions included in CHCF’s Health Care Almanac Regional Markets Study, which provides extensive data on local populations and market characteristics.
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