It has been nearly one year since Governor Gavin Newsom signed into law health care trailer bill AB 133 which aims to transform healthcare for Californians by expanding Medi-Cal eligibility, investing in behavioral health initiatives, and requiring providers and health plans to share data with each other by 2024.

This law requires, on or before July 1, 2022, that California Health and Human Services Agency (CHHSA), in consultation with stakeholders and local partners, establish the California Health and Human Services Data Exchange Framework that includes a single data sharing agreement and common set of policies and procedures that will govern and require the exchange of health information among health care entities and government agencies in California.

AB 133 required the creation of a framework for the seamless and secure exchange of this data in real time between healthcare entities across the state, and the convening of a Stakeholder Advisory Group to advise on the development and implementation of the data exchange framework.

AB 133 requires all “specified entities” to “exchange health information or provide access to health information to and from” other specified entities in real-time, as defined in the bill, by January 31, 2024. Specified entities include general acute care hospitals, physician organizations and medical groups, skilled nursing facilities, health care service plans, disability insurers, Medi-Cal Managed Care Plans, clinical laboratories, and acute psychiatric hospitals.

Certain health care providers do not need to meet the data sharing mandate until January 31, 2026. This includes physician practices of fewer than 25 physicians, rehabilitation hospitals, long-term acute care hospitals, acute psychiatric hospitals, critical access hospitals, and rural general acute care hospitals with fewer than 100 acute care beds, state-run acute psychiatric hospitals, and any nonprofit clinic with fewer than 10 health care providers.

But little attention went to Section 1862 of the bill, which required just one public hearing about the rules and operating principles for the largest-ever state compendium of private medical records. An there is now some consternation about privacy in the media.

An article this week in the Orange County Register says that the law will “end the concept of patients keeping any secrets from doctors, psychologists or other medical folk.”  Conversely, it would seem that the flow of electronic health information will assist with the data collection and distribution needed to manage the delivery of medical benefits in the workers’ compensation claims administration process.

It will also assist with the discovery of important medical histories during the discovery phase of workers’ compensation litigation.

It also remains to be seen if the information network materializes within the specified timeframe. There have been previous attempts and failures along the way in California.

A Timeline of Health Data Exchange in California, prepared by the California Health Care Foundation (CHCF), Governor Arnold Schwarzenegger issued an executive order calling for “100% electronic health data exchange” within 10 years.

The order identified key actions, including providing state leadership, taking advantage of the state’s purchasing power, developing a quality reporting mechanism through the Office of the Patient Advocate, and strengthening the ability of the Office of Statewide Health Planning and Development to collect, integrate, and distribute data.

The 100% goal within ten years specified by Governor Schwarzenegger has not materialized. However, this month, the first mandated deliverable under AB 133 seems to be on track as scheduled.

A July 2022  announcement by the California Health & Human Services Agency said the agency has finalized the state’s first-ever Health and Human Services Data Exchange Framework, a single data sharing agreement and common set of policies and procedures that will govern and require the exchange of health information among health care entities and government agencies in California beginning in 2024.

And Executive Summary prepared by the Agency sets for the timeline of the remaining steps anticipated to take place to meet the 2024 startup.