California’s First-Ever Data Exchange Framework (DxF): New Tool for Making Data Sharing a Reality

January 4, 2024 |  By Transform Health

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The Capability to Share Health-Related Data is a Key Driver in Creating Lasting Systems Change

Your health record is central to a new or existing provider understanding the type of care you need. Yet, health data is stored in various paper files, data systems, and analytics.

Take a moment to visualize Lisa. Lisa is an older adult at high risk for certain medical conditions. One day, Lisa notices swelling in her leg and calls 911. During the ambulance ride, the EMS team queries her health information through a regional data exchange network. Within seconds, the EMS providers can review Lisa’s clinical summary, medications, and allergies. Once she arrives at the hospital, staff notify Lisa’s primary care provider of her admission via the regional data exchange network. The attending physician quickly reviews her medical records and symptoms and diagnoses her with cellulitis. Upon her discharge from the hospital, Lisa’s primary care physician requests Lisa’s discharge summary. The two review the discharge summary and her recovery at their next appointment.

The scenario above is not representative of California’s current health information exchange practices. However, it’s a very possible reality thanks to a new California policy.

The Ability to Share Data is Key to Future-Proofing Health Care Delivery in California– and Beyond

Every Californian, no matter where we live, should be able to walk into a doctor’s office, a county social service agency, or an emergency room and be assured health and human services providers can access the information they need to provide safe, effective, whole person care—while keeping our data private and secure. This is the goal of California’s Health and Human Services Data Exchange Framework, a first-ever, statewide data sharing agreement that will accelerate and expand the exchange of health information among health care entities, government agencies, and social service programs beginning in 2024.”

California Center for Data Insights and Innovation

The Data Exchange Framework (DxF) in California

The Data Exchange Framework (DxF) – designed by the California Health & Human Services (CalHHS) Center for Data Insights and Innovation (CDII) mandates that certain health care providers sign on to a Data Sharing Agreement (DSA) and a common set of Policies & Procedures (P&Ps). Although not required to sign the DSA, social services providers may also share data under the DxF.

By signing on, a broad spectrum of health care and social service organizations commit to making their health and social service records accessible to other DxF Participants via health information exchanges, health information organizations, or DSA-adherent technology.

Data exchange shown on a laptop screen

A Step Towards Achieving Health Equity in California

In 2022, the California Health and Human Services Agency (CalHHS) highlighted substantial gaps in health organizations’ capacity to store and share electronic health and social service information. For the more than one-third of California’s population who are Medi-Cal enrollees, accessing quality, whole-person care is exceedingly difficult as only a small portion of Medi-Cal’s primary care providers share quality health data.

How to Sign On: New Resource: DxF Implementation Toolkit

Evaluate your data sharing practices and make changes to internal policies and procedures, technology, and workflows to align with the DxF. To support implementation, the Multi-Association DxF Education Initiative led by America’s Physician Groups (APG), under a DSA Education Initiative Grant from CDII, contracted with Transform Health and BluePath Health to support DxF education efforts. The coalition developed this toolkit for health care and social services providers to understand how to implement data exchange practices under the DxF.

Data exchange chart

The toolkit features the following:

  1. Process overview: Step-by-step instructions for signing the Data Sharing Agreement (DSA) and creating and maintaining data sharing practices under the DxF.
  2. Internal planning guidance: Guidelines for making any necessary changes to internal policies and procedures, technology, and workflows.
  3. Understanding your environment: Questions to ask trading partners to better understand your data-sharing environment and partners.
  4. Additional DxF resources: a summary of funding and technical resources available to your organization.

Please share the DXF toolkit to help your organization complete its own data sharing journey!

Transform Health is a nationally certified women and minority led health care consulting firm. Reach out to us today if you would like to work together. Contact Heather Bates, COO, and VP of Stakeholder Engagement at We would love to hear from you!

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