Among the many bills introduced in the California State Legislature this legislative session are two that focus on expanding on the Data Exchange Framework (DxF) and further defining the entities that are required to sign and uphold the Data Sharing Agreement (DSA).
At C4BH’s March 9 meeting, attendees were joined by Ken Branson from State Senator Josh Becker’s (D-San Mateo) office and George Soares from the California Medical Association who elaborated on and responded to questions regarding Senate Bill 582.
Senate Bill 582 requires electronic health record (EHR) vendors to execute the DSA on or before July 1, 2024, and that any fees charged by vendors comply with the fees exception in the federal information blocking rule (45 CFR 171.302(a)). It also introduces a process for DSA signatories to report vendor fees that aren’t in compliance.
As proposed in the bill, an EHR vendor is defined as “a company that develops and provides real-time, patient-centered records that make information available securely to authorized users in a digital format capable of being shared with other providers across more than one health care organization.”
Branson from Senator Becker’s office said that providers are “very dependent” on software companies to enable their capacity to uphold the DSA. This bill was introduced to address concerns that vendors could provide said features at “exorbitant prices” to customers with little to no choice to switch, he added.
Meeting attendees were in resounding agreement as to the intent of the bill, but a few expressed unease about its potential implications.
Jennifer Inden, senior program manager of health IT at Aliados Health (formerly known as the Redwood Community Health Coalition), worried that the language of this bill would grant EHR vendors ownership over patient data. Aliados Health is a network of 17 community health center members with sites in Marin, Napa, Sonoma, Contra Costa, Solano, and Yolo counties.
Marilee Benson, president and co-founder of interoperability solutions provider Zen Healthcare IT, voiced her apprehension that the language of the bill would have it apply not only to EHR vendors but to all health information organizations (HIOs), whose singular source of revenue is vendor fees.
Senate Bill 582 will be evaluated at a Senate Health Committee hearing on March 21 or April 18.
Following Branson and Soares’ presentation about Senate Bill 582, Kristene Mapile from the California Assembly Health Committee joined the meeting to define the intent for Assembly Bill 1331.
Assembly Bill 1331 establishes the DxF governing board, outlines the appointment of members, and requires board approval for any amendments to the DSA and its Policies and Procedures (P&Ps).
Mapile explained that this bill’s objective is to provide an avenue to garner feedback and discussion from as many stakeholders as possible for the administration’s trailer bill language (TBL) that would establish DxF governance and grant the California Health and Human Services (HHS) Center for Data Insights and Innovation (CDII) explicit authority to enforce the DxF.
The recently introduced TBL would also:
- Add the Department of State Hospitals, Department of Developmental Services, Emergency Medical Services Authority, and Department of Corrections and Rehabilitation as required stakeholders to advisory groups
- Amend a statute to explicitly refer to social services information and developmental disabilities information
- Require emergency medical services agencies to sign the DSA
- Grant CDII authority to “administer, manage, and maintain” the DxF, DSA, P&Ps, and governance, as well as the power to oversee dispute resolution
- Establish the Data Exchange Board, which would include ex-officio state agency members and requires one Governor appointee to represent consumers
- Require members to have expertise, represent diversity of the state, and be subject to strict conflict-of-interest policies
