California Gov. Arnold Schwarzenegger named Cal eConnect as a new nonprofit organization that will help hospitals, physicians, clinics, and other providers purchase appropriate health information exchanges under meaningful use rules, and thereby capture more than $3 billion in stimulus funds, the biggest chunk for any state, over the next decade.
"This organization is intended to help create a consensus about how institutions like hospitals, clinics, and physician practices can communicate with each other in a safe way," said Jonah Frohlich, California's deputy secretary for health information technology. Labs, pharmacies, imaging services, and many other healthcare providers, who will use electronic health information in the care of Medicaid and Medicare patients, may be affected.
Frohlich explained that Cal eConnect, and its 22-member board, will hold public meetings to determine which health information technology vendors meet criteria for various purposes, from e-prescribing to records sharing between hospitals and physicians.
Board members, who have not yet been appointed, will also establish ground rules and technical architecture standards for how the systems will work, and how and what types of sensitive health information may be shared electronically.
An important decision for the new entity will be whether certain types of information exchanges are provided by one, or by multiple vendors, in certain regions of the state. Many health information technology companies are expected to compete for industry contracts.
Cal eConnect is actually a consolidation of two organizations that were among seven that wrangled against each other over a tense 10 months for the title. Those two—CalRHIO and the California eHealth Collaborative—were asked in November to prepare a joint application promising their willingness to cooperate.
"The bottom line is that we felt it was absolutely important that this organization be one that is trusted by all stakeholders, and that was one of the dominant themes," Frohlich said. "We must have confidence in organizations that trade sensitive health information."
David Lansky, CEO of the Pacific Business Group on Health, and Don Crane, CEO of the California Association of Physician Groups, will be co-chairs. Board members will come from hospitals, medical groups and independent doctors, employers, private and public health plans, consumers, labor groups, clinics, informatics, and consumers—just about any stakeholder that uses health information, Frohlich said. Safety net providers will be heavily represented, he added.
The state will transfer responsibilities for health information technology governance to the new entity in the next six months.
Kim Belshé, California Health and Human Services secretary, said, "The efficient and secure exchange of health information is fundamental to the future of healthcare delivery in our state. This new governance entity will help ensure that California is able to promote and expand the exchange of health information."
An information exchange for health has never been accomplished before. It's a unique opportunity but will require some innovation and a great deal of hard work to proceed and establish information exchange broadly and in a safe and secure way.
Molly Coye, former director of the state Department of Health and Human Services, and former director of CalRHIO, said she believes Cal eConnect "will define the services and health information exchanges that are considered acceptable by the state, or by this organization. And therefore, a hospital or other provider organization can feel confident with services connected with this effort."
In an interview in late January, Frohlich said, "the hardest challenge" of the state's selection process "is that nothing like this has ever been accomplished before anywhere" although every state is grappling with similar decisions.
Frohlich said not all providers are eligible for stimulus funds. Rather, a certain percentage of care must be provided to Medicaid (Medi-Cal in California) patients to receive $1.4 billion of the $3 billion. Likewise, those providers eligible for stimulus funds from the remaining stimulus portion allocated for Medicare must have a certain percentage of care provided to Medicare patients.