YOU ALL FOR BEING HERE WELCOME
TO THE ASSEMBLY HEALTH
COMMITTEE HEARING ON HEALTH
INFORMATION EXCHANGE DUE TO THE
CONTINUED STAY AT HOME ORDER
WE'RE PRACTICING PHYSICAL
DISTANCE SEEN HERE IN THE
HEARING ROOM AND THROUGHOUT THE
CAPITOL BUILDING AND SO WE ARE
ONLY ABLE TO HAVE A LIMITED
NUMBER OF PEOPLE WATCH AND
PARTICIPATE IN THE HEARING IN
PERSON. ROSS REQUIRED MASKS BE
WORN IN PHYSICAL DISTANCE IN BE
MAINTAINED BY ALL MEMBERS OF
THE PUBLIC TESTIFYING WHETHER
HERE IN THIS ROOM WHERE ONE OF
OUR VIDEO CONFERENCING SITES
YOU DON'T HAVE A MASS WE WILL
PROVIDE ONE FOR YOU. FOR A
WITNESS IN THE VIDEO- ROOM AND
REMOTE TESTIMONY STATE STATE.
STATION WITNESSES WHEN WE
REACHED THE PUBLIC COMMENT
PORTION. OF THE- AGENDA I WOULD
ASK THAT ANY MEMBERS THE
PUBLIC. TO TESTIFY EITHER IN
THE STATE CAPITAL OR- IN IN THE
WITNESS VIDEO ROOM PLEASE
MAINTAIN- SOCIAL DISTANCING AS
YOU MOVE AROUND THE ROOM. THIS
YEAR WE HAVE PANELISTS AND
OTHER MEMBERS OF THE PUBLIC
MAKING USE OF OUR WITNESSES
VIDEO CONFERENCING ROOMS HERE
IN THE CAPITAL. AND A FEW OTHER
LOCATIONS THROUGHOUT THE STATE.
WAS WITNESSES WILL APPEAR ON
THE SCREEN SO MEMBERS CAN WATCH
THEIR TESTIMONY LIVE FROM
OUTSIDE OF THE HEARING ROOM.
AND ALSO ASK THEM QUESTIONS.
FOR MEMBERS OF THE PUBLIC WILL
BE CALLING IN WE WILL BE USING
A MODERATED OF TELEPHONE
SERVICE THROUGH. THROUGH WHICH
ANY MEMBER THE PUBLIC CAN
PROVIDE COMMENTARY WHEN WE GET
TO THAT POINT IN THE AGENDA. OF
PANELISTS WOULD HAVE BEEN
PROVIDED WITH THE CALL IN
NUMBER PRIOR TO THIS HEARING.
THE NUMBER IF YOU WANT TO JOT
THIS DOWN IN ADVANCE FOR PUBLIC
COMMENT FOR THIS HEARING. IS
EIGHT SEVEN SEVEN SIX NINE TWO.
EIGHT NINE FIVE SEVEN AND THE
ACCESS CODE IS TWO FOUR TWO.
SIX TWO THREE SEVEN READ THAT
AGAIN. EIGHT SEVEN SEVEN SIX
NINE TWO. EIGHT NINE FIVE SEVEN
AND THE ACCESS CODE. IS TWO
FOUR TWO SIX TWO THREE SEVEN.
YOU CAN FIND THIS NUMBER ON THE
ASSEMBLY HEALTH COMMITTEE'S
WEBSITE. AS WELL AS ON YOUR TV
SCREEN. THE OPERATOR OPERATE ON
THE LINE AT THAT POINT WILL
GIVE INSTRUCTIONS ON HOW TO BE
PLACED IN THE QUEUE. TO PROVIDE
YOU PUBLIC COMMENT IF YOU'RE
CALLING IN PLEASE ELIMINATE ALL
BACKGROUND NOISE THIS INCLUDES
MUTING YOUR LIVESTREAM
BROADCAST BECAUSE THERE'S A
LITTLE DELAY. AND YOU'RE SMART
ABOUT DEVICES BECAUSE THEY TEND
TO MEET MEET. MEET EMIT SOUNDS
AS WELL- ONCE YOU'RE IN THE
QUEUE- YOU'LL BE ASKED TO MUTE
YOURSELF UNTIL YOU'RE CALLED
UPON TO SPEAK. ONCE AGAIN IF
YOU IF YOU DO HAVE ANY TROUBLE.
WITH THE MODERATE PHONE SERVICE
YOU CAN CALL THE COMMITTEE AT
NINE ONE SIX. THREE ONE NINE
TWO ZERO NINE SEVEN AND MY
STAFF WILL BE THERE TO HELP. I
ALSO WANNA NOTE THAT WE'RE
ACCEPTING WRITTEN PUBLIC
COMMENT THROUGH THE ASSEMBLY
HEALTH COMMITTEES PUBLIC EMAIL.
AND THAT IS A H. E. A. DOC
COMMITTEE. S. ASSEMBLY. DOT CA.
DOT G. O. V. WHICH CAN ALSO BE
FOUND ON OUR WEBSITE. WE MAY
NEED TO LIMIT HOW LONG EACH
PERSON. HAS TO PROVIDE PUBLIC
COMMENT- BUT I THINK YOU FOR
YOUR PATIENCE. THANK YOU ALL
OUR SPEAKERS FOR A COMPANY TO
REQUEST TO PRESENT AT THIS
HEARING- DURING THE PANDEMIC.
THIS IS OUR SECOND
INFORMATIONAL HEARING ON HEALTH
INFORMATION EXCHANGE. BECAUSE
THIS ISSUE IS SO COMPLEX. AND
WE WANT TO GET IT RIGHT. WE
WILL ADDRESS TODAY WHAT- WHAT
WHAT ARE SOME OF THIS OUR STATE
HEALTH INFORMATION EXCHANGE
PRIORITIES. OTHER QUESTIONS WE
WILL ASK OUR- HOW CAN
CALIFORNIA DEVELOP IN H. I. E.
POLICY THAT BEST SUPPORTS STATE
AND LOCAL PUBLIC HEALTH
AGENCIES IN THEIR EFFORTS TO
RESPOND TO THE CURRENT AND
FUTURE PUBLIC HEALTH
EMERGENCIES. HOW CAN H. I. E.
BE UTILIZED TO HELP THE STATE
IDENTIFYING BEGIN ELIMINATE
HEALTH DISPARITIES TO CONTINUE
TO IMPACT FAR TOO MANY
CALIFORNIANS. WHAT IS THE BEST
WAY TO ESTABLISH DATA EXCHANGE
ACROSS HEALTH CARE AND SOCIAL
SERVICE PROVIDERS THAT ENABLES
POPULATION HEALTH MANAGEMENT
AND PATIENT CENTERED CORD CARE
COORDINATION. AND FINALLY WHAT
POLICIES CAN CALIFORNIA ENACT
TO LEVERAGE THE PROGRESS MADE
THROUGH THESE NETWORKS BUT BE
MORE INCLUSIVE AND ENSURE THAT
CALIFORNIA'S H. I. E. SYSTEM
SIR ALL CALIFORNIANS AND
PROIDE SERVICES THAT ADDRESS
THE WHOLE PERSON- IF ANY
MEMBERS OTHER MEMBERS WOULD
LIKE TO SAY ANYTHING BEFORE WE
START. AND IT WAS. OKAY ALL
RIGHT C. NONE- WE HAVE- TWO
PANELS TODAY TO DISCUSS THE
ISSUE. THEY'RE ALL USING WEBEX
YOU CAN SEE THEM AS WE SPEAK I
KNOW WE HAVE MEMBERS WATCHING
THIS REMOTELY AND I THINK THERE
MAY BE A COUPLE THAT MIGHT BE
TRY. EVEN TRY TO PARTICIPATE
MIGHT RIP REMOTELY SO WE WILL
OPS OPS OBVIOUSLY WELCOME THAT.
THEIR POWER POINT PRESENTATIONS
IN THE AGENDA AND OTHER
MEETINGS- MATERIALS ARE POSTED
ON THE ASSEMBLY HEALTH
COMMITTEE WEBSITE UNDER THE
HEARINGS AND THEN INFORMATION
INFO HEARINGS TAB. OUR FIRST
BIGGER IS JONAH. FROM
MANAGEMENT AT HEALTH. HE ALSO
PRESENTED OUR FIRST
INFORMATIONAL HEARING. WELCOME
BACK JOHN. THANK YOU VERY MUCH
DOCTOR WHAT THE CITY
OPPORTUNITY- THANK YOU MEMBERS
OF THE SENATE HEALTH COMMITTEE
AND THE PUBLIC- I DO APPRECIATE
THE OPPORTUNITY TO PROVIDE A
TOUGH MONEY AGAIN TODAY- I.
WHAT I WILL BE DOING IS
PROVIDING- OPTIONS THAT WERE
PUBLISHED IN A PAPER FROM THE
HELP HEALTH CARE. APPRECIATE
THEIR SUPPORT THE- I WAS
PUBLISHED- PRODUCED I THEIR
WEBSITE- AND WHAT I'D LIKE TO
DO IS GO THROUGH. FINDING AND-
OPTIONS THAT ARE THAT ARE IN
THE- THAT DIRECTLY THE TO-
FINISH STOCK WITH THAT YOU ARE.
THAT THEY ONSET OF CHARACTER WE
GO TO THE NEXT SLIDE- FOR
REALLY CHARACTER THAT OF THE IS.
WE WORKED THIS FOR MANY YEARS-
THAT THE ISSUE THAT FALL-
REALLY ACCESS TIMELY AND
COMPLETE. ELECTRONIC THE HEALTH
BEHAVIORAL HEALTH AND SOCIAL
SERVICES. IS VERY LIMITED CAL
TODAY- WITHOUT IT WITH
COMPLETING FOR AROUND PHYSICAL
HEALTH BEHAVIOR HEALTH AND A-
ARE ENDEMIC EMERGENCY RESPONSE
AND HEALTHCARE POLIC PROGRAM
NEEDED EVERYBODY CAN'T PASSED.
AND THAT'S BECOME VERY OF IN
THE- IT REALLY LAID BARE REAR-
THE BILL IN THE WELL BEING OF
CALIFORNIA ARE. BY IN A BILL TO
SAFELY AND SECURELY CHAU FROM.
NO I NEVER IN THE IN THE RIVER.
WE ARE THREE DID EXCHANGE OR-
TO ISSUE THAT NEED TO BE
RESOLVED. OVER COMBAT AND THEN
TO ADDRESS ALL OF CALIFORNIA
NEED. AND HAVE A CHARACTER THEM
ONE- PERSON AROUND WHO DATA.
WHAT WE NEED BY THAT. IS
THIRTEEN. PROVIDE PURCHASED.
HAHA CLINICS AND- IN READ AND
NATIONAL AND THE OR H. IDEA. IT
MAY RURAL AND MANY UNDERSERVED
COMMUNITIES NOT BY DATA
EXCHANGE ACTIVITIES. THAT
CLINICAL DATA FRAGMENTATION.
THE SECOND CATEGORY EXCLUSION
OF EXCHANGE SECTORS AND BY THAT
WE MEAN THAT TEN YEARS
PURCHASERS PUBLIC HEALTH
INSTITUTIONS SOCIAL SERVICE
AGENCIES AND PROVIDERS
BEHAVIORAL HEALTH AND IN MOST
CASES EMERGENCY RESPONSE
PROVIDERS AN AGENCY CAN'T
PARTICIPATE IN MOST HIV
ACTIVITY. PART BECAUSE THEY
WERE DESIGNED. TO EXCHANGE
PHYSICAL HEALTH DATA. ALSO DUE
TO THE FACT THAT MANY OF THEM
DON'T HAVE ELECTRONIC SYSTEMS
IN PLACE WITH WHICH THEY CAN
SHARE DATA WITH OTHERS. THE
THIRD CATEGORY OF ISSUES IS- IS
REALLY A LEGAL ONE AND THIS IS
FOCUSED ON CLICK ON COMPLEX AND
RIGID EXCHANGE RULES AND
REGULATIONS. AND IN THIS CASE
THERE ARE MANY RESTRICTIVE
AMBIGUOUS AND THE LINE STATE
AND FEDERAL LAWS. THE RESULT IN
MANY ORGANISATIONS ELECTING NOT
TO PARTICIPATE IN DATA EXCHANGE
ACTIVITIES GEARING LIABILITY
AND REALLY AMBIGUITY
UNCERTAINTY ABOUT WHAT THEY ARE
AND ARE AND ARE NOT ALLOWED TO
EXCHANGE. SO THOSE ARE THE
THREE MAIN CATEGORIES OF ISSUES
WE'VE IDENTIFIED AND PURPORT
THROUGH. A SERIES OF INTERVIEWS
AND RESEARCH EXTENSIVE RESEARCH
WE'VE DONE AND- I'M OVER MANY
YEARS- AND MANY OF THE OTHER
STATES THAT HAVE H. I.
INITIATIVE COMPLEX. OUR NEXT
LIKELY. NOW WE IN THIS REPORT
DESCRIBED FOR SCENARIO TO
REALLY HELP THE HUMAN AND- OF
THIS. H. I. IN. AND WE NOTED
PER THE DE IMPACT IT'S- AND ARE
AMERICAN LATIN ACT NATIVE CAN
WHO BEEN PART HARD HIT BY THE
PANDEMIC. BUT DISPARITIES EXIST
BEYOND THE PANDEMIC AND THEY
EXISTED AND THEY PRE DATED AT
AND THE LIMITED H. I.
INFRASTRUCTURE WE HAVE TODAY
DOES NOT SERVE THEM WELL. NOW
BEFORE SCENARIOS REALLY TRIED
TO CREATE THIS SEARCH WITH
HUMAN PICTURE OF WHAT ACTUALLY
HAPPENED TO AN INDIVIDUAL IN
NEED FOR DIFFERENT SCENARIOS
WHEN THEY TRY TO SEEK SERVICES
WITH THE PROVIDERS TRY TO CARE
FOR THEM. I'M TO THE FORESTERS
ARE AS FOLLOWS FIRST DISASTER
BONTA PRIMARILY WE'RE REALLY
FOCUSING ON WALL PARTS BECAUSE
THEY BECOME INCREASINGLY
PRESENT AND- UNFORTUNATELY IT.
AN ANNUAL. EVENT IN CALIFORNIA.
AND RECENTLY THEY DISPLACED
LITERALLY HUNDREDS OF THOUSANDS
OF BALLOTS OF RESIDENTS
EVACUATED AWAY FROM THEIR HOMES
OUTSIDE OF THEIR COUNTIES. AND
WITHOUT THESE ROBUST DATA
EXCHANGE CAPABILITIES.
EMERGENCY RESPONSE PERSONNEL
HEALTH AND SOCIAL SERVICE
PROVIDERS HAVE THE COMPLETE
INFORMATION ABOUT PATIENT NEEDS
WHEN A PATIENT ARRIVES IN THE
CLINICS ARE IN THE HOSPITAL
WE'RE SEEKING CARE AND THEY
HAVE UNLIMITED MEANS ELECTRONIC
ELECTRONICALLY SHARING WHAT
THEY DO NOW ONCE THEY ACTUALLY
HAVE THE PATIENT OR THE CLIENT-
IN IN THEIR IN THE NEXT IN A
CLINIC OR- I SITE. THE SECOND
AN RESPONSE- AND WORLD VERY OF
THE ISSUES HERE BUT JUST IN.
PUBLIC HEALTH INSTITUTIONS WE
SEE DATE HAVE ACCESS TO RE TIME.
IN FOR. THE CONFLICT UNIT
INFORMATION- DATE ABOUT A REAL
TIME VENTILATORS ACCEPT.
VACCINE AND OTHER INFORMATION
THAT NECESSARY TO RAPIDLY
MOBILIZE RESPONSES AND
RESOURCES BUT WITHOUT THAT KIND
OF REAL TIME ACCESS TO THAT
INFORMATION. I CAN'T LINK
RECORD THEY CAN'T SHOW FOR
EXAMPLE THAT SOMEBODY GOT THE
POT THE BLACK IS ALSO A MAN CAL
FROM. WHO ALSO A SOCIAL SERVICE
NEED AND ALL THOSE RESOURCES
CAN RAPIDLY BE MOBILIZED TO
SUPPORT THEM. SO THEY CAN'T
LIKE THOSE RECORDS. PUBLIC
HEALTH CANNOT DEMOBILIZE
RESOURCES AND OTHER PROVIDERS
TO CARE FOR THAT NUMBER BASED
ON WHAT THEY'RE- A THIRD ISSUES
RUN CERTAIN PATIENTS WITH
COMPLEX NEEDS AND THIS IS
PARTICULARLY IMPORTANT FOR-
CALIFORNIA NOW IN IN LIGHT OF
WHAT. WHAT CULT CAL AIM WHICH
IS THE DEPARTMENT HEALTHCARE
SERVICE PROGRAM WHICH IS
LAUNCHING NEXT YEAR. WHICH IS
DESIGNED SPECIFICALLY TO
ADDRESS THOSE. INDIVIDUALS
ENROLLED IN MEDICARE NOW- WE
HAVE A NUMBER OF. TECHNIQUE IN
A IF AN INNOCENT WE THE PAY
WITH NEEDS OFTEN HAVE CRY
MEDICAL CONDITION LIKE THAT OR
HEART COULD BEHAVIORAL AND
SOCIAL MEETING THEY HAVE A
SUBSTANCE USE DISORDER OR
SERIOUS AND PERSISTENT MENTAL
ILLNESS SOCIAL NEEDS LIKE
HOUSING INSECURITY. AND THE
NETWORK OF PROVIDERS THAT
CERTAIN HAVE NO WAY OF SHARING
VITAL INFORMATION ABOUT EACH
ONE OF THOSE FACTORS. SO THAT
WHEN PROVIDERS ARE TRYING TO
CARE FOR THEM HELP THEM GET
HOUSING HELPED THEM GET IT BUT
REPORTER THE SUBSTANCE USE
DISORDER. IT'S INCREDIBLY
DIFFICULT ACCESS INFORMATION TO
DO THAT. AND THE RESULTANT
UNCOORDINATED CARE AND
INCREASED MORBIDITY AND
MORTALITY FOR THOSE NUMBERS.
FINALLY QUALITY REPORTING BY
BASED CARE. REPAIRS HELP PLANT
IN THE MEMBERS HAVE TO ACCESS
TO HELP INFORMATION SO. I NEED.
WHO IS TRYING TO FIND A
PROVIDER FOR. GLAUCOMA FOR- AN-
A CHRONIC DISEASE MAY NOT OR OR
A SURGERY PROCEDURE MAY NOT
HAVE INFORMATION ABOUT.
PROVIDERS AND THEIR OUTCOME HOW
WELL THEY PERFORM ON A
PARTICULAR SURGICAL PROCEDURE
HOW MUCH IT COSTS- AND SO THEY
MAKES IT DIFFICULT FOR THEM
CHOOSE THE PROVIDER THAT BEST
MEET THEIR NEEDS AND FOR A
HEALTH PLAN AND PURCHASERS TO
DEVELOP VALUE BASED. PAYMENT
PROGRAMS THAT ARE BASED ON
THINGS LIKE QUALITY BECAUSE
THEY DON'T HAVE ACCESS TO
CLINICAL DATA. THEY CAN'T
REALLY USE THAT TO DRIVE
DECISIONS ABOUT WHO SHOULD BE
ON OUR NETWORK. AND WHAT SHOULD
THE BY THE- PAYMENT PROGRAMS BE
BASED ON. SO THOSE ARE THE FOUR
THINGS THAT WE DESCRIBE IN OUR
IN OUR REPORT. AND THAT REALLY
HELPS- ILLUSTRATE THE IMPACT OF
THE HUMAN TOLL OF A LOCKING. H.
I. INFRASTRUCTURE. AND THE
OPTIONS THAT ARE GOING TO FALL
IN A MOMENT. NOT QUITE THE. SO
IN TERMS OF THE KEY ACTION
TAKEN THESE OPTIONS FOR
CONSIDERATION SO- CLEARLY WHEN
YOU CONSIDER THESE FOUR
SCENARIO THERE'S A COMPLEX
SENTENCE HIV CHALLENGES. THE
HIGHLIGHT THE SIGNIFICANT GAPS
IN OUR INFORMATION EXCHANGE
CAPABILITIES AND I HAVE SERIOUS
IMPLICATIONS FOR RESIDENTS.
PROVIDERS TO CARE FOR THEM AND
THE PUBLIC AND PRIVATE AGENCIES
TO COVER AND SUPPORT THEM. SO
AS I MENTIONED WE SUPPORTER
NUMBER STAKEHOLDER INTERVIEWS
RESEARCH INTO A NUMBER OF
DIFFERENT STATE POLICIES. TO
HAVE SOME SOME WHICH HAVE
MARKED COMPREHENSIVE STATEWIDE
HIV. AND WHAT WE FOUND IS THAT-
THE INFRASTRUCTURE AND
SERVICES- HIV STRUCTURE
SERVICES AND INITIATIVES ARE
BEST SUPPORTED WHEN THEY USE A
RANGE OF POLICY CONTRACTING AND
FINANCING LEVERS THAT THEIR
YOUTH TOGETHER IN UNISON IN A
COORDINATED WAY. AND
SPECIFICALLY WE FOUND THAT
STATES THAT HAD MORE REQUIRE
HEALTH INFORMATION EXCHANGE THE
FOLLOWING COMPONENTS. ONE THE
BIGGEST DRAWBACK PUBLISHED A
STRONG LEADERSHIP STRUCTURE
WITHIN GOVERNMENT THAT HELP
GUIDE POLICY AND PROGRAM ACTION
ACROSS VARIOUS AGENCIES HEALTH
CARE SOCIAL SERVICES PUBLIC
HEALTH. AND THAT THEY CAN USE
YOUR THEY USE THAT ALIGNMENT.
TO ADDRESS HIV OVERCOME
BARRIERS AND PRIORITIZE
ACTIVITIES THAT WILL BENEFIT
ALL. A SECOND ELEMENT IS
CREATING A MULTI STAKEHOLDER
HIV ADVISORY BODY. THAT WAY
YOU'RE GETTING INPUT DIRECTLY
INTO THOSE DECISION MAKERS INTO
STATE GOVERNMENT TO HELP GUIDE
PRIORITIES POLICIES AND
PROGRAMS THAT CAN BE
IMPLEMENTED TO THE BEST A FACT.
THIRD IS THAT THE STATE IS
GENERALLY INACTIVE NEW LAWS
SOME OF WHICH ARE ARE ARE
CALLED MANDATE SHARON. ABOUT
PROMULGATED RULES TO ENCOURAGE
OR REQUIRE HEALTH INFORMATION
EXCHANGE AND RELATED TO THAT
THE FOURTEENTH WANT IT MANY
WITHOUT WORST. HELP INFORMATION
EXCHANGE CONTRACTING PROVISIONS
IN PUBLIC PURCHASING PROGRAMS
LIKE MEDICAID OR PUBLIC
EMLOYEE AND EMPLOYER
PURCHASING PROGRAMS. UPFIT
COMMON L. IS THERE'S A NAY AND-
THAT THE STATE IN BACK. IN
TECHNOLOGIES AND TRAINING. OFF
THE WHICH IS BY FUNDING. THERE
ARE WAYS THAT PROTECT THAT
STATE MONEY DRAW INTO TEN
DOLLARS SO THAT WE CAN
POTENTIALLY ENHANCE THE FUNDING
THAT WE CAN PROVIDE FOR
TRAINING. FOR TECHNOLOGY- AND
FOR INFRASTRUCTURE. AND THEN
FINALLY. WHAT WE FOUND AND WHAT
THE I. PAPER ALSO PUBLISHED BY-
FUTURE FROM HEALTH TECH THAT
MOST OF THE STATE'S WITH MORE
ABOUT ARE USED. BUT THAT OF H.
T. ACT YOU CASE ARE YOU KIDDING
IN FROM LIKE. WE WILL SEE-
HELLO DISCHARGE TRANCE OUT OF
THE- WILL MADE OF A WHEN EVER
PAY AT THIS FOR HOT. OR FROM TO
OR FROM AN URGENT CARE. THAT
THE USE CASE. AND MANY STATE.
IF THAT SITUATION- THAT OF. USE
CASES WHICH THAT. INTEGRATE AND
PRO PRIOR CON AND IN SOME CASES
THAT MAY BE LAW. SO THOSE ARE
THE KEY ACTION AND THEY'VE
REALLY IN THE FOOTBALL ARE
UNTIL NEXT BY THREE. THE FIRST
OPTION- THAT REALLY SORT TRAN.
AND IT'S REALLY MY TO ADDRESS
ALL THE THESE OPTIONS BOB- IS-
FIRST TO ALLOW LEADERSHIP STATE.
REGULAR HELP AND IMPLEMENT
SERVICES A THE AND BY. WE MEAN
THAT CALIFORNIA COULD STOP AN
OFF. AND LED BY BOARD WITH IN
STATE GOVERNMENT. THAT WOULD BE
CHARGED WITH THE- AGE
INITIATIVE TO ALIGN OF FINE
BECAUSE- A POLICY LEADERS STATE.
NOT WHAT THAT COULD LOOK LIKE.
THAT THIS OFF THE COULD BE
FIFTY OFFICER NEW OFF THE
CRITIC FOR IN THE TOP HEALTH
AND HUMAN. THEY. OR OUT FOR BUT
THE OFFICE COULD BEACH WITH THE
STATE. GOALS AND PRIORITIES FOR
ADVANCING AND FOR X. SO THAT'S
YOU START. REALLY BEGINS WITH
WHAT WE WERE WANT TO ACCOMPLISH.
THE SECOND IS THE OFFICE CA BE
IN AND OUT WITH WILL MAKING
FORTY. AND WHAT THAT WOULD IT
WOULD ALIGN REGULAR. CON LIKE
AND- LEVERS OF TO GOVERNMENT.
TOOK THAT H. I. E. THAT COULD
MEAN THAT WE MAKING A UPON TO.
DEPARTMENTS IN IN TERMS OF.
WHAT WOULD REQUIRE. THEIR CALL.
TO DO WITH RESPECT THAT. HELP
EXCHANGE ACTIVITY TOOK COULD
REQUIRE THAT THEY- HAVE ALL THE-
IN NETWORK- TO THE PAID INCOME
WAY INTO SORT OF H. I. ACT THAT.
SAYS GOAL- OFFICE COULD ALSO BE
CHARGE WITH THE BELT RECOMMEND.
TO HARMONIZE STATE AT CONFLICTS
WITH. LAW AND TO THE CLEAR HELP
INFORMATION EXCHANGE. AND
TECHNICAL ASSISTANCE THE STATE
AGENCIES INSTEAD. SO THERE ARE
MANY STAY LAWS THAT WERE TO.
AROUND PRIVACY PRIVACY INTO.
PER SOME OF WHICH WERE. BEFORE
A I. EVEN REALLY IN. GONNA
CONFLICT WITH LAW. AND SOME OF
THOSE REALLY DO NEED TO REVIEW
AND REFINED. AND UPDATED TO
BRING US INTO THE FIRST. AND
FINALLY THE THIRD THIS- THAT
OPTION INCLUDE- CREATING A
MULTI STATE HELP INFORMATION
EXCHANGES BOARD- AND THAT COULD
INCLUDE STATE AND COUNTY A REP.
AS A HIMSELF SO SERVICE
PROVIDERS PUBLIC HOW CONCERN
AND OTHER TO THE RECORD. TO
HELP ADVANCE PRIORITIES TO HELP
DEVELOP USE CASES- AND TO
IDENTIFY THINGS LIKE STATE LAW
THAT WOULD BE DOES NEED TO BE
UPDATED BROUGHT INTO THE TWENTY
FIRST CENTURY HARMONIZE WITH
FEDERAL LAW. THAT'S ONE OF AND
AGAIN YOU'LL SEE IT AS GO
THROUGH MORE. OF HAVING THAT
KIND OF IN AWE. AND THIS KIND
OF. IS REALLY. I THINK MATHIS
OR TO REALLY ENABLE ME TO
OTHERS I OTHER OPTIONS AS WELL.
NEXT SLIDE PLEASE. SO NEXT- IS
REALLY OPTIONS TO ADDRESS CLING
DATA FRANK COOKIE REMEMBER THE
BEGINNING OF MY TESTIMONY I
MENTION THESE THREE DIFFERENT-
PROBLEMS ARE CHALLENGE
CATEGORIES THE FIRST ONE WITH
CLINICAL DATA FRAGMENTATION AND
THIS IS WHERE. WE HAVE
INCOMPLETE LIKE CLINICAL DATA
NOT BEING SHARED SOME REGIONS
DON'T HAVE LIKE A REALLY ROBUST
OR OR VIRTUALLY ANY H.
CAPABILITIES OUT IN ORDER TO
ADDRESS THAT PARTICULAR
CHALLENGE- THIS OPTION WOULD.
STATEWIDE HEALTH INFORMATION
EXCHANGE REQUIREMENTS. MANDATE
FOR EXAMPLE PLUS CREATING
CENTER THE PANEL FROM BROUGHT
H. I. U. OF THE BY PLAN AND
PROVIDERS AND HEALTH CARE
SOCIAL SERVICE EMERGENCY
RESPONSE AND PUBLIC HEALTH
PROGRAMS. SO THIS COULD FOR
EXAMPLE REQUIRE- INCREASE ENACT
A NEW LAW THAT WOULD. HOSPITALS
PROVIDERS HEALTH PLANS AND
OTHERS TO PARTICIPATE IN THE
SECOND SPECIFIED HEALTH
INFORMATION EXCHANGE ACTIVITY.
THAT MET SPECIFIC STATE HEALTH
CARE PUBLIC HEALTH SOCIAL
SERVICES AND EMERGENCY RESPONSE
CALLS. THE REQUIREMENTS COULD
ALSO BE DESIGNED BY THE BY THE
NEW OFFICE. WITH INPUT FROM THE
ADVISORY BOARD. AND THEY
SHOULD. AND THEY SHOULD ALIGN
WITH AND REINFORCE FEDERAL
RULES UNDER THE TWENTY FIRST
CENTURY CURES ACT HIPAA AND
ELSEWHERE THE LAST THING WE
NEED TO DO IS CREATE NEW STATE
LAW. THE COMPLEX WITH FEDERAL
LAW WE HAVE ENOUGH OF THOSE. WE
REALLY NEED TO HARMONIZE WE
NEED TO RIDE ON FEDERAL LAW
THAT IS REALLY TRYING TO
ADVANCE THE MORE GOALS BRAND
HIV. NOW WHAT I MEAN IS A
MODEST SUGGEST THAT MANDATE
LIKE JUST A REQUIRE THAT YOU
MUST. HAVE BEEN HIV THE FISH ON
ABOUT AND IT REALLY NEEDS BE
COUPLE WITH A COUPLE OF THINGS
WE IS. PURCHASE CONTRACTING AND
OF REQUIRE. AND PRO TO
STIMULATE H. PART TO. THE BACK
BE THAT REQUIREMENT IN HIV PRO-
FOR CONTRACTED PROVIDERS WOULD
BE PUT INTO A CONTRACT AND THAT
THEY'RE BEING HIV PROGRAM
INCENTIVE PROGRAM THAT ACTUALLY
PAYS THEM INCENTIVES FOR
MEETING MILESTONES. THE SECOND-
AREA AROUND THE CORPORATION
THOSE TYPES OF H. I. IN AND
GOALS TO CLASS PROGRAM. I'M
LOOKING THINK THAT THERE IS
THAT OF THE MISSION QUALITY.
AND WE CEASE TYPE OF THAT BY
INTEGRATE CARE SO ARE HA ALL I
KNOW PERFORM PROGRAM AND IN THE
EARLY OF CHECK FOR PETER
ARAMBULA SIMILAR. OF. TAKE A
DEPARTMENTS MAY WHEN IT TO
THINGS LIKE REPORTING LAW
RESULTS DATA TO HELP FROM THE
BACK SPOKE. THE THINGS OF THE
BUT AND REALLY HELP BY AND
SUPPORT- IT AND KIND OF A COVER.
FOR AMANDA. NEXT LIKELY. SO THE
SECOND FARM- YOUR AREA THE
EXTRA SECTOR AND IF YOU'RE FROM
BEGINNING A TEST TOMORROW HERE
THIS THING CLEAN LIKE BEHAVIOR
HEALTH SOCIAL SERVICES AND FROM
PUBLIC HEALTH AND THAT WERE
DON'T PART IN AN H. I. E. TODAY
A TWENTY THE THESE OPTIONS
INCLUDE ONE. ESTABLISHING
FINANCING PRO THAT STATEWIDE IS
A BEHAVIOR SOCIAL SERVICE STATE
X. NOW ABOUT TWELVE YEARS AGO
THERE IS A LAW PASSED BY THE
FEDERAL GOVERNMENT THE I WITH
THAT AMERICAN RECOVERY IN
REINVESTMENT ACT ARE UP. AND
IT'S PART OF THAT THERE IS A
BILL CALLED HIGH TECH. HI TECH-
ALSO- THE PROGRAMS ON THE PALM
COMMUNIQU FOR USE. PROVIDED
OVER THIRTY FIVE BILL DOLLAR
NATIONALLY HELP PROVIDER. AND
HA BUT CLINICS AND HOSPITALS.
PUT ELECTRONIC HEALTH RECORDS
THAT WERE IN PLACE TO IMPLEMENT.
TWELVE YEARS AGO MOST OF OUR
CARE SO WITH BILL PAY BASED.
AFTER TWELVE YEARS WITH OVER
THIRTY FIVE DOLLAR IN FAT
INVEST- MO OF THE HOT. AND
CLINICS TODAY AND CAL ACTUALLY
INTEROPERABLE HEALTH
INFORMATION EXCHANGE BUT WE
STILL DON'T HAVE. THOSE KIND OF
SYSTEMS IN PLACE WITH OUR MANY
BEHAVIORAL HEALTH PROVIDERS AND
VERY FEW SOCIAL SERVICE
PROVIDERS AND OTHERS ACTUALLY
HAVE ANYTHING LIKE. A PLATFORM
LIKE ELECTRONIC HEALTH RECORD
THAT WOULD ALLOW FOR DATA
EXCHANGE. SO WHAT THIS IS
PROPOSING IS A SET OF FINANCING
PROGRAMS TO HELP BRING THOSE
OTHER TYPES OF PROVIDERS UP ON
RECORDS THAT CAN SHARE DATA- I
CREATE FINANCING STREAMS TO
ACTUALLY ALLOW THEM TO EXCHANGE
DATA. WITH OTHER PROVIDERS
INCLUDING PHYSICAL HEALTH AND
PUBLIC HEALTH AGENCIES TO FOR
EXAMPLE RESPONSE THE PANDEMIC.
AND THEN RELATED WHICH IS THE
FOURTH ITEM HERE- IS TO UPGRADE
CALIFORNIA'S PUBLIC HEALTH AND
EMERGENCY RESPONSE INFORMATION
EXCHANGE INFRASTRUCTURE. SO WE
KNOW THAT THERE WILL BE MONEY
COMING FROM THE CDC TO HELP-
BILL THAT CAPABILITIES WE
SHOULD LEVERAGE AND SUPPLEMENT
THAT FUNDING WITH STATE
RESOURCES UPGRADE OUR COUNTY
SURVEILLANCE OUR STATE AND
COUNTY SURVEILLANCE REPORTING
AND EMERGENCY RESPONSE SYSTEM.
WE SHOULD BE CREATING INCENTIVE
PROGRAMS. TO SHARE INFORMATION
WITH EMERGENCY RESPONSE PUBLIC
HEALTH AND SYNDROMIC
SURVEILLANCE SYSTEM. AND
PROVIDE FUNDING TO TRAIN PUBLIC
HEALTH WORKFORCE AND USE THE
REQUIRED INFRASTRUCTURE. THE
NEW PUT NEW SYSTEMS AND YOU
CAN'T BOTTOM ASSUME THAT THE
WORKFORCE NOW HOW TO USE THAT
THERE NEED TO BE EDUCATED AND
TRAINED THEIR- ABOUT THE FOR
ABOUT THE- OP. AFTER CONSIDER
AND THEN THERE'S MORE MORE SET
ON A SLIDE PLEASE. AND THIS IS
REALLY AROUND BARRIER ARE A COM
IN OUR STATUS OR- AND THERE TWO
OPTIONS HERE TO CONSIDER. THE
FIRST TO ENACT LAW. THANK
RECOMMENDED MADE THE NEW ALL
AND IT SAID BY THREE TRY DONE
UP BY CONFLICTING AND THEN.
THEY HELP THE COMMISSION
PRIVACY IN SECURITY. AND I
THINK HELP HELP TAKE A CO TO
HARMONIZE THE WITH FEDERAL. NOW
THAT DOESN'T MEAN THAT EVERY
THE CAN AND. SHOULD NOT. BE
ABOLISHED TERM THEIR NOT
CERTAIN LAWS PROTECT PATIENT.
COP AND TO FOR GOOD REASON. AND
WEBER YOU CAN TO PURSUE. BUT IT
NEEDS TO GO FOR A PROFIT REVIEW.
AND TO ME FOR IDENTIFY WHAT
SHOULD REMAIN. AND WHAT REALLY
NEEDS TO BE UPDATED BECAUSE
IT'S ANTIQUATED. NOW ONCE THAT
PROCESS IS GONE THROUGH OR
INCREASE IN AND IN PARALLEL.
BOB ONE OPTION AS WELL WHICH
WOULD REALLY HELP SHARE THE
DIFFERENT TYPES OF DATA THAT IT
TO DEFINE REQUIREMENTS FOR WHAT.
OUR CALLING A STATE WIDE
UNIVERSAL INFORMED CONSENT
MODEL AND STANDARD CONTENT
AUTHORIZATION FORMS. BUT THAT
WOULD REALLY HELP TO IS IT
WOULD HELP IDENTIFY THROUGH
THIS THESE TYPES OF THAT
FRAMEWORK. AND THROUGH A
STANDARDIZED STATEWIDE CONSENT
FORM. WHAT STATE LAW NEED TO BE
FOR. WHAT TYPE OF CONTENT YOU
NEED FROM RESIDENTS IN ORDER TO
SHARE INFORMATION SO THAT THOSE
WHO PARTICIPATE FEEL LIKE THEY
UNDERSTAND WHAT THE LAW SAYS.
AND THEY UNDERSTAND WHAT IT IS
THAT THEY ARE AND ARE NOT
ALLOWED TO SHARE. NOW WE CAN
THE WHAT THIS OPTION WOULD
INCLUDE USING CONTRACTING AND
LICENSING LEVERS AGAIN THAT'S
THE THEME WHAT LOVERS CAN WE
USE AT THE DISPOSAL OF STATING
COUNTY AGENCIES. AND PRIVATE
PURCHASERS TO INCENTIVIZE YOU
REQUIRE THAT THESE POLICIES BE
USED BY PLAN PROVIDERS AND
OTHERS WERE PARTICIPATING. IN A
VARIETY OF DIFFERENT PROGRAMS.
I MEAN I'M FINALLY- THERE SOME
EMERGING- THAT DIFFERENT FROM-
EFFORTS TO CREATE CONTENT
AROUND DAY USE AGREE. UNTIL
OPTION IS PART OF THE WOULD BE
TO A PARTS WITH PUBLIC- TRUSTED
EXCHANGE OR C. TEN TO SUPPORT
WITH CAL HEALTH INFORMATION.
AND NASH NETWORK. AND TO BY
DOCTOR CALLED THE SO IF THE
DATA SHARING A- THAT PART OF A
BROADER SET OF DATA SHARING AND
CONTENT POLICIES THAT WOULD BE
DEVELOPED HERE. I'M AND THAT'S-
AND THAT THAT ESSENTIALLY
CONCLUDES MY TESTIMONY SO I'M
HAPPY AT WHATEVER POINT IN
TIME- DOCTOR WOULD AND NUMBERS
THEY HAVE NOTHING TO HELP MANY
TO TAKE QUESTIONS. OKAY THANK
YOU VERY MUCH JOHN AND SEE IF
THERE ARE QUESTIONS FROM THE
COMMITTEE HERE. I DO HAVE- I DO
HAVE A COUPLE MYSELF AND-
PRECIADO VERY MUCH APPRECIATE
YOUR TESTIONY HERE. SO YOU'VE
BEEN INVOLVED IN THE POLICY
ISSUES AROUND SURROUNDING
HEALTH INFORMATION EXCHANGE FOR
SEVERAL YEARS. SO IF YOU WERE
TO WAVE A MAGIC WAND WHAT STEPS
YOU KNOW WOULD YOU RECOMMEND
CALIFORNIA TAKE. I HAVE BEEN
AROUND THE BLOCK ON THIS TOPIC
BEFORE- I ABOUT TWELVE YEARS
AGO- I WITH THAT THE DEPUTY
SECRETARY IN THE HEALTH AND
HUMAN SERVICES AGENCY AND HELP
IMPLEMENT HIGH TECH- AND IN
THAT POSITION IT WITH. IT WAS
WONDERFUL EXPERIENCE REALLY
HELPED TRYING TO ADVANCE- CHARM
COMMITTEE AND HELP INFORMATION
EXCHANGE- WE'RE HAD T OUR
DISPOSAL. THE FEDERAL FUNDING.
BUT THIRTY EIGHT MILLION
DOLLARS FOR HEALTH INFORMATION
EXCHANGE- AND THEN THEY WERE
SENT THE PAYMENT THAT WERE MADE
THROUGH DEPARTMENT HEALTHCARE
SERVICES NOT A COW. BUT THERE
IS NO AUTHORITY OTHER THAN. THE
ABILITY TO DRIVE DOWNTOWN FUNDS
IN THAT OFFICE. HI THAT WAS ONE
OF REAL LIMIT- ABOUT POSITION
AND- AND WEBER SO ABOUT OR
CREATE AGAIN IF THERE WERE NOT
POWER TO THIRTY EIGHT THAT. FOR
THE FIRST OPTION THAT ARE LAID
OUT THE PLAYED OUT HERE- I
COULD WAVE A MAGIC WAND THAT
WOULD BE ESTABLISHED AND YOU'D
HAVE. YOU HAVE AN ADVISORY
BOARD THAT REALLY UNDERSTAND
FUNDAMENTALLY THE ISSUES FROM
THE PERSPECTIVE OF CONSUMERS
AND PROVIDERS AND PURCHASERS OF
PUBLIC HEALTH. WHO COULD REALLY
HELP INFORM. IN A CONSTRUCTIVE
WAY. WHAT NEDS TO BE DONE AND
WHAT NEEDS TO BE PRIORITIZED.
THAT WOULD BE NUMBER ONE. AND
NUMBER TWO WOULD BE IT'S ONE
THAT IS REALLY CLEARLY
ESTABLISHED- WHAT WHAT TO
PRIORITIZE- REALLY WHERE TO
FOCUS. IS THAT THE STATE WOULD
PROVIDE FUNDING THAT COULD BE
MATCHED WITH FEDERAL ANOTHER
DOLLARS- TWO TWO I REALLY DON'T
THE INFRASTRUCTURE THAT. THAT'S
NEEDED- NOT JUST FOR PHYSICAL
HEALTH INFORMATION EXCHANGE BUT-
FOR SOCIAL SERVICE PROVIDERS
THAT ARE PROVIDING HOUSING
SUPPORT SERVICES. TO CONNECT
THE JAIL WITH PROVIDERS IN THE
COMMUNITY SO WHEN A PATIENT
WHEN A RESIDENT- WE'VE
INCARCERATIONS. THE CLINIC THAT
ACTUALLY GOING TO TAKE CARE OF
THEM THE COMMUNITY HAS A FULL
ACCOUNT OF THAT RECORD THE
PRESCRIPTION AND OTHER MEDICAL
INFORMATION. AND FOR THE PUBLIC
HEALTH SYSTEM WITH WHEN THIS
HAPPENED AGAIN- WHEN THE NEXT
RESPONSE THAT I'S IMPORTANT-ORDERS FOR THE NEXT A WILDFIRE
I LIVE IN DAVIS BUT THE FACT
THAT. THE SUSPECT ME PERSONALLY
MY FAMILY. THAT HEALTH HAS BEEN.
THEY NEED TO MOBILIZE QUICKLY.
THEY KNOW WHO'S BEING IMPACTED
THEY KNOW WHAT SOCIAL SERVICES.
SERVICES BEHAVIOR HEALTH
SERVICES THEY NEED TO WORK
THEIR FACT HE WAITED. TWENTY
CHASING COUNTY. SOME SAFE.
WHERE THEY TO PROVIDE AND THAT
I CARE HAVE A FULL ACCOUNT OF
WHAT THAT AND I AM. WELL SO
THANK YOU ALMOST INTO MY
ADDITIONAL HERE BUT- WHAT ONE
THAT THAT YOU DIDN'T QUITE HIT
ON THAT. THAT I THINK IS
IMPORTANT HERE IS THAT. WHAT
WHAT DO YOU WHAT PAYER SHOULD
REPORT DATA FOR EXAMPLE SHOULD
COUNTY MILK MENTAL HEALTH PLANS
OR COUNTY DRUG MEDI PLANS RISA
PLANS. WHO WOULD YOU HAVE AMONG
THE YOU KNOW THOSE WOULD YOU
HAVE THEM ALL REPORTING OR YOU
THINK OR OR- IS THERE IS THERE.
A WAY OR A PRIOR THERE. YEAH
MEAN I IDEALLY WE WOULD ALLOW
ALL OF THE DATA WITHIN REASON I
MEAN THAT THERE OBVIOUSLY SOME
LIMITATIONS ON WHAT THE STATE
CAN DO FOR AN ORIGINALLY
PLANNED FOR. THAT ARE THAT ARE
WHERE FEDERAL OVER AND NOT
STATE OVERSIGHT BUT IDEALLY.
HERE'S BE ABLE TO REPORT DATA
PREPARE STAFF ADMINISTRATIVE
AND CLAIMS DATA I MEAN THAT'S
REALY WHAT THEY HAVE AT THEIR
DISPOSAL DISPOSAL BY AND LARGE-
AND FOR- YOU KNOW THE PHARMACY
THAT. A CLAIM IS VERY MUCH LIKE
IT'S ALMOST. CLINICAL BECAUSE
IT DESCRIBES THE PRESCRIPTION
THAT WAS ACTUALLY DISPENSE. BUT
I'LL TELL YOU THAT THE PERSON.
MATT FOREMAN AND FOR YOU CAN
MAKE INFERENCES ABOUT WHAT THAT
INDIVIDUAL PATIENTS WHO. SPENT
THAT DRUG HABIT YOU CAN'T. NOT
DETERMINE IT RIGHT DOESN'T MEAN
THEY HAVE DIABETES BUT IT'S
INFORMATION THAT IT'S IMPORTANT.
BUT IT'S BASICALLY
ADMINISTRATOR SO IT'S LIMITED
AND CAN HELP INFORM THINGS LIKE
THE VALUE OR THE PRICE THAT WAS
PAID FOR A SERVICE. BUT IT
GENERALLY CAN'T TELL YOU HOW
CLINICAL OUTCOMES. BOTH DATA
LIVE WITHIN ELECTRONIC HEALTH
RECORDS OR BEHAVIORAL HEALTH
RECORDS. AND SO YEAH PLAN
SHOULD ALL PLANS IDEALLY SHOULD
BE SHARING ADMINISTRATIVE DATA
LIKE CLAIM. BUT THEY ALSO
SHOULD HAVE ACCESS TO WITH THE
CLINIC RESTRICTIONS ABOUT HOW
THEY CAN USE THAT. CLINICAL
INFORMATION THAT THEY CAN
UNDERSTAND WHO THE WHO THE HIGH
QUALITY PROVIDERS ARE WHO THEY
MAY WANT HAPPEN THOSE NETWORKS
BECAUSE THEY HAVE GOOD OUTCOME.
WHAT THE COST OF THE SERVICES
ARE THAT THEY GET- THAT THEY
PAY FOR. THAT YOU WE CAN
ACTUALLY. BEND THE COST CURVE.
THAT'S GREAT. SO YOU'VE YOU'VE
BEEN YOU'VE BEEN A STUDENT THIS
FOR MANY MANY YEARS SO- THEN
THERE IS A HUGE AMOUNT OF
INFORMATION THAT'S OUT THERE-
THERE ARE H. I. EASE THAT ARE
OPERATING OUT THERE BUT THEY'RE
NOT THEY'RE NOT TERRIBLY
LINKED. I THINK THERE THERE ARE
SOME PEOPLE OUT THERE WHO FEEL
THAT MAYBE WE SHOULD STUDY THE
NEED FOR THIS YOU KNOW THIS
THIS GOING FORWARD RATHER THAN
ACTUALLY MOVING ON SOMETHING- I
GUESS I'M GOING TO GUESS THAT
YOU'RE PROBABLY YOU'VE STUDIED
THIS FOR THE LAST TWELVE YEARS.
DO YOU THINK WE REALLY NEED
ANOTHER STUDY OR SHOULD WE BE
MOVING ON SOMETHING AT THIS
POINT. IN YOUR OPINION ALL. IN
MY OPINION WE START YEAH WE'VE
DONE WE'VE STUDIED THE ISSUE.
BUT I MEAN WE KNOW EVERYTHING-
I THINK THE TIME FOR ACTION IS
NOW I THERE'S IN MY MIND
THERE'S NO NEED TO WAIT AND
STUDY THE PROBLEM ANY LONGER.
BUT WHAT REALLY IS NECESSARY AS
PART OF THIS PROCESS. IS TO
HAVE A REALLY CLEAR SET OF
GOALS THAT WE'RE TRYING TO WORK
TOWARDS. AND THAT REALLY NEED
TO COME FROM THE STATE. THEY
NEED TO HAVE AN ARTICULATED
POINT OF VIEW ABOUT WHAT KIND
OF HEALTH INFORMATION EXCHANGE
ACTIVITIES WE WANT TO SUPPORT
TO ENABLE SPECIFIC STATE GOAL.
THAT WOULD REQUIRE A LITTLE BIT
OF TIME FOR STAKEHOLDERS TO ALL
FOR THE STATE AND STAKEHOLDERS
TO REALLY SORT OF MAKE THAT
PROCLAMATION. AND WHEN THEY'RE
GOING THROUGH THAT SORT OF THAT
INTERNAL ANALYSIS AND THAT- AND
ADVANCING RECOMMENDATION. YES
THEY SHOULD BE LOOKING AT WHAT
OTHER STATES HAVE DONE AND WHAT
OTHER COUNTRIES HAVE DONE. TO
BE SUCCESSFUL AND HOW THEY'RE
EXCHANGING INFORMATION TO
ADVANCE. POLICY AND PROGRAM
GOALS. SO WE SHOULD NEVER STOP
STUDYING THE ISSUE BECAUSE YOU
CAN ALWAYS LEARN SOMETHING. BUT
I THINK GENERALLY WE HAVE A
PRETTY GOOD UNDERSTANDING OF
WHAT NEEDS TO GET DONE NOW
THEY'RE BIG GAPS IN PHYSICAL
HEALTH INFORMATION EXCHANGE WE
NEED TO CLOSE THOSE GAPS WE
NEED. THIS FINANCING IF
NECESSARY. AND THERE MAY BE
NEED TO BE POLICY AND
REGULATORY THINGS LIKE MANDATE.
WE KNOW THAT THERE'S A NEED FOR
BEHAVIORAL HEALTH. INFORMATION
EXCHANGE WITH CLINICAL DATA AND
WE NEED TO COME UP WITH
POLICIES TO ENABLE TO DO THAT.
WE KNOW THERE IS A NEED TO
ACCESS SOCIAL SERVICE DATA LIKE
HOUSING. INFORMATION AND THAT
THERE'S A NEED FOR CAPACITY FOR
INFRASTRUCTURE TO HELP SUPPORT
AND MAKE THE BRIDGE BETWEEN
HOMELESS MANAGEMENT INFORMATION
SYSTEM. AND ELECTRONIC HEALTH
RECORD. IT CAN BE DONE WE'VE
SEEN IN OTHER COMMUNITIES THERE
ARE GOOD STUDIES THAT HAVE
SHOWN HOW IT CAN BE DONE AS
BEST PRACTICES. IT'S REALLY
TIME AT THIS POINT
IMPLEMENTABLE AND TO PRIORITIZE
THAT WE CAN- THE QUINT. AND
INTERNET. SO I'M THINKING AHEAD
A LITTLE BIT SO IF WE HAD. A
ROBUST SORT OF CENTRALIZED
STATE HEALTH INFORMATION
EXCHANGE. I JUST THINK ABOUT
THE VALUE POTENTIAL VALUE OF
THAT IN THE COVIDIEN COVERT FOR
EXAMPLE THERE IS A GREAT
INTERVIEW ON NPR RECENTLY THAT
I LISTEN TO THAT TALKED ABOUT
THAT WE DON'T KNOW THE EFFICACY
OF THE CODE NINETEEN VACCINE
FOR THE LONG HAUL WE DON'T KNOW
THAT. BUT IF WE HAD INTO IT WE
HAD A WAY TO BE ABLE TO COLLECT
THAT DATA S IF WE KNEW THE
PATIENT. CONTRACTED IT LATER
ON- WE COULD BE DOING SOME OF
THESE HEALTH POPULATION STUDIES
TO BE ABLE TO ACCESS THAT WE
CAN'T DO THAT NOW BECAUSE THE
SYSTEM IS COMPLETELY
FRAGMENTED- AND THAT'S- LAST
NIGHT I WAS ON A CALL-
REGARDING. WITH WITH OUR
ADMINISTRATION- REGARDING-
ISSUES AROUND COVE IT. AND ONE
OF THE THINGS THAT WE ASKED OF
THE STATE IS YOU KNOW CAN YOU
TELL US- HOW MANY YOU KNOW IN
STATEWIDE AND IN EVERY COUNTY
YOU KNOW- BREAKDOWN OF THE
NUMBER OF CASES THE NUMBER OF
VACCINES THAN THE ETHNICITY OF
WHO'S GETTING THEM IN. AND THE
ANSWER WAS NOT REALLY WE DON'T
HAVE WE CAN'T DO THAT RIGHT WE
CAN'T EASILY DO THAT WE CAN DO
IT BUT IT REQUIRES LOTS OF
PAPER AND LOTS OF LOTS OF
COORDINATION BUT BUT WITH THE
HEALTH INFORMATION EXCHANGE WE
COULD PROBABLY DO THAT WITH
WITH WITH QUERIES AND NOT A TO
DO. TOO DIFFICULT WAY IF IT
WAS. PUT TOGETHER RIGHT. RIGHT
THERE THE BUT PUBLIC HEALTH
INFRASTRUCTURE. THAT CALIFORNIA
HAVE TODAY LIKE CAL READY AND
CARE FOR NOT DESIGNED FOR A
GLOBAL PANDEMIC- AND IT AND
IT'S CLEAR YOU KNOW THE- IT WAS
SO CAL READY WAS NOT ABLE TO
HANDLE JUST THE VOLUME THE
SHEER VOLUME OF DATA. FOR EVERY
RESIDENT IN THE STATE TO GET
TAX ON A ROUTINE BASIS THE CAP
THAT CAPACITY DID NOT OCCUR.
CARE WHICH IS THE SET OF
IMMUNIZATION REGISTRIES WAS
REALLY DESIGNED. FOR PEDIATRIC
MOSTLY FOR PEDIATRIC
IMMUNIZATION NOT. AS A
REPOSITORY FOR AND FOR AND FOR.
OUR SYSTEM THAT'S GOING TO
VACCINATE EVERY SINGLE RESIDENT
AND HELP TRACKING REPORT ALL OF
THAT EVEN THOUGH IT'S BACK
ACTUALLY DOING A FAIRLY GOOD
JOB WITH THINGS LIKE INVENTORY
MANAGEMENT NOT PERFECT. THERE
ARE SOME INTERFACES WITH THE HR
SO SOME OF THIS ACTUALLY KIND
OF WORKS- AND YOU GOTTA GIVE
HIM CREDIT- THEY DON'T GET A
LOT OF IT BUT YOU GOT TO GIVE
SOME CREDIT TO THEM. BUT THE
PUBLIC HEALTH WORKERS WHO HAVE
BEEN FOR AN ENTIRE YEAR.
WORKING TIRELESSLY. NOW WHAT
DATE WHAT ISN'T HAPPENING. WHAT
YOU MENTIONED. WE DO NOT HAVE
THE ABILITY TO LINK A RECORD I
THINK THE PUBLIC HEALTH HAS ON
A POSITIVE TAX OR EVEN A
VACCINE LET'S JUST SAY A
POSITIVE TAX. EFFECT OF THAT
PERSON ARE THEY A MEDIC CAL DO
THEY GET FOOD STAMPS DO THEY
ARE THEY HOMELESS. THAT
INTEGRATION OF DATA. THAT BACK
BACK BY LOAD DATA. IT DOES NOT
ALLOW PUBLIC HEALTH AND THE
PROVIDERS WHO SERVE THE
INDIVIDUAL WHO JUST GOT TESTED
POSITIVE FOR COVERT NINETEEN
THE VIRUS THE CAUGHT COVER
NINETEEN. THEY DON'T HAVE THOSE
DATA LINKED TOGETHER AND A WAY
TO. IDENTIFY THE TO THEY CAN
IMMEDIATELY RESPOND AND SAY
OKAY WE KNOW THIS INDIVIDUALS
ON MEDICAID. WE KNOW WHAT THOSE
BENEFITS ARE WE CAN MOBILIZE
THOSE MEDICAL SERVICES TO THAT
INDIVIDUAL. WE KNOW THAT THEY
HAVE DATE THAT THEY'RE ON FOOD
STAMPS. WE KNOW THAT THEY'RE
GOING TO LIKELY HAVE PRUDENT
SECURITY SO WE NEED TO MOBILIZE
FOOD TO THEIR PRESIDENT BECAUSE
THEY'RE GOING TO HAVE T BE-
ISOLATING FOR TWO WEEKS- OUR IF
THEY'RE UNEMPLOYED THAT THEY
DON'T ACTUALLY HAVE A PAYCHECK
SO WE'RE GOING TO HAVE TO
SUPPLEMENT THEIR INCOME-
FURTHER YOU KNOW WE DON'T HAVE
THAT CAPABILITY AND IF WE WERE
JUST. AND IF WE WERE TO
PRIORITIZE. THE ABILITY FOR
SYSTEMS TO SHARE INFORMATION
WITH PUBLIC HEALTH AND- PUBLIC
HEALTH THAT THE INFRASTRUCTURE
ALONG WITH THE OTHER AGENCIES
TO MARRY THOSE DATA. ORDER THE
LONGITUDINAL TYPE OF STUDY SO
THAT WE CAN ACTUALLY PHOEBE
AFRICA THE LIKE YOU'RE STAYING
FOR LONG HAULERS. WE HAVE A
BETTER PICTURE OF HOW TO
RESPOND AND WHAT THE IMPACT OF
COVERED IT'S BEEN FOR SOME OF
THE RESIDENTS WHO ARE.
ADVERSELY IMPACTED. I ALSO
CAN'T HELP BUT THINK THAT OUR
OUR ABILITY FOR PEOPLE TO
ACCESS VACCINES AND TESTING.
WOULDN'T BE DRAMATICALLY
IMPROVED IF YOUR PROVIDER.
COULD QUERIA SYSTEM AND SAY.
AND LOOK AT ALL THE VACCINE
AVAILABILITY OR ALL THE TESTING
AVAILABILITY AND MATCH YOU UP
IT WOULD PREVENT YOU AS THE
CONSUMER FROM HAVING TO MAKE
CALL AFTER CALL AFTER CALL. OR
SPENT HOURS AT A COMPUTER
TRYING TO FIND A WAY TO MAKE AN
APPOINTMENT TO GET A VACCINE.
OR OR WHATEVER IF WE HAD THE
ABILITY TO SYNTHESIZE THIS
INFORMATION IN A WAY. THE
OUTCOME IN AND OF AND THE USER
EXPERIENCE WOULD BE GREATLY
ENHANCED- I THINK. IT CERTAINLY
WHAT. WE'RE EXPERIENCING THAT
NOW IN TERMS OF TRYING TO GET
ACCESS TO VACCINES FOR
TEACHERS. WE'RE TRYING TO FIND
WHERE'S THE DOOR IF I CAN FIND
UP AND GET BACK TO ME THAT
THOUGH. WE CAN GET OUR KIDS TO
SCHOOL BUT BACK IN THE SCHOOL
MORE MORE RAPIDLY. WORK THAT
ANY TEACHER HOW CAN TELL YOU
WE'RE GOING TO THAT PROCESS
RIGHT NOW AND IT AND IT IS
CHALLENGING. WE DON'T HAVE WE
DID NOT DESIGN THE
INFRASTRUCTURE THAT WE HAVE
TODAY. AND ALL THAT- SO
ABSOLUTELY THAT IS. THAT'S ONE
OF THE OUTCOMES OF NOT HAVING.
WHAT WE NEED IN ORDER TO
SUPPORT. ALL OF OUR RESIDENTS
IN GETTING- BACK TO BACK WINS
UNDERSTANDING APPLY CHAIN AND-
ALL THE CAPITA ISSUES YOU JUST
MENTIONED. THANK YOU I'M I
THINK DECEMBER AGUIAR-CURRY HAD
A QUESTION. THANK YOU FOR YOUR
PRESENTATION AND UNFORTUNATELY
I DON'T HAVE THE BEST HEARING
IN THIS ROOM IS REALLY ACCURATE
SO I APOLOGIZE BUT THERE'S YOU
KNOW SOMETHING THAT KIND OF I
JUST WANT YOU TO SEE IF YOU TO
DRESS AND YOU MAY HAVE ALREADY
IN THE PRESENTATION BUT- YOU
KNOW I HAVE A CONCERN OF HOW
WELL THE EXCHANGE OF HEALTH
INFORMATION CALIFORNIA EVER A
LINE WITH FEDERAL REGULATIONS.
YEAH I MEAN I THERE IS SO
CALIFORNIA HAS A VERY COMPLEX.
WEB- NIELSEN POLICIES- PRIVACY
AND SECURITY POLICIES AND SOME
OF THEM- SOMEONE DO CONFLICT
WITH FEDERAL LAW- AND I- HI I
DON'T THINK THEY'LL EVER. IN MY
LIFETIME AT LEAST COMPLETELY
HARMONIZE MEANING THAT. WE ARE
JUST GOING TO DISCARD OUR LAW
THEY WERE PLANNING TO FEDERAL
LAW. THERE ARE AND THERE THERE
MAY BE VERY GOOD REASONS FOR-
AND RATIONALES FOR WHY CERTAIN
POLICIES LIKE HIV I THINK
THERE'S VERY GOOD REASON WHY.
THERE ARE EXCEPTIONS AROUND.
SHARING DATA WITHOUT INFORMED
CONSENT. I AND THERE. SO WE MAY
NEVER GET TO A POINT WHERE WE
ARE COMPLETELY ALIGNED WITH
FEDERAL POLICY. WHAT'S REALLY
IMPORTANT I THINK FOR US TO
MEANINGFULLY. ENGAGE IN DATA
EXCHANGE IT FOR THE STATE TO GO
THROUGH A PROCESS OF
IDENTIFYING WHAT WHO DON'T
ALIGN. AND SHOULD WE TRY TO
AMEND. BECAUSE I THERE'S NO
RATIONAL OR THE RATIONALE DOES
NOT SUIT THE CURRENT DATE
MEANS. THE MADE INTERNATIONAL
TWENTY YEARS AGO. OR EVEN TEN
YEARS AGO BUT TODAY THE
RATIONALES CHANGED OR THE
SYSTEMS OF CHANGE TO OVERCOME.
THE REASON WHY THE POLICY WAS
CREATED IN THE FIRST PLACE. WE
GO THROUGH A RIGOROUS PROCESS
OF. REVIEWING ALL OF THOSE
RULES AROUND CALIFORNIA DATA
PRIVACY AND SECURITY. AND WE
IDENTIFY THOSE POLICIES THAT WE
THINK SHOULD BE CHANGED OR
HEALTH AND SAFETY CODE COULD BE
REVIVED WHAT WOULD BE LEFT WITH
OUR SET THE POLICY THAT WE
COLLECTIVELY AGREE. SHOULD
REMAIN THAT DIFFER FROM FEDERAL
POLICY. AND IN THAT CONTEXT YOU
CONSTRUCT A CONSENT THAT THAT
THAT DOCUMENT THAT BASICALLY
CALL THOSE POLICIES OUT THERE
WE RECOGNIZED THAT THEY EXIST
BUT THEY'RE DIFFERENT WITH
FEDERAL POLICY. IF WE INFORM
OUR PATIENTS AND PROVIDERS
ABOUT THE POLICIES. BUT THEY
UNDERSTAND HOW THEIR DATA CAN
BE USED. THAT'S ABOUT AS GOOD
AS WE CAN DOAND IF WE CAN
CREATE THAT KIND OF A UNIVERSAL
CONSENT FRAMEWORK AND SET OF
DOCUMENTS. WE'LL HAVE CAN ONLY
COUNCIL WILL HAVE BEHAVIORAL
HEALTH PROVIDERS WILL HAPPEN TO
HELP PROVIDERS BEING MUCH MORE
COMFORTABLE. BUT THERE'S BEEN
LIKE A STATE INCOME ON TOUR ON
TO SEND OF DOCUMENTS AND
GUIDELINES. THAT FOLLOW AND
RESPECT THE RULE OF LAW AND THE
WISHES OF RESIDENTS. YEAH RIGHT
HER COMMENT WAS WHAT A WEB SELF.
YEAH. I THINK WE MAY HAVE A
COUPLE OF MEMBERS WERE
PARTICIPATING REMOTELY AS WELL
SEE IF THEY'RE OUT THERE IF
THEY HAVE ANY QUESTIONS AND I'M
NOT EVEN SURE HOW WE DO THAT
BUT- THE. WELL APPARENTLY
APPARENTLY NOT OKAY WELL THANK
YOU VERY MUCH- JOHN I REALLY
APPRECIATE THE INFORMATION AND-
WE'RE GOING TO GO AHEAD MOVE
ONTO OUR NEXT PANEL. THANK YOU
DOCTORATE. SO FOR OUR SECOND
PANEL WE'VE INVITED A NUMBER OF
STAKEHOLDERS AND ASK THEM
ADDRESS TO ADDRESS SPECIFIC
QUESTIONS AS IT RELATES TO
STATE PRIORITIES IN FOR BRAT
BROAD CATEGORIES EACH PANELIST
WILL HAVE FIVE MINUTES TO
ADDRESS OUR ISSUES AND FOR THIS
PANEL WILL ASK EACH OF THE
PANELISTS TO MUTE AND UNMUTE
THEMSELVES AND I THINK WHAT
WE'LL DO IS WE'LL HAVE EACH
PANELIST ADDRESS ISSUES WE HAVE
THERE AND THEN WE'LL COME BACK
TO THE COMMITTEE FOR QUESTIONS
FROM FROM FROM EACH OF THEM
RATHER THAN DOING IT- YOU KNOW
DOING IT ONE AT A TIME THEY'RE
SO. SO OUR FIRST TO AND THEY
WERE TO HAVE YOUR ACCOUNTING
THERE ARE SEVERAL TOGETHER SO-
OUR FIRST AND WE WILL BEGIN
WITH- SEIU I'M AT LEAST THE
GOVERNMENT RELATIONS- THAT IF
YOU'RE OUT THERE AND YOU ALMOST
EVERYBODY KNOWS THE QUESTIONS
OF THESE THERE'S NO SURPRISE
HERE SO- THE TRANSITION TO HER
DOCTOR WOULD. OFTEN TEAR. CAN
YOU HEAR ME OK WE SURE CAN'T
THANK YOU. THE RADIO YOU CAN
SEE IT TOO. OKAY SO THAT WAS A
WITH US YEAH YOU CALIFORNIA
FIRST JUST THANK YOU FOR
INCLUDING OUR PERSPECTIVE IN
THIS IMPORTANT CONVERSATION
ABOUT HOW TO IMPROVE DATA
SHARING CALIFORNIA- IT'S A
PLEASURE TO SEE YOU ALL- BIG
COVE IN NINETEEN PANDEMIC IS
REALLY SHINE A LIGHT ON THE
NUMBER OF PROBLEMS THAT EXIST
THROUGHOUT THE HEALTHCARE
DELIVERY SYSTEM- I WAS THE
FIRST QUESTION A LITTLE ALLUDES
TO WHICH IS HOW CAN CALIFORNIA
DEVELOP WAY EACH ID POLICY THAT
BEST SUPPORTS THE STATE AND
LOCAL PUBLIC HEALTH AGENCIES
AND EFFORTS TO RESPOND TO THE
CURRENT AND FUTURE A PUBLIC
HEALTH EMERGENCY. THE CHRONIC
UNDERFUNDING OF OUR PUBLIC
HEALTH INFRASTRUCTURE HAS
MANIFESTED ITSELF DURING THE
PANDEMIC RESPONSE IN NUMBER OF
WAYS- FROM THE FAILURES OF THAT
CALTRAIN THE SYSTEM TO THE
DIFFICULTIES OF THE VACCINE
DISTRIBUTION AND TRACKING. ONE
OF THE MOST EFFECTIVE WAYS TO
ADDRESS THESE ISSUES IS BY
ENSURING THAT WE ARE COLLECTING
AND SHARING DATA AT SCALE-
HOWEVER RIGHT NOW I SEE ARE YOU
MEMBERS ARE STILL USING FAX
MACHINES TO SHARE PATIENT
RECORDS. CALIFORNIA MUST DO
BETTER. S. CI YOU BELIEVE THAT
IN ORDER FOR THE STATE O SHARE
DATA AT SCALE WE MUST HAVE
BROAD PARTICIPATION. WITHOUT A
MANDATE IN PLACE THERE ARE A TO
MANY REASONS FOR- HOSPITALS AND
HEALTH PLANS TO NOT SHARE THE
DATA UNIVERSALLY. SO WE WIND UP
WITH THAT INADEQUATE PATCHWORK
OF THE SYSTEM THAT WE HAVE
TODAY. FOR US WE KNOW
INFORMATION IS POWER FRONT LINE
HEALTH CARE WORKERS WHO HAVE
BEEN WORKING ON THE FRONT LINES
OF THE PANDEMIC SINCE DAY ONE-
COULD UTILIZE HIV TO MAKE
CERTAIN THE HEALTH CARE TEAMS
UP ACCURATE REAL TIME
INFORMATION. ABOUT THEIR
PATIENTS. A STATE Y. H. I. E.
NEEDS TO PROVIDE INFORMATION TO
PROVIDERS. OF BURST AND
COMPREHENSIVE UNIFIED RECORD SO
CARE TEAMS CAN- CAN KNOW AS
MUCH AS POSSIBLE ABOUT EVERY
SITUATION THEY'RE WALKING INTO.
IF A PATIENT COMES INTO ANY
HEALTHCARE SETTING OUR CARE
TEAM MEMBERS DESERVE TO KNOW IF
THAT PATIENTS TESTED POSITIVE
FOR COKE WITH NINETEEN. SO THAT
ARE. SO THAT PROPER PRECAUTIONS
CAN BE TAKEN. FRONTLINE WORKERS
NEED TO KNOW THEIR PATIENTS AND
PUBLIC HEALTH PROFESSIONALS
MUST HAVE READILY AVAILABLE
DATA. ON HANDS THAT SO THEY CAN
DO THEIR JOBS MORE EFFECTIVELY.
IN HEALTHCARE GAPS IN PATIENT
DATA HAVE- CAN HAVE DISASTROUS
IMPACTS ESPECIALLY DURING AN
EMERGENCY. EVERY GAP IN DATA
MAKES IT HARDER FOR SEIU
MEMBERS ARE FRONTLINE WORKERS
TO DO THEIR JOB. AND MANY OTHER
STATES HAVE SHOWN THE ABILITY
FOR H. ID'S TO SUPPORT THEIR
PUBLIC HEALTH INITIATIVES IN
CALIFORNIA SHOULD FOLLOW SUIT.
I'M IN WITH REGARD TO THE
SECOND QUESTION ABOUT HOW- ANY
SHOW YOU CAN UTILIZE THAT TO
HELP THE STATE DIDN'T FIND
BEGIN TO ELIMINATE HEALTH
DISPARITIES YOU THINK THIS IS
ONE OF THE MOST IN QUEST
IMPORTANT QUESTIONS ON THE
PANEL- AS WE HAVE SEEN DURING
THE PANDEMIC PEOPLE OF COLOR-
IN THOSE AND DISADVANTAGED
COMMUNITIES ARE REALLY BEARING
THE BRUNT OF THIS PANDEMIC AND
FRANKLY. WE DO NOT BELIEVE
THAT- WE EVEN HAVE ACCURATE
SENSE OF HOW BAD THINGS REALLY
ARE. YOU CANNOT BEGIN TO MAKE A
GOOD FAITH GOOD FAITH EFFORT TO
ADDRESS HEALTH CARE INEQUITIES
IF YOU DON'T HAVE A TRUE
PICTURE OF WHERE THE EXISTING
HOW PROFOUND THEY ARE. S. YEAH
YOU BELIEVE STRONGLY THAT A
ROBUST STATE WHITE EACH IT CAN
HELP THE STATE MOVE THE NEEDLE
ON EQUITY. AND THERE ARE
SEVERAL THINGS WE MUST CONSIDER
AS THIS POLICY AND FINANCES.
HEALTHCARE SERVICES HEALTH
INSURERS AND PROVIDERS MUST BE
REQUIRED TO COLLECT RACE AND
ETHNICITY DATA ON THEIR MEMBERS
AND PATIENCE AND SUBMIT THAT
INFORMATION TO THE H. I. T. H.
I. E. SHOULD MAINTAIN THIS
INFORMATION IN A MASTER PATIENT
INDEX. AND MUST HAVE THE
ABILITY TO MEASURE TRACK AND
REPORT ON A RANGE OF- STANDARD
ACCESS QUALITY AND OUTCOME
MEASURES THAT. ARE STRATIFIED
BY RACE AND ETHNICITY. WE
SHOULD REQUIRE THE STATEY. H.
TO PRODUCE AN ANNUAL EQUITY
REPORT FOR POLICY MAKERS ON THE
AGENCY ARE. ON THE AGENCY FOR
HEALTHCARE RESEARCH AND
QUALITY. INDICATORS AND ON THE
IN C. Q. EIGHT HEALTH
EFFECTIVENESS DATA INFORMATION
SAT ALSO KNOWN AS HE DOES.
SORTED BY RACE ETHNICITY THAT
IS BROKEN DOWN BY PROVIDER AND
REGION. THE H. I. T. SHOULD
HAVE THE CAPACITY TO
ELECTRONICALLY EXCHANGE HEALTH
AND INFORMATION WITH THE HEALTH
CARE PAYMENTS DATABASE. AND I
JUST WANT TO ACKNOWLEDGE- AS I
MENTIONED THE IMPORTANCE OF
THAT FIRST TWO QUESTIONS- THAT
REALLY SHINE A LIGHT ON THE
REASONS THAT AND EACH ARE YOU
SHOULD BE CONSTRUCTING
CALIFORNIA THAT NOT ONLY
IMPROVES COMMUNICATION BETWEEN
PLANS AND PROVIDERS TO BETTER
COORDINATE CARE FOR PATIENTS.
BUT ALSO FOR THE STATE- SO THAT
THEY CAN PROVIDE REAL VALUE FOR
OUR PUBLIC HEALTH
INFRASTRUCTURE AND INFORM OUR
POLICY MAKERS TO TACKLE ISSUES
LIKE- HEALTHEQUITY WHICH IS SO
VITAL- TO CALIFORNIA IN OUR
FUTURE- IMPORTANTLY MOVING TO
THE SECOND. TO THE THIRD
QUESTION- WHAT IS THE BEST WAY
TO ESTABLISH- DATA EXCHANGES
ACROSS HEALTH CARE SOCIAL
SERVICES PROVIDERS THAT ENABLES
A POPULATION HEALTH MANAGEMENT
AND FUTURE PATIENT CENTERED.
COORDINATION THE VULNERABLE
PATIENT POPULATIONS WE TALKED
ABOUT- PREVIOUSLY ALSO STAND TO
BENEFIT THE MOST FROM ADVANCES
IN PATIENT HEALTH MANAGEMENT WE
KNOW THAT AND WE HAVE KNOWN FOR
SOME TIME THE HIGHEST RISK IN
ROWLEY'S A MEDIC CAL HAVE
MULTIPLE NEEDS AND WOULD
GREATLY BENEFIT FROM A SYSTEM.
THAT NOT ONLY INTEGRATES
PHYSICAL HEALTH AND BEHAVIORAL
HEALTH BUT THAT LOOKS ACROSS
THE CONTINUUM OF SERVICES
AVAILABLE FROM VARIOUS STATE
AND COUNTY DEPARTMENTS IT CAN
UNIFORMLY. ASSESS A PERSON'S
INDIVIDUAL NEEDS. THERE IS BEEN
A LONG STANDING ISSUE AS IT
RELATES TO THE SHARING OF DATA
FROM BEHAVIORAL HEALTH
PROVIDERS MOSTLY DUE TO THE
I'M- UNEXPLAINABLE STIGMA THAT
WE HAVE ATTACHED TO BE A RURAL
HEALTH. BECAUSE THERE IS A LACK
OF CLARITY ABOUT WHAT TYPE OF
BEHAVIORAL HEALTH INFORMATION
CAN BE SHARED. IT IS TIME FOR
THE STATE TO PROVIDE LEADERSHIP
ON THIS FRONT SO THAT WE CAN
PROVIDE THAT SO THAT PROVIDERS
CAN FEEL COMFORTABLE EXCHANGING
INFORMATION THAT IS ESSENTIAL
TO MANAGING THE INDIVIDUAL'S
CARE. AT THE VERY LEAST WE
SHOULD USE THIS OPPORTUNITY TO
DEFINE A MINIMUM SET OF DATA
THAT SHOULD BE SHARED ACROSS
SOCIAL AND TRADITIONAL HEALTH
CARE PROVIDERS. RATING SYSTEM
THAT MANAGES WHOLE PERSON CARE
AND SIMPLIFIES ELIGIBILITY FOR
STATE AND COUNTY PROGRAMS
ACROSS DEPARTMENTS CAN UNLOCK
THE FULL POTENTIAL OF HEALTH
INFORMATION EXCHANGES. THAT THE
VOTE WAS THAT NEED CARE THE
MOST ARE ABLE TO ACCESS IT. AND
IF WE BILL CALIFORNIA'S HIV TO
CERTAIN- MEDICAID FUNCTION. WE
CAN ALSO LEVERAGE- HUGE AMOUNTS
OF FEDERAL DOLLARS TO HELP PAY
FOR IT. FINALLY POLICIES ARE
BACK CALIFORNIA CAN ENACT TO
LEVERAGE THE PROGRESS MADE
THROUGH THESE NETWORKS- AT. BUT
I'LL BE MORE INCLUSIVE AND
ENSURE THAT CALIFORNIA H. ID
SYSTEM SERVE ALL OF
CALIFORNIANS AND PROVIDE
SERVICES THAT ADDRESS THE WHOLE
PERSON IN RESPONSE TO THAT
QUESTION IN ORDER TO DETERMINE
WHAT POLICIES THE STATE SHOULD
PURSUE- WE MUST FIRST DETERMINE
WHAT THE STATE'S GOALS ARE. IF
THE ONLY GOAL IS TO FACILITATE
EXCHANGE BETWEEN PROVIDERS
PLANS TO BETTER COORDINATE
PATIENT CARE WHICH IS GREAT WE
ARE BUT WE MUST ALSO ENSURE
THAT- WE ARE REALLY MOVING THE
NEEDLE ON EQUITY. ON MEDICAL
TRANSFORMATION I'M BOLSTERING
OUR PUBLIC HEALTH
INFRASTRUCTURE IN ON RESPONDING
TO COVERT NINETEEN ANOTHER
PUBLIC HEALTH EMERGENCIES SO
THAT WE CAN QUICKLY CLOSE
EXISTING DATA GAPS MYSTICS
SWIFT AND DECISIVE ACTION TO
STYLE H. ID- IN SA USE VIEW THE
MOST IMPORTANT POLICIES NEEDED
TO ACCOMPLISH THIS BROAD SET.
OF GOALS ARE- ESTABLISHING US
SHARING MANDATE SIMILAR TO WHAT
WAS CONTAINED IN THE
GOVERNOR'S. BUDGET PROPOSAL- IN
REQUIRING HEALTH PLANS
PROVIDERS TO COLLECT AND SHARE
RACE AND ETHNICITY DATA. CREATE
A STATEWIDE HIV THAT LEVERAGES
PREVIOUS INVESTMENTS IN HEALTH
INFORMATION INFRASTRUCTURE- AND
IS ABLE TO SUPPORT THE STATE'S
PUBLIC HEALTH GOALS. ENSURED
HIV HAS THE ABILITY TO MEASURE
TRACK AND REPORT ON A RANGE OF
ACCESS QUALITY OUTCOME MEASURES
THAT ARE STRATIFIED BY RACE AND
ETHNICITY. AND THAT THEY
PRODUCE AN ANNUAL ACT REPORT
FOR POLICY MAKERS AND THEN
FINALLY TO CREATE H. ID IN A
MANNER THAT UTILIZE AVAILABLE
FEDERAL RESOURCES TO THE
GREATEST EXTENT POSSIBLE.
WITHOUT I ONCE AGAIN REALLY
APPRECIATE THE TIME AND- I WILL
STAY ON FOR ANY ADDITIONAL
QUESTIONS. THANK YOU VERY MUCH
WE'RE GOING TO GO THROUGH HE
WHOLE PANEL AND THEN WE'LL ASK
QUESTIONS SO I HOPE YOU CAN
STAY WITH US THERE SO. THANK
YOU- NEXT WE'RE GONNA HEAR
FROM. THE RIVERSIDE COUNTY
MEDICAL ASSOCIATION AND I
BELIEVE IT'S GONNA BE DORIS-
GREEN THE EXECUTIVE DIRECTOR.
HI GOOD AFTERNOON THANK YOU- MY
NAME IS DELORES SCREEN I NEED
THAT I COULD'VE DIRECTOR WITH
THE RIVERSIDE COUNTY MEDICAL
ASSOCIATION. AND I THE FIRST
QUESTION THAT I'VE BEEN ASKED
TO ADDRESS IS HOW CAN
CALIFORNIA DEVELOP AN H. I EAT
POLICY THAT BEST SUPPORT STATE
AND LOCAL PUBLIC HEALTH
AGENCIES IN THEIR EFFORTS TO
RESPOND TO CURRENT AND FUTURE
PUBLIC HEALTH. EMERGENCIES ONE
OF MY BIGGEST CONCERNS AND ONE
OF OUR BIGGEST COLLECTIVE
OPPORTUNITIES IS TO SUPPORT AND
LEVERAGE THE PHYSICIAN
PRACTICES THAT ARE THE BACKBONE
OF HEALTHCARE IN CALIFORNIA.
THESE PRACTICES HAVE STRONG
RELATIONSHIPS WITH THEIR
PATIENTS THEY ARE IDEALLY
POSITIONED TO REACH OUT TO
VULNERABLE PATIENTS TO MAKE
SURE THEY ARE VACCINATED. AND
HELP PATIENTS CATCH UP ON
MISSED PREVENTATIVE AND CHRONIC
DISEASE CARE THIS IS PUBLIC
HEALTH. IN MY COMMUNITY I'VE
SEEN HOW IMPORTANT H. I EAT
DATA AND TOOLS ARE TOO SMALL
PRACTICES PLAYING THIS ROLE.
THE HIV ALERT PROJECT ALERTS
PRACTICES RECEIVED ONE OF
PATIENTS TEST POSITIVE FOR
COBIT NINETY. POSITIONS USE THE
H. I. E. TO IDENTIFY HIGH RISK
PATIENTS THAT SHOULD BE
PRIORITIZED FOR VACCINATION AND
DESPITE MISSING PREVENTATIVE
CARE HAVE INCOMPLETE DATA IS
ESSENTIAL I'LL GIVE YOU TWO
EXAMPLES OF HOW WE UTILIZE OUR
H. I. E. AT THE BEGINNING OF
BECAUSE OF IT AND NOW DURING
THE VACCINATION PROCESS. AT THE
BEGINNING OF CODE WHEN THE
GOVERNOR ISSUED THE STAY AT
HOME ORDER WE KNEW WE NEEDED TO
GET THAT MESSAGE OUT TO OUR OUR
ELDERLY PATIENTS. AND THE
PATIENTS THAT WERE OF MOST SAID
AT RISK. AND SO WE DEVELOPED A
LIST OF ABOUT TWENTY FIVE
CHRONIC CONDITIONS OF HIGH- FOR
HIGH RISK PATIENTS AND WE ASKED
OUR LOCAL H. I EAT TO RUN AS A
LIST OF ALL PATIENTS IN
RIVERSIDE COUNTY. THAT MET THAT
CRITERIA- THEY WERE. IN TWO
DAYS TO COME BACK WITH US WITH
A LIST OF SEVENTY THREE
THOUSAND PATIENTS IN RIVERSIDE
COUNTY THAT WERE HIGH RISK WE
THEN- WITH OUR FOR A COUPLE OF
OUR PHYSICIANS. RECORDED A PSA
A PUBLIC SERVICE ANNOUNCEMENT
IN BOTH ENGLISH AND SPANISH
THAT DAN WAS SENT OUT- TO.
ELECTRONICALLY OBVIOUSLY TO THE
SEVENTY THREE THOUSAND PATIENTS
ADVISING THEM TO STAY AT HOME
IF THEY HAD TO GO OUT THE
CUPBOARDS OR BASED MAINTAIN
SOCIAL DISTANCE X. CETERA
WITHOUT THE H. I. E. WE WOULD
NEVER HAVE BEEN ABLE TO
IDENTIFY SEVENTY THREE THOUSAND
PATIENTS. IN ALMOST FORTY EIGHT
LESS THAN. FORTY EIGHT HOURS TO
GET OUR MESSAGE OUT. WE
RECENTLY- I WOULD. WE'RE
WORKING WITH OUR PUBLIC HEALTH
DEPARTMENT AND WE NEEDED TO
IDENTIFY- A PATIENTS THAT WERE
OVER SEVENTY FIVE OVER SIXTY
FIVE AND THEN UNDER SIXTY FIVE
THAT AGAIN HAD MULTIPLE CHRONIC
CONDITIONS TO ENCOURAGE THOSE
AND GET THESE PATIENTS IN TO
GET THEIR VACCINE SO WE WENT
BACK TO OUR H. I. E. WE ASK-
FOR- THEM TO IDENTIFY ALL
PATIENTS WHO HAD BEEN RELEASED
FROM- AREA HOSPITALS IN THE
LAST TWO YEARS. THEY HAD TO
WERE OVER THESE AGE BANDS AND
AGAIN WITH THE AND JUST A FEW
DAYS WE WERE ABLE TO GET THAT
INFORMATION AND THEN WE WERE
ABLE TO THROUGH THE PUBLIC
HEALTH SYSTEM CONTACT THOSE
PATIENTS AND ENCOURAGE THEM TO
COME IN FOR THEIR THEIR FOR
THEIR VACCINE WITHOUT A ROBUST
H. I EAT- WE WOULD NEVER BE
ABLE TO DO THIS TYPE OF PUBLIC
HEALTH. SO HAVE- IN- HOW CAN WE
REPLICATE THIS FOR ALL OF
CALIFORNIA WHAT WE'VE BEEN ABLE
TO ACCOMPLISH HERE IN THE
INLAND EMPIRE HERE'S WHAT I
WOULD DO NEARLY A 100% OF THE
HOSPITALS IN THE INLAND EMPIRE
FOR PARTICIPATING IN OUR H. I.
E. PARTICIPATION REALLY SPED UP
WHEN OUR LARGEST- LOCAL HEALTH
PLAN ESTABLISHED FINANCIAL
INCENTIVES FOR H. I EAT
PARTICIPATION AND DATA SHARING.
TO GET UNIVERSAL PARTICIPATION
WE WILL NEED TO BUILD BUILD ON
SUCCESSFUL MODELS LIKE THE ONE
WE DEVELOPED HERE IN THE INLAND
EMPIRE. A STATE WIDE H. I. E.
NEEDS TO PROVIDE COMPREHENSIVE
DATA AND TOOLS FOR PRACTICES
WHICH DOES INCLUDE ALERTS SO
ALERTS MEANS- WHEN A PATIENT IS
ADMITTED- OR GO TO THE
EMERGENCY ROOM OR IS DISCHARGED
FROM THE HOSPITAL. TO MAKE SURE
THAT THEIR PRIMARY CARE
PHYSICIAN KNOWS ABOUT THAT IF
THEY HAVEN'T SEEN HIM IN THE
HOSPITAL AND THAT THEY'RE ABLE
TO GET THEIR PATIENTS IN IN A
TIMELY MANNER TO PROVIDE FOLLOW
UP CARE SO THEY'RE NOT
READMITTED. ALSO ANALYTICS
TOOLS THEY NEED TO BE ABLE TO
RUN POPULATION HEALTH TYPE OF
REPORTS ON ALL OF THEIR
PATIENTS NOT JUST A ONE ON ONE
BASIS. AND THEN OBVIOUSLY THEY
NEED COMPREHENSIVE UNIFIED
RECORDS THAT CONTAINS ALL THE
pMATTER WHERE THAT PATIENT
RECEIVES THEIR CARE. AND LASTLY
HIV ACCESS SHOULD BE FREE WE
ARE VERY LOW LOW COST FOR SMALL
PRACTICES SMALL PRACTICES
CANNOT ABSORB LARGE IT AND-
CLASS IN ORDER TO RECEIVE
INFORMATION ON THEIR PATIENTS.
THE NEXT QUESTION HOW CAN H. I.
E. BE UTILIZED TO HELP THE
STATE IDENTIFY AND BEGIN TO
ELIMINATE HEALTH DISPARITIES
THAT CONTINUE TO IMPACT FAR TOO
MANY CALIFORNIANS. THANK YOU
CAN I WOULD LIKE TO FOCUS ON
THE CRITICAL ROLE OF SMALL
PRACTICES AND MAKING SURE EVERY
PERSON IN CALIFORNIA HAS
EQUITABLE ACCESS TO NEEDED
HEALTH CARE INCLUDING THE
VACCINES. ONE OF THE TRENDS WE
ARE SEEING IS THAT COVERT
ACCION'S ARE BEING DELIVERED
OUT MARCH COMMUNITY SITES NOT A
PHYSICIAN OFFICES. THIS MEANS
THAT PRACTICES ARE COMPLETELY
IN THE DARK ABOUT THEIR
PATIENTS JACKSON NATION STATUS
DOCTORS CAN LOOK AT PATIENTS
VACCINATION STATUS ONE OTHER
TIME OF THE VACCINATION
REGISTRY BUT FOR OBVIOUS
REASONS THIS IS NOT FEASIBLE-
FOR BUSY PRACTICES. I'M REALLY
EXCITED ABOUT THE MODEL IN
MARYLAND WHERE THE H. I. E.
PROVIDES DAILY VACCINATION
REPORT SEGMENTED BY AGE RACE
AND GEOGRAPHY TO PROVIDERS
ACROSS THE STATE. THE H. I. E.
RECEIVES A DAILY VACCINATION
DATA FILE FROM THE STATE
REGISTRY AND THEN MATCHES IT UP
WITH THE PATIENT LESS HE H. I.
E. ALREADY HAS FOR EACH
PROVIDER. PROVIDERS GET A DAILY
REPORT OF ALL OF THEIR PATIENTS
VACCINATION STATUS. ADDRESSING
DISPARITIES WILL TAKE A LOT OF
PROACTIVE OUTREACH FROM TRUSTED
ADVISORS THOSE TRUSTED ADVISORS
ARE ARE CALIFORNIA PRIMARY CARE
PROVIDERS. ROW AFTER ROW REJECT
THEM POSSIBLE WITHOUT
INFORMATION AND THE INSIDE
PROVIDERS NEED UNIFIED RECORDS
THAT COMBINE INFORMATION FROM A
PATIENT'S HEALTH PLAN AND ALL
OF THEIR PROVIDERS NO MATTER
WHERE THEY SEEK THEIR CARE.
THEY NEED TOOLS TO IDENTIFY
SUBSETS OF THEIR PATIENTS BASED
ON RACE GEOGRAPHY AND THAT
PREVENTED IT NEEDS VACCINATION
STATUS. ALL THE INFORMATION
ORGANIZATIONS CAN PROVIDE
CRITICAL INFRASTRUCTURETO MEET
THESE NEEDS THE STATE WIDE H.
I. E. SHOULD BE THE PLATFORM
THAT COMBINES CLAIMS AND
CLINICAL DATA TO PRODUCE A
UNIFIED VIEW OF PATIENTS
HEALTH. AND PROVIDE ANALYTIC
TOOLS TO SUPPORT PROACTIVE
OUTREACH AND POPULATION HEALTH.
THE NEXT QUESTION WHAT IS THE
BEST WAY TO ESTABLISH DATA
EXCHANGE ACROSS HEALTHCARE AND
SOCIAL SERVICES THAT ENABLES
POPULATION HEALTH MANAGEMENT
AND PATIENT CENTERED CARE
COORDINATION. IT'S IMPORTANT TO
LAY OUT A STRATEGY FOR EXCHANGE
ACROSS A PHYSICAL BEHAVIORAL
AND SOCIAL SERVICE PROVIDERS.
BUT I DON'T WANT PEOPLE TO LOSE
SIGHT OF HOW FAR WE ARE TODAY
FROM WIDESPREAD INFORMATION
SHARING JUST AMONG HEALTH CARE
PROVIDERS AND PLANS WHERE WE
ALREADY HAVE WORKABLE H. I. E.
MODELS AND SUPPORT OF POLICIES
THROUGH YEP UP. BUT AFTER
FIFTEEN YEARS OF EFFORTS AND
MILLIONS OF FEDERAL AND STATE
DOLLARS EXPANDED WE STILL HAVE
A FRAGMENTED SYSTEM. WHERE DATA
CANNOT MOVE EASILY BETWEEN
REGIONAL H. I. EASE THE
NATIONAL EXCHANGE NETWORKS AND
STATE AND LOCAL PUBLIC HEALTH
DEPARTMENTS. SO AS WE EXPAND
THE SCOPE OF WHAT WE ARE
CONSIDERING WE NEED TO BE
DRIVEN BY BOTH URGENCY AND
PRAGMATISM WE DON'T HAVE A
HUNDRED OR EVEN TEN YEARS TO
FIGURE THIS OUT. LET'S SET A
GOAL THAT ALL HEALTH FOR HEALTH
PROVIDERS AND PLANS PARTICIPATE
IN HEALTH INFORMATION EXCHANGE.
SHARE NEEDED DATA WITHIN THE
NEXT FEW YEARS OUR PHYSICIANS
CANNOT PROVIDE BETTER CARE TO
PATIENTS WITHOUT A FULL VIEW OF
THE PATIENT'S RECORD. AND THEIR
HELP. BUT AT THE SAME TIME
LET'S PROVIDE ADDITIONAL
SUPPORT AND BASECAMP LIMITATION
SO EVEN THE SMALLEST PROVIDER
CAN PARTICIPATE WITHOUT
HARDSHIP. LET'S DEFINE A
MINIMUM SET OF DATA THAT SHOULD
BE SHARED ACROSS SOCIAL AND
HEALTH CARE PROVIDERS AND
VIABLE WORKFLOWS TO SUPPORT
THIS EXCHANGE. AND LASTLY LET'S
ELIMINATE THE POLICY MURKINESS
THAT OFTEN SLOWS PROGRESS IN
THIS AREA. AND THE LAST
QUESTION WHAT POLICIES CAN
CALIFORNIA ENACTED LEVERAGE THE
PROGRESS MADE THROUGH THESE
NETWORKS BUT BE MORE INCLUSIVE
ENGINE AND ENSURE THAT
CALIFORNIA'S H. I. E. SYSTEM
SERVE ALL CALIFORNIANS AND
PROVIDE SERVICES THAT ADDRESS
THE WHOLE PERSON. EARLIER I
POINTED OUT THAT IN ORDER TO
STRENGTHEN PUBLIC HEALTH
IMPROVE CARE AND ADDRESS
DISPARITIES PROVIDERS IMPLANTS
NEED INSIGHTS ABOUT WHICH
PATIENTS ARE HIGH RISK WHICH
PATIENTS NEED PREVENTATIVE
CARE. WHICH PATIENTS REQUIRE
FOLLOW UP IN WHICH PATIENTS ARE
NOT YET VACCINATED. THESE
QUESTIONS CANNOT BE ANSWERED
WITH THE DATA IN ONE EHR- ONE
HEALTH PLANS CLAIMS THEY
REQUIRE ASSEMBLING DATA FROM
MANY SOURCES AND DISTILLING
INSIGHTS THAT IS WHAT IS STATE
DATA EXCHANGE INFRASTRUCTURE
SHOULD ACCOMPLISH. SOME LARGE
HEALTH SYSTEMS HAVE THE DATA
TEAMS AND TOOLS TO ACCOMPLISH
THIS ON THEIR OWN. BUT MOST
PROVIDERS DO NOT HAVE THE DATA
INFRASTRUCTURE- TOOLS THEY NEED.
SOME TWO THINGS THAT NEED TO
HAPPEN. ONE WE NEED EVERYONE TO
SHARE THE CORE SET OF DATA WAS
SHARED INCLUDES CLAIMS PATIENT
SUMMARIES AT T. MESSAGES WHICH-
ADMIT THIS CHARGING TRANSFER.
AND TEST RESULTS THAT ARE
NEEDED FOR BETTER PATIENT CARE
AS QUICKLY AS POSSIBLE THE
FEDERAL INFORMATION BLOCKING
AND PATIENT ACCESS ROLES ARE
MOVING US IN THIS DIRECTION NOW
CALIFORNIA SHOULD TAKE UP THE
CAUSE AND BUILD ON THOSE
EFFORTS. WE ALSO NEED A ROBUST
DATA INFRASTRUCTURE AND
POWERFUL POPULATION HEALTH
TOOLS AVAILABLE TO ALL
PROVIDERS AS QUICKLY AS
POSSIBLE. DID YOU THIS WITH
URGENCY OF PRAGMATISM WE NEED
TO FIGURE OUT WHAT IT SIX TODAY
WHERE ARE THE GAPS AND WHAT'S
THE MOST RAPID AND PRAGMATIC
WAY TO FILL THOSE GAPS. THANK
YOU. THANK YOU VERY MUCH
APPRECIATE AND WILL WILL HAVE
QUESTIONS I HOPE YOU CAN STICK
AROUND. AND YES THANK YOU THANK
YOU. WILL MOVE ON TO OUR NEXT-
OUR NEXT PANELIST- FROM THE
CALIFORNIA MEDICAL ASSOCIATION
IS DAVID WARD THE VICE
PRESIDENT OF HEALTH INFORMATION
TECHNOLOGY MISTER FORD. THANK
YOU DOCTOR WOULD MEMBERS OF THE
COMMITTEE- THANK YOU FOR HAVING
ME TODAY AND MORE IMPORTANTLY
THANK YOU FOR GIVING ME THE
FIRST RECENTLY I'M MORE THAN A
YEAR WELL HI. AND YOU CONSIDER
THE QUESTIONS AT YOUR STOP
LOSSES TO ADDRESS AND- THIS IS
THE BEST PLACE TO GET STARTED
HERE. IT'S IMPORTANT UNDERSTAND
THAT HEALTH INFORMATION
EXCHANGES NOT AND NOW WE IT'S A
FOR. A CHINESE THE ACTION THE
POSITION PROVIDER ORGANIZATIONS
HEALTH PLANS AND OTHERS
ENGAGING WHEN THEY
TRANSPORTATION DATA. WHAT WE
TRADITIONALLY REFERRED TO AS AN
H. IDEAS MORE PROPERLY CALLED
H. I. L. HEALTH INFORMATION
ORGANIZATION. AND H. I. L. IS
ONLY ONE METHOD THAT PHYSICIANS
AND OTHER PROVIDERS USED TO
GAUGE IN H. I. E. THERE ARE
ALSO IN THE NATIONAL NETWORKS
SUCH AS CAREQUALITY AND COMMON
WELL. AND THEN WITH THE COMING
OF THE IN THE COMING
IMPLEMENTATION OF THE FEDERAL
INFORMATION BLOCKING RULE THE
PATIENT ACCESS ROLE. WE'RE
GOING TO SEE THE RISE OF
PATIENT DRIVEN OUT THE STATE
EXCHANGE. AND IT'S IMPORTANT TO
CONSIDER THOSE CONTACTS AS WE
APPROACH SETTING HIV POLICY
STATE. WE UNFORTUNATELY OFTEN
ACCEPT AS TRUTH THE PROVIDERS
DON'T DO ANY CHARITY WHAT WE
NEED IS THAT THEY MAY NOT- FOR
DISSIPATE IN H. I. L. BUT THEY
MAY BE EXCHANGING A WHOLE LOT
OF DATA USING OTHER METHODS.
AND ANY SOLUTION WE WOULD BUILD
THE STATE HAS TO BE INCLUSIVE
AS ALL THE CHECK OF LL OF
THESE TECHNOLOGIES AS WELL AS
THE NEW ONES. COMING ONLINE. NO
IT'S ALSO TRUE HOWEVER THAT THE
ROLE OF HIV IN THE STATE BEEN.
ON THE PHONE. AS OF THE
PREVIOUS SPOKE SO WELL TO. MANY
SMALLER UNDERSERVED AND RURAL
PROVIDERS HAVE BEEN LEFT ACT.
OTHERS EITHER BECAUSE THEY
DON'T HAVE ACCESS TO A HIGHER
FROM CAN BE HR'S WHICH ALLOW
THEM TO GET ON TO THE NATIONAL
NETWORKS. THEY LACK THE
RESOURCES AND SUPPORT TO
CONNECT TO AN HMO OR THEY DON'T
HAVE ACCESS TO BROADBAND.
INTERNET THAT CAN SUPPORT
EXCHANGE. ABOUT THREE YEAR AGO.
CNN LARGE COALITION OF OTHERS
WORK WITH THE LEGISLATURE TO
BUILD A FIFTY MILLION DOLLAR
PROGRAM. FORTY FIVE MILLION
DOLLARS OF WHICH WAS FEDERAL.
KNOWN AS CAL HOCKLEY CALIFORNIA
H. IT ONBOARDING PROGRAM. THAT
WAS SUPPOSED TO HELP RESOLVE
THIS ISSUE AND BRING HELP BRING
THE SMALLER PROVIDERS INTO THE
FOLD. UNFORTUNATELY THREE YEARS
LATER THAT PROGRAM HAS ONLY
SPENT ON A FRACTION OF ITS
ALLOTMENT. ANDREAS ALMOST OUT
OF TIME. THE OTHER ESSENTIAL
PIECE OF THIS CONTACT OF
CONTACTS THIS DISCUSSION WHICH
I. MENTIONED VERY BRIEFLY AND
AS TO THE PREVIOUS SPEAKER. IS
BETWEEN FEDERAL REGULATIONS SET
TO TAKE EFFECT THIS YEAR THE
INFORMATION BLOCKING RULE WHICH
COMES IN APRIL AND THE PATIENT
ACCESS ROLE WHICH COMES IN
JULY. TAKEN TOGETHER THESE TWO
ROLES MARKET SHIFTING DIRECTION
IN THE WORLD OF THE JD. ONCE
THEY ARE FULLY IMPLEMENTED ALL
ACTORS IN THE HEALTH CARE
SYSTEM SO THAT PHYSICIANS
HEALTH PLANS HOSPITALS AND
OTHERS. ARE GOING TO BE SUBJECT
TO FEDERAL CIVIL MONETARY
PENALTIES IF THEY ATTEMPT TO
IMPEDE THE FLOW OF PATIENT
DATA. SO ANYTHING WE DO IN
CALIFORNIA HAS. HAD ALL OF THAT
AS A BACKDROP. WITH ALL THE IN
MIND INTO A DRASTIC DREADED BUT
IT CAN BE SENATE VOTED TO SAY
CALIFORNIA SHE TO. MAJOR THANK-
AND FOR SINCE IT'S BEEN. IN
SEVERAL ON- SO THAT ARE HELD
WITHIN STATE- COMMITTEE STAFF
AND ASKED A QUESTION ABOUT
HOUSE TO STAY IN THAT RICH DATA
EXCHANGE TO ADDRESS THE CURRENT.
PUBLIC HEALTH EMERGENCY AS WELL
AS FUTURE. HELLO HEALTH. AND
REALLY THE MOST AND- THING
REGION DO ABOUT CAR. IS TO MAKE
THE DATA THAT'S CURRENTLY HELD
AND CAL READY. IMMUNIZATION
REGISTRY AND I WOULD LIKE TO
ADD SECURITIES DATABASE.
ANOTHER SIMILAR SOURCES
ACCESSIBLE HEALTH. CARE THIS
WOULD HELP TREATING PHYSICIANS
TO NOW WHEN ONE OF THEIR
PATIENTS FOR EXAMPLE HAS TESTED
POSITIVE FOR REPORTABLE
DISEASE. OR AS WE'RE DEALING
WITH RIGHT NOW WHEN THEY HAVE
RECEIVED THE VACCINE- THE
SECOND THING THAT WE NEED TO DO.
IS TO PROVIDE SUPPORT TO SMALL
UNDERSERVED GENERAL PRACTICES
OF THE COMMITTEE HAD ASKED A
QUESTION ABOUT HOW HIV COULD BE
USED TO ADDRESS IMPORTANT WORK
OF ADDRESSING HEALTH
INEQUALITIES. WHICH IS AN
IMPORTANT TOPIC IS A VERY
IMPORTANT THING FOR SIAMANG.
THE BIGGEST THING WE CAN DO TO
START OFF WITH. IS WE NEED TO
MAKE SURE THAT DATA IS FLOWING
BOTH TO AND FROM THE PLACES
WHERE UNDERSERVED PATIENTS ARE
RECEIVING CARE- LARGELY THOSE
ARE GOING TO BE SMALL
PRACTICES. COMMUNITY HEALTH
CENTERS- RURAL PROVIDERS AND WE
NEED TO MAKE SURE THAT HAS
MENTIONED SEVERAL TIMES NOW WE
NEED TO BRING ALL THOSE FOLKS
INTO THE FOLD HEALTH
INFORMATION EXCHANGE- THIRD.
ARE REESTABLISHED THE STATE'S
ROLE AS THE FACILITATOR OF
HEALTH INFORMATION EXCHANGE. OF
I DON'T WANT TO SAY ON THIS BUT
JONAH FOR WORK THE FIRST PERSON
WHO HELD THE POSITION OF DATA
SECRETARY AND- DEPUTY SECRETARY
FOR HEALTH INFORMATION
TECHNOLOGY- I WAS A GOOD SPEECH
OF MUCH BETTER THAN I COULD-
BUT- THE POINT IS THERE USED TO
BE AN ITALIAN FOR STRUCTURE THE
WITH THE STAKEHOLDER. WITHIN
HHS AGENCY- OVER TIME THAT
INFRASTRUCTURE ATROPHIED AND
NOT DISSOLVED- IT WAS NOT
CONSIDERED A PRIORITY. AND
WEBER WHAT HAPPENED WAS WHEN
OPPORTUNITIES LIKE CAL HOP WERE
DELAYED OR FACE DIFFICULTIES IT
WAS REALLY UNCLEAR WHO WAS IN
CHARGE- STAKEHOLDERS LIKE US TO
GO TO TALK ABOUT. WHAT WAS
GOING ON AND HOW TO FIX IT SO
IT'S TIME TO START BRINGING
BACK THAT. THAT INFRASTRUCTURE.
AND FINALLY AS WE START TALKING
ABOUT- THE NEW ONE MIGHT
CONSIDER SOME OF THE
NONTRADITIONAL SOURCES OF DATA
SO FROM TERMINALS BEHAVIORAL
HEALTH- AS- YOU KNOW. WE REALLY
DO NEED TO BE LOOKING AT ALL
THE AVAILABLE FEDERAL FUNDING
OPPORTUNITIES- THE CHF REPORTS
THAT WERE GIVEN TO THE
COMMITTEE PROVIDE SEVERAL
EXCELLENT POSSIBILITIES. IS
INCLUDED- WHAT'S CALLED LATER
MEDICAID INFORMATION TECHNOLOGY
ARCHITECTURE WHICH IS A LINE OF
FEDERAL FUNDING THAT PROVIDES.
A 90% FEDERAL MATCH FOR BUILD
OUT AND 75% FEDERAL MATCH
MAINTENANCE. THERE'S MORAL
BROADBAND FUNDING AT THE FCC
WHICH COULD HELP FILL IN A LOT
OF THE GAPS IN OUR- IN OUR
INTERNET INFRASTRUCTURE. AND
I'LL JUST TACK ON ONE THAT
HASN'T BEEN MENTIONED THAT
PROCESS ASSEMBLY DOESN'T ENOUGH
ATTENTION. WHICH IS TEXAS
SECTION SIX ZERO ZERO ONE OF
THE FEDERAL SUPPORT ACT WHICH
ACTUALLY OPENS UP THE
POSSIBILITY OF CREATING A
MEANINGFUL USE TYPE PROGRAM FOR
BEHAVIORAL HEALTH- WE SHOULD BE
LOOKING AT THAT AS WELL. REALLY
IT'S YOU KNOW ALL THESE FEDERAL
DOLLARS COULD HELP US FILL IN
THE GAPS IN THE SYSTEM. BRING
NONTRADITIONAL PROVIDERS. AND I
ONLY THAT NONTRADITIONAL IN
THAT THEY HAVE NOT
TRADITIONALLY. PARTICIPATING
HEALTH INFORMATION EXCHANGE.
BRING THEM INTO THE NETWORK AND
GET THEM EXCHANGING DATA. SO
WITH THAT MISTER CHAIRMAN THANK
YOU FOR YOUR TIME AND I'LL BE
HAPPY TO HANG ON FOR QUESTIONS
GREAT THANK YOU VERY MUCH- SO
WE HAVE NEXT- FROM THE
CALIFORNIA PAN ETHNIC HELP
NETWORK KERRYSANDERS A SENIOR
POLICY DIRECTOR. HI THERE ARE.
THANK YOU SO MUCH FOR THE
OPPORTUNITY TO- ADDRESS YOU
TODAY AND MY NAME IS KERRY
SANDERS AND SENIOR POLICY
DIRECTOR WITH THE CALIFORNIA
PAN ETHNIC HEALTH NETWORK WHERE
STATEWIDE MULTICULTURAL HEALTH
ADVOCACY ORGANIZATION DEDICATED
TO ELIMINATION OF HEALTH
DISPARITIES FOR COMMUNITIES OF
COLOR- YOU ALSO HEALTH
UTILIZED TO HELP THE STATE-
IDENTIFYING BEGIN TO LEMONADE
HEALTH DISPARITIES THAT
CONTINUE TO IMPACT PARKING MANY
CALIFORNIANS. CALIFORNIA NEEDS
OF COLOR INCLUDING LESBIAN GAY
BISEXUAL TRANSGENDER AND QUEER
INDIVIDUALS- PERSONS WITH
DISABILITIES- CAN CONTINUE TO
EXPERIENCE DISCRIMINATION AND
HAVE POOR OTCOMES ON KEY
HEALTH INDICATORS INCLUDING
ASTHMA DIABETES. MENTAL HEALTH
AND OTHER CONDITIONS. AND THEY
SAY THAT ALLOW MORE. COLLECTION
A DEMO DATA A GOOD
SIGNIFICANTLY HELP IMPROVE
HEALTH OUTCOMES FOR
CALIFORNIANS IN COMMERCIAL AND
PUBLIC HEALTH PROGRAM- BUT HOW
WOULD THIS WORK WE KNOW FOR
EXAMPLE THAT PREVENTABLE
HOSPITAL ADMISSION RATES FOR
AFRICAN AMERICAN CHILDREN AGES
TWO TO SEVENTEEN BUT I'M NOT.
IS ROUGHLY THREE AND A HALF
TIMES THAT OF WHITE CHILDREN ON
SIGNIFICANT DISPARITIES ARE
ALSO EXIST IN PREVENTABLE
ADMISSIONS OF AFRICAN AMERICAN
ADULTS SUFFERING FROM DIABETES.
WHAT LONG TERM COMPLICATIONS
COMPARED TO WHITE ADULT.
HOSPITALS THAT HAVE RAISED AT
THE FEELING WHICH INFORMATION
ABOUT THEIR PATIENTS. WOULD BE
ABLE TO IDENTIFY DISPARITIES
WITHIN THEIR PRACTICE- AND
IMPLEMENTING- DEVELOP HOW AND
IN MY CULTURALLY APPROPRIATE
PROGRAMS TO ADDRESS-
ADDITIONALLY WHEN LANGUAGE
PREFERENCE IS AVAILABLE
ELECTRONICALLY HOSPITAL CAN
HAVE A BETTER IDEA PDATED A
PATIENT NEEDS I CAN ENSURE THE
AVAILABILITY OF INTERPRETATION
OTHER RESOURCES. ESPECIALLY
WHEN A PATIENT MIGHT REQUIRE
MULTIPLE RESOURCES WITHIN A
HOSPITAL SUCH AS SURGERY
IMAGING PHYSICAL THERAPY- ONE
AREA WHERE THIS CAN ALSO BE
VERY EFFECTIVE IS WHEN A
PATIENT IS READY TO LEAVE THE
HOSPITAL DISCHARGE INSTRUCTIONS
TRANSLATED INTO LANGUAGE THAT A
PATIENT UNDERSTAND CAN ENABLE
PATIENTS THAT EASIER ACCESS TO
IMPORTANT. HEALTH INFORMATION
AND- AS WELL AS SHARING WITH
PRIMARY CARE PROVIDERS
PHARMACISTS AND OTHERS FOR
HOSPITAL FOLLOWING TREATMENT.
I'M USING DEMOGRAPHIC DATA CAN
ALSO HELP TO FACILITATE
APPROPRIATE REFERRALS TO
COMMUNITY SUPPORT SERVICES
INCLUDING NUTRITION AND
EXERCISE YOUR SUPPORT ADULT DAY
HEALTH REHABILITATION CHILD
CARE AND TRANSPORTATION- MORE
BROADLY THERE ARE EFFORTS
UNDERWAY TO DEVELOP ELECTRONIC
HEALTH RECORDS AND OTHER
AGENCIES THAT ARE ACCEPTABLE
FOR PEOPLE WITH DISABILITIES-
AND- THIS CAN ALLOW YOU KNOW.
THAT THEIR GUIDELINES AND
RECOMMENDATIONS ALLOW AND
PATIENCE YOU. INPUT THEIR DATA
FINALLY ASSEMBLY MEMBER WOULD
MENTION NOT THE CODEPENDENT
MAKE IN RECENT NATURAL
DISASTERS THAT DEMONSTRATED.
HEALTH INFORMATION EXCHANGE
COULD BE A SIGNIFICANT HELP TO.
THE CALIFORNIA LOCAL PUBLIC
HEALTH DEPARTMENTS RESPONDING
TO PUBLIC HEALTH EMERGENCY IT'S
LIKE KOPEN NINETEEN OR- EARTH
WILL OPERATE BY PROVIDING
ACCESS TO REAL TIME DATA ON
CASES THROUGH. DIRECT ACCESS TO
HOSPITAL MEDICAL RECORDS- I
SUPPOSED TO YOU KNOW CURRENT
FAX PAPER FAX. REPORTING
SYSTEMS THAT ARE IN PLACE. I
WELL IT I. EFFECT POTENTIAL TO
REDUCE HEALTH THIS. AS WE TO
HER THE POWER OF NEW TECH. AND
HEALTH WE MUST BE CAREFUL TO
TEMPER POLICIES AND DESIGN
SYSTEMS ROUNDING H. I. T.
DIFFICULT ACCESS FOR ALL
COMMUNITY AS WELL I PROTECTING
CONSUMERS. IN TWENTY THIRTEEN
YOU CAN PUBLISHED EQUITY IN THE
DIGITAL AGE HOW HEALTH
INFORMATION. TECHNOLOGY CAN
REDUCE DISPARITIES. CONTAINS A
NUMBER. FOR WAYS TO ENSURE
HEALTH INFORMATION EXCHANGE
LEAD TO HEALTH EQUITY THERE ARE
STILL RELEVANT TO TODAY'S
DISCUSSION I MENTIONED A FEW
TODAY. THE START ARE REQUIRED
THERE MUST BE A COMMITMENT AND
REQUIREMENTS- FROM THE STATE
AND I'LL H. I. USERS TO
COMPREHENSIVE DEMOGRAPHIC DATA
COLLECTION AND REPORTING. BY
UTILIZING THE FEDERAL TWENTY
FIFTEEN OPPOSITE NATIONAL
COORDINATOR FOR H. I. T.
STANDARD FOR ELECTRONIC HEALTH
RECORD. THIS INCLUDES FULL
DISAGGREGATE OF RACE ETHNICITY
LANGUAGE SEXUAL ORIENTATION
GENDER IDENTITY AND DISABILITY
STATUS. THE TWENTY FIFTEEN-
ANTI STANDARD HOWEVER ALSO
INCLUDED ON BEHAVIORAL AND
SOCIAL RISK FACTORS INCLUDING
AGE THE- ON TOPICS LIKE SOCIAL
ISOLATION DOMESTIC VIOLENCE
FOOD AND OR HOUSING INSECURITY
WHICH HAVE ALSO BEEN SHOWN TO
IMPACT HEALTH OUTCOMES.
SELECTION REPORTING OF THE DATA
WILL ALLOW DHS TO SET YOUR OF
YOUR TARGET FOR QUALITY
IMPROVEMENT AND DISPARITIES
REDUCTION- AND PROVIDE GREATER
OVERSIGHT OF MANAGED CARE PLANS
UNDER THE NEW POPULATION HEALTH
MANAGEMENT REQUIREMENTS AND
CALLING- SECOND HEALTH
INFORMATION HEALTH SYSTEMS FOR
HEALTH INFORMATION XCHANGES
MUST BE DESIGNED FROM A NO
WRONG DOOR APPROACH. H. ARE YOU
CAN HELP WITH POPULATION HEALTH
MANAGEMENT THROUGH BETTER
INTEGRATION OF MEDICAL RECORDS
WITH. I'M EMERGING CONCEPT OF
COMMUNITY INFORMATION EXCHANGES
BUT INCLUDE DATA FROM HOUSING
FOOD EDUCATION AND OTHER
SECTORS- TO JUSTICE OF SOCIAL
DETERMINANTS OF HEALTH. THERE'S
SOME FOUNDATION FOR THE FROM
THE MOMENT SIDE WITH NO WRONG
DOOR INVOLVEMENT CHANNEL-
CAREFUL THOUGHT HOWEVER MUST BE
GIVEN TO THE APPLICATION AND
PROGRAMMING INTERFACE. OR API
OF HEALTH INFORMATION EXCHANGE
BUT THAT IS CAPABLE. OF
EXTRACTING ONLY THE DATA. THANK
NOTHING JERRY FOR THE COMMUNITY
HEALTH WORK. FOR EXAMPLE WHO'S
BEEN TRAINED TO PROVIDE ADLER
MEDIATION SERVICES WHICH IS AN
LUIS VARGAS- IN CALAIS AND TO
SCHEDULE AN APPOINTMENT WITH A
PATIENT WHO MAY BE IDENTIFIED
AS HAVING ASTHMA I WITHOUT ALSO
YOU KNOW UNNECESSARILY
ACCESSING AND DETENTION OTHER
SENSITIVE INFORMATION- THIRD OF
THE MONTH. I HAVE TO CHANGE
MUST BE CONSUMER FRIENDLY WHILE
ENSURING STRONG CONSUMER
PROTECTION- MORE SPECIFICALLY
IT CHANGE SHOULD BE DESIGNED TO
ENSURE FULL LANGUAGE ACCESS FOR
ALL CONSUMER FACING FUNCTIONS-
ALLOW CONSUMERS TO REPORT OUT
PATIENT REPORTED OUTCOMES DATA
SUCH AS FROM FITBIT. YOU KNOW
THAT THAT THAT YOU TAKE INTO
DAILY BLOOD PRESSURE READINGS
TO GLUCOSE LEVELS FOR
INDIVIDUALS WITH DIABETES- IT
SHOULD BE ALLOWED IT SHOULD BE
DESIGNED TO ALLOW CONSUMERS TO
SEE REVIEW AND CORRECT THEIR
HEALTH INFORMATION- AND
TRANSPARENT AND ACCESSIBLE
RECONCILIATION AND PEELED
PROPERTY. IS THERE ANY CONFLICT.
IT SHOULD ALSO BE DESIGNED TO
ALLOW CLEAR STATE AGAIN AND FOR
SHE WITH SUBJECT. WHAT AFTER. A
POLICE AND OTHER COURSE WITHOUT
A SPECIFIC. A COURT ORDER
SUBPOENA OR AND- YOU KNOW OTHER
AGREEMENT- AND SHOULD HAVE
CLEAR EASY TO UNDERSTAND
PATIENT CONSENT FOR SHARING OF
INFORMATION PARTICULARLY
SENSITIVE INFORMATION SUCH AS
INFORMATION ON MENTAL HEALTH
AND SUBSTANCE USE- SERVICES.
FINALLY I'M MORE GENERALLY.
THEY TELL YOU MUST BE BROAD
INCLUSIVE AND OPEN TO ALL AND
THE HEALTH INFORMATION EXCHANGE
MUST BE GNOSTIC ABOUT- THE PLAN
OR PROVIDER IS- THERE ARE A LOT
OF EXISTING PRIVATE CLOTHES
COULD. NOT FORM- AND MUST BE
ACCEPTABLE TO ALL SECTORS
INCLUDING PUBLIC PURCHASERS IN
SAFETY NET PROVIDERS.
PARTICULARLY IMPORTANT GIVEN
THE DEGREE OF CHURN BETWEEN
COVER CALIFORNIA MEDIKAL.
EVERYONE MUST BE BROUGHT INTO
THE EXCHANGE EVEN INTEGRATED
HEALTH SYSTEMS LIKE KAISER-
WHICH HAVE THEIR OWN INTERNAL
NETWORK- AND IT MUST INCLUDE
OTHER EXCHANGE FACTORS
INCLUDING LOCAL PUBLIC HEALTH
DEPARTMENTS WHO. HAS NOT SHARED
AFTERMATH YOU MUST BE
ADEQUATELY FUNDED ENOUGH TO
CABLE DURING THE DESIGN. OF THE
HEALTH INFORMATION EXCHANGE. IT
NOT OFTEN BY YOUR- SO. PUBLIC
HEALTH TO CAN CAN REAL TIME JOB
ARE DOWN OF THE BREAK. WILL
ALSO BE ABLE UTILIZE THE HEALTH.
EXCHANGE SEND A PUBLIC HEALTH
ALERT BACK YOU PROVIDERS TO
WARN THEM OF AN IMPENDING
OUTBREAK- I'M- THAT. CENTURY
BUT THOSE ARE OUR
RECOMMENDATIONS WE THANK YOU
AGAIN FOR INVITING US TO SHARE
OUR PERSPECTIVES ON THIS
CRITICAL TOPIC. MOVING FORWARD
WE SUPPORT THE RECOMMENDATIONS-
BY JOHN OF THE THERAPY A STRONG
PART. AND IF I REPORT TO HELP
WITH THE TO THE DESIGN OF HIV
AND WE WOULD ADD THAT THERE
SHOULD BE STRONG PARTICIPATION
BY CONSUMERS. ADVOCATE AND
EXPERT ON EQUITY- YOU ENSURE
THAT THE SUCCESS OF THE HIV. I
WILL LOOK FORWARD TO CONTINUE
THIS DISCUSSION AND THANK YOU
AGAIN. FOR INVITING US TO SHARE
OUR PERSPECTIVE. THE YOU VERY
MUCH. I WILL GO AHEAD MOVE ONTO
OUR- PAM- IN LINDEN HEALTH
PLAN. JARROD NOT. A CHAU GOOD
AFTERNOON CHAIRMAN WEBER AND
MEMBERS OF THE COMMITTEE THANK
YOU SO MUCH FOR THE OPPORTUNITY
TO OFFER SOME COMMENTS ON THE
IMPORTANCE OF EXPANDING THE
HEALTH INFORMATION EXCHANGE
INFRASTRUCTURE. AND
PARTICIPATION HERE IN
CALIFORNIA- I AM THE CEO HERE
AT- INLAND EMPIRE HEALTH PLAN
THE LOCAL INITIATIVE MEDICAL
HELP PLAN WHICH COORDINATES AND
PROVIDES CARE FOR MORE THAN ONE
POINT THREE MILLION MEDICARE
MEMBERS. IN RIVERSIDE AND SAN
BENITO COUNTIES AND I H. P.
ACTUALLY HELP TO CREATE OUR OWN
HIV AND ELLEN HIGHER BACK IN
TWENTY TEN AND OUR REGIONAL HIV
MERGED WITH CALENDAR JACKSON
TWENTY SEVENTEEN WHICH CREATED
MANIFEST MAX WHICH I ALSO SIT
ON THE BOARD OF DIRECTORS FOR.
AND MANIFESTATION MIGHT KNOW IS
THE NONPROFIT STATEWIDE HEALTH
INFORMATION NETWORK
ORGANIZATION THAT FACILITATES
INFORMATION SHARING ACROSS MORE
THAN FIVE HUNDRED HEALTHCARE
ORGANIZATIONS INCLUDING NINETY
SIX HOSPITALS AND- SEVEN HEALTH
PLANS INCLUDING US HERE AT OUR
H. P. AND I'VE HAD THE
PRIVILEGE OF SERVING AS CEO OF
THIS FANTASTIC ORGANIZATION
SINCE TWENTY NINETEEN BUT PRIOR
HELD. SEVERAL LEADERSHIP AND
EXECUTIVE ROLES FOR HOSPITALS
AND HEALTH SYSTEMS FALL HERE IN
CALIFORNIA AND IN THE MIDWEST.
AND IF MY TWENTY FIVE YEARS OF
SERVICE AND HEALTH CARE FIELD
HAS TAUGHT ME ANYTHING IT IS
THAT WITHOUT TIMELY TIMELY
ACCESS TO ALL AVAILABLE DATA
FOR PATIENT. PROVIDING CARE TO
THE PATIENTS WHOLE PERSON
CANNOT BE ACHIEVED. NOW IMAGINE
WITH ME FOR JUST A MOMENT. THAT
YOU PURCHASE ONE OF THOSE
SPECIAL CREDIT GIFT CARDS LIKE
ONE OF THOSE VISA GIFT CARDS.
OR A LOVED ONE AT A NATIONAL
RETAILER MAYBE LIKE TARGETS AND
YOU'RE EXCITED ABOUT BEING ABLE
TO MAIL THAT DECENT GIFT CARD
TO YOUR LOVED ONE WHO HAPPENS
TO LIVE IN THE CENTRAL VALLEY
OF CALIFORNIA WHERE I WAS BORN
AND RAISED SO THEY CAN USE. THE
LOCAL GAS STATION BUT IT
DOESN'T WORK AND WHEN THEY CALL
THE NUMBER ON THE BACK OF THE
CARD IT SAYS YOUR NETWORK
DOESN'T ALLOW FOR DATA SHARING
WITH GAS STATIONS THAT ONLY
ALLOWS FOR RETAILERS LIKE
TARGET SINCE YOU PURCHASED IT
AT A RETAILER. SO YOU CAN USE
THAT- IS THE CAR MAYBE AT
NORDSTROM'S ALL WALMART OR ANY
RETAILER BUT YOU CAN'T USE THE
CARD AT GAS STATIONS
RESTAURANTS OR ANYWHERE ELSE.
NOW WE WOULD NEVER IMAGINE THAT
KIND OF REALITY IN TODAY'S
MARKETPLACE DESPITE ADVANCES IN
INFORMATION TECHNOLOGY THAT HAS
TRANSFORMED INDUSTRIES AROUND
THE WORLD JUST LIKE OUR EXAMPLE
OF THE SPECIAL CREDIT GIFT
CARD. IN THE HEALTH CARE SPACE
PATIENT RECORDS ARE STILL OFTEN
SILO BY EACH HEALTH SYSTEM OF
PHARMACY LAB INDEPENDENT
PHYSICIAN AND HEALTH PLAN JUST
LIKE THE UNIMAGINABLE THOUGHT
OF THAT GIFT CARD EXAMPLE
MAKING THE DELIVERY. OF
INFORMED CARE AT BEST
INEFFICIENT AND THE
CONSEQUENCES OF THIS DATA
STYLING SHOULD BE UNACCEPTABLE
FOR CALIFORNIA AND IT CERTAINLY
IS NOT ACCEPTABLE FOR US HERE I
EACH P. AND THE COMMUNITIES
THAT WE SERVE IN THE INLAND
EMPIRE. I H. P. IS INVESTED
TREMENDOUS RESOURCES AND
COLLABORATIVE ENERGY AND
BUILDING OUT THE REGIONAL H. I.
INFRASTRUCTURE AND
INCENTIVIZING CONTRACTED
PROVIDERS AND HOSPITALS
PARTICIPATING THE END OF THE H.
ID NETWORK AND IT IS BECAUSE OF
THESE INVESTMENTS AND EFFORTS
AND THE LESSONS LEARNED. THAT I
BELIEVE WE HAVE A UNIQUE
PERSPECTIVE ON NOT ONLY HOW TO
IDENTIFY AND OVERCOME THE
BARRIERS TO HIV PARTICIPATION.
BUT CAN ALSO SPEAK TO HOW THE
CHINESE BREAK DOWN DATA SILOS
TO ALLOW PROVIDERS THE
INFORMATION THEY NEED TO WORK
WITH THEIR PATIENTS TO ACHIEVE
POSITIVE HEALTH OUTCOMES. NOW I
FULLY ACKNOWLEDGE THAT IT IS
THAT DIFFICULT TO DISCUSS
ANYTHING RELATED TO HEALTH CARE
TODAY WITHOUT TOUCHING ON COBIT
NINETEEN AND THE- INCREDIBLE
IMPACT THE VIRUS CONTINUES TO
OUR ENTIRE COUNTRY. AND WHAT
THE VIRUSES TAKEN TOO MANY FROM
US- IT IS MY HOPE THAT IS THE
STATE AND FEDERAL GOVERNMENT IN
PARTNERSHIP. WITH COUNTIES
ACROSS THE STATE AND YOU DON'T
VALUE DOLLAR. AND ADMINISTER
CARBON BACK. BRIGHTER DAY ARE
AT. HOWEVER THE ISSUE OF DATA
SILO CONTINUES TO PROCESS AND
WE'RE SEEING THAT FIRST HAND AS
THE VACCINATION EFFORT PLAYS
OUT. AND WHILE I H. P. AND
HEALTH PLANS ARE GRATEFUL FOR
THE EFFORTS THAT ARE PARTNERS
AND FRIENDS AT THE CALIFORNIA
DEPARTMENT PUBLIC HEALTH.
DEPARTMENT HEALTH CARE SERVICES
ARE MAKING A PROVIDING WEEKLY
DATA SUBMISSIONS TO PLANS ON.
MEMBERS RECEIVED THEIR VACCINES
AND THEIR RESPECTIVE DOSAGES
DELAYS IN RECEIVING THESE DATA
FEEDS PROCESSED. THIS DATA IS
SO IMPORTANT ENSURING THAT
HEALTH PLANS LIKE I H. P. CAN
ASSIST THEIR MEMBERS. BY
PROVIDING TRANSPORTATION TO
VACCINE SCIENCE AND OUT
REACHING TO THEM TO ENSURE THEY
UNDERSTAND WHEN IT'S THEIR TURN
WHERE TO GO. AND REMIND THEM TO
RECEIVE SECOND SHOTS. THE
UTILITY OF THIS INFORMATION
WOULD BE EXPONENTIALLY GREATER
FAXING DATA WAS AVAILABLE
WITHOUT THE DELAY. THEREFORE IT
IS OF THIS COMMITTEE AND OTHERS
IN THE STATE CONSIDER OF
PRESENT AND FUTURE HIV POLICY
DALY PATIENT DATA FEEDS ST
TRINIAN'S FROM RELEVANT STATE
AGENCIES ESPECIALLY DURING
PUBLIC HEALTH EMERGENCIES. MUST
BE A PRIORITY. THIS WILL
GREATLY ASSIST IN TRACKING AND
FORECASTING HOSPITAL CAPACITY
AND I DID TO FIND RISK PATIENTS
THAT NEED AN EXTRA LEVEL OF.
PROACTIVE OUTREACH. NOW LOOKING
PAST THE PANDEMIC I'M HOPEFUL
FOR THE FUTURE OF MEDIC CALLOUS
NATIONALLY WHEN CONSIDERING THE
OPPORTUNITY THAT CALTRAIN COULD
PROVIDE PLANS AND PROVIDERS. TO
BETTER TACKLE HEALTH
DISPARITIES THAT HAVE ONLY
GROWN DUE TO THE PANDEMIC. AND
TO PROVIDE TRUE WHOLE PERSON
CARE TO BENEFICIARIES WITHIN
THE RESOURCES PROPOSED. UNDER
THE ENHANCED CARE MANAGEMENT-
ECM AND IN LIEU OF SERVICES FOR
IOS PROPOSALS. NOW WHILE I KNOW
FIRST HAND THAT OUR TEAM BY H.
P. IS WORKING NONSTOP TO
PREPARE TO IMPLEMENT ECM AND I
ALL OF US. IN TWENTY TWENTY TO
MUCH OF THE SUCCESS OF CALAMP
WILL ULTIMATELY DEPEND ON ALL
PROVIDERS. HAVE ACCESS TO THE
SAME AD YOUR COMPLETE. UP DATA.
WITH PATIENTS MEANS BY. PROVIDE
FOR OUR PRIME CARE FOR. A
COUPLE OF SPECIALIST A MENTAL
PROVIDER ANOTHER'S IT IS
VITALLY IMPORTANT THAT THE
PATIENTS HOLD YOUR TEAM HAVE
ACCESS TO THE INSIGHTS AND
INFORMATION. TO PROVIDE
SEAMLESS EFFECTIVE HIGH QUALITY
CARE. CARE TEAMS EQUIPPED WITH
CURRENT PATIENT DATA ALLOW FOR
QUICK RESPONSES TO PROVIDE
RELEVANT RESOURCES AND
SOLUTIONS TO HELP A PATIENT.
WHEN AND WHERE THEY NEED IT WE
HAD A HEALTH CALLENGE THAT
MERITS A REFERRAL TO AN
ADDITIONAL CLINICIAN OR NON
CLINICAL CHALLENGES SUCH AS
FOOD OR TRANSPORTATION. IN
CHINESE CAN ALSO ASSIST
CHARACTER NAMES AND MAINTAINING
CONNECTION WITH THE PATIENT
THEMSELVES. IMAGINE OF A
PATIENT MOVES OR CHANGES THEIR
PHONE NUMBER AND ONLY REVEALS
THAT CHANGE TO ONE MEMBER OF
THEIR CARE TEAM. UNDER THE
EXISTING SILENCE SYSTEMS OF
CARE THAT ONE PROVIDER WOULD BE
THE ONLY CONNECTION TO THE
PATIENT UNLESS THAT INFORMATION
IS SHARED WITH EACH MEMBER OF
THE CARE TEAM. HOWEVER WITH A
FULLY REALIZED AN INTEGRATED
HIV THAT IS FURTHER SUPPORTED
WITH THE STATEWIDE CONSENT
REGISTRY THAT CHANGING CONTACT
INFORMATION AS APPROPRIATE CAN
BE SHARED INSTANTANEOUSLY.
THROUGH THE A TRYING ALLOWING
THE REST OF THE TEAM TO
CONTINUE TO PROVIDE CLINICAL
AND NON CLINICAL CARE FOR THE
PATIENTS. THE SCENARIOS ARE
TRULY THE TYPE OF THE ICEBERG
WHEN IT COMES TO THE POTENTIAL
OF HOW FULLY INTEGRATED AND
INTEROPERABLE IN CHINESE IN THE
STATE CAN HELP ADDRESS. HEALTH
DISPARITIES AND ELEVATE THE
LEVEL OF CARE FOR PATIENTS IN
CALIFORNIA ESPECIALLY THOSE
MOST VULNERABLE SURVIVE
MEDICARE PROGRAM. I TRULY
BELIEVE THAT A CHINESE CAN BE
THE FOUNDATION AND PLATFORM FOR
YOUR TEAM'S WORKING
COLLECTIVELY TO PROVIDE QUALITY
CARE. I'D LIKE TO CLOSE OF MY
THOUGHTS AND REMARKS BY BRIEFLY
TOUCHING ON THREE KEY POINTS
THAT I RESPECTFULLY REQUEST THE
LEGISLATURE CONSIDERS
CONVERSATIONS OF ALL. IN THE
STATEWIDE HIV SPACE FIRST IT IS
IMPERATIVE. THAT WE WORK TO
ENSURE. THAT EVERY PROVIDER AND
HEALTH PLAN IN THE STATE HAVE A
UNIT PLAN. TO SAVE AND SICK
CHAU THAT. IN THE DAY. THIS
PLATFORM I ALSO SHOULD BE
ACCOMPANIED BY CLEAR GUIDANCE
FROM THE STATE AROUND WHAT DATA
CAN'T BE CHANGED HOW TO DO IT.
SECONDLY CALIFORNIA SHOULD
DEVELOP AND SECURE AN ONGOING
SOURCE OF FUNDING FOR H. I.
INFRASTRUCTURE AND INCENTIVES
TO PARTICIPATE. ESPECIALLY
LEVERAGING FEDERAL FINANCING
WHERE POSSIBLE. AND FINALLY THE
STATE SHOULD FOLLOW THE LEAD OF
SO MANY OTHER STATES AND
CONSIDER BUILDING A SECURE
STATEWIDE HIV INFASTRUCTURE
THAT LEVERAGES EXISTING
REGIONAL IN CHINESE IN
CALIFORNIA. AND CORRELATING
INVESTMENTS THEY'VE ALREADY
MADE THAT HAVE ALREADY OCCURRED.
THANK YOU SO MUCH DR RUTH AND
THE ENTIRE COMMITTEE AND STAFF
FOR THE OPPORTUNITY TO DRESS
THE COMMITTEE TODAY AND- I LOOK
FORWARD TO FUTURE CONVERSATIONS
AROUND A STATEWIDE HIV. THANK
YOU THANK YOU VERY MUCH AND I
HOPE YOU'LL BE ABLE TO HANG
WITH US AND- MAYBE ANSWER SOME
QUESTIONS LATER- SO NEXT OUR
NEXT STEP PARRIS THIS FROM.
KAISER'S DR WALTER CHAV AS FAR
AS EXCUSE ME- APOLOGIES.
EXECUTIVE DIRECTOR OF HEALTH
INFORMATION TECHNOLOGY STRATEGY
AND POLICY. DOCTORS WERE AS.
YEAH THANK YOU I JUST WANT TO
CHECK THAT YOUR- THE ARMY OKAY
YES WE ARE PERFECT THANK YOU.
ALL RIGHT WELL- NEED TO SHARE A
MEMBERS OF A COMMUNITY MY NAME
IS WALTER SWART THEM EXECUTIVE
DIRECTOR FELT LIKE THE PRIVATE
THE APOLOGY BURKHART THE
PERMANENTLY. AND I WANT TO
THANK YOU FOR GIVING US THE
OPPORTUNITY TO TALK ABOUT OUR
STATE POLICY CAN BE USED TO
DRIVE THE EXCHANGE OF HEALTH
INFORMATION. KAISER PERMANENTE
STRONGLY SUPPORTS STATEWIDE AND
NATIONWIDE HEALTH INFORMATION
EXCHANGE OF POLICY THE BILL
FUNDING FIFTEEN LOCAL REGIONAL
AND NATIONAL HIF. WE DO BELIEVE
THAT CALIFORNIA HAS A ROBUST
AND DIVERSE HEALTH DATA
EXCHANGE INFRASTRUCTURE IN
PLACE. AND SIGNIFICANT
ELECTRONIC EXCHANGE OF
INFORMATION IS ACTUALLY
HAPPENING EVERY DAY. IN TWENTY
TWENTY FOR EXAMPLE YOU
CALIFORNIA ALONE CHI TO
PERMANENT IT EXCHANGE HEALTH
INFORMATION ELECTRONICALLY WITH
OVER TWENTY SIX HUNDRED- AND I
STATE AGAIN THAT TWENTY SIX
HUNDRED- PROVIDERS OUTSIDE OUR
SYSTEM MORE THAN A HUNDRED AND
FIVE MILLION TIMES THE I.
FIFTEEN REGIONAL. AND NATIONAL
HRD NETWORK. FIFTY FIVE THE
ERROR CODE NINETEEN
DEMONSTRATED HOW CRITICAL HIV
CAPABILITIES ARE TO SUPPORT
VIRTUAL CARE. DELIVERY AND
PUBLIC HEALTH EFFORTS MAYBE
BRIEFLY ADDRESSED THE POOR
QUESTIONS PROVIDED TO US BY THE
COMMITTEE. REGARDING QUESTION
ONE- CALIFORNIA LAW REQUIRES
PROVIDERS IT'S A BIT PUBLIC
HEALTH OKAY REPORT DIRECTLY TO
THE LOCAL HEALTH AGENCIES IN
THEIR JURISDICTIONS. AND
BECAUSE OF LIMITATIONS IN THEIR
TECHNICAL CAPABILITIES MOST
COUNT YET HEALTH DEPARTMENT ARE
CONNECTED TO HEALTHCARE
PROVIDERS. YEAH THE CALIFORNIA
HEALTH MEDICAL RESEARCH CORP OR
T. HMRC WHICH SERVES AT THE
CLEARING HOUSE THAT ENABLES THE
LOCAL HEALTH DEPARTMENT TO
RECEIVE ELECTRONIC DATA.
INCLUDING HANDLING THAT THE
MEXICAN INCREASE IN REPORTING
TO CALL IT. THERE ARE HOWEVER
TWO IMPORTANT GAPS THAT WE
BELIEVE NEED TO BE ADDRESSED.
FIRST COVERED NINETEEN HAVE
UNDERSCORED THE NEED TO
STRENGTHEN AND MODERNIZE THE
PUBLIC HEALTH INFORMATION
INFRASTRUCTURE. OKAY CAPACITY
AN AGENCY RESOURCES TO BETTER
SUPPORT AND A CHRONIC REPORTING
USING NATIONAL STANDARDS AND TO
CONNECT TO REGIONAL AND
NATIONAL HRD NETWORK. AND
SECOND IT IS IMPERATIVE TO ALSO
ADDRESS BASIC INFORMATION
TECHNOLOGY NEEDS OF KEY
HEALTHCARE ORGANIZATIONS
INCLUDING CRITICAL ACCESS
HOSPITALS SMALL RURAL AND URBAN
PRACTICES. COMMUNITY HEALTH
CENTERS AND OTHER SAFETY NET
PROVIDERS IN AREAS SUCH AS THE
USE OF INTEROPERABLE EHR SYSTEM
AND ACCESS TO AFFORDABLE
BROADBAND CONNECTIVITY SERVICES.
SEVERAL FEDERAL AND STATE
PUBLIC HEALTH AGENCIES
INCLUDING PVC AND INDUSTRY
GROUPS ARE WORKING ON A
NATIONAL INITIATIVE CALLED
DIGITAL BRIDGE TO ENABLE BETTER
FASTER SIMPLER AND MORE
RELIABLE EXCHANGE OF PUBLIC
HEALTH REPORTING INFORMATION
BETWEEN HEALTHCARE PROVIDERS
AND PUBLIC HEALTH AGENCIES
USING EXISTING NATIONAL AND
REGIONAL NETWORKS AND
STANDARDS. AND ADDING DECISION
SUPPORTING TELL AGAINST A
REPORT ABILITY KNOWLEDGE BASE
THAT. THIS INITIATIVE OF
RAPIDLY HAVE EXPANDED THE
ABILITY TO PERFORM IN THE
TRUNCATE REPORTING DURING
PUBLIC NINETEENTH AND THAT
MAKE- LAST YEAR- AND THIS- WHAT
THEY'VE BEEN ABLE WAS ABLE TO
BE DONE WITHOUT THE NEED TO
CREATE IN THE YOU KNOW. HIV OR-
ORGANIZATIONS OR OR H. ID
NETWORKS. ON YOUR SECOND
QUESTION- I THINK IT'S
IMPORTANT TO POINT OUT THAT THE
CHALLENGES WITH HEALTHY SPIRIT
AND HELP CONNECT WOULD THE-
HAVE DEEPER ROADS COST-
DIFFERENT ROUTE COST THAN. THE
LACK OF HIV OPTIONS. MAJOR
FACTORS- BUT IF I COULD. TO
HELL DISPARITIES INCLUDE LACK
OF EQUITABLE ACCESS TO CARE.
AND A COMBINATION OF ADVERSE
SOCIAL DETERMINANTS OF HEALTH
AND SOCIAL HELP THE- ADDRESSING
HEALTH INEQUITIES REQUIRES-
THAT WE FIRST IDENTIFY THEM BY
CAPTURING THE RIGHT INFORMATION
AND THEN DETERMINE THE ROOT
CAUSE. IN THIS REGARD ABILITY
OF HIV TO SUPPORT THESE
ACTIVITIES THAT ARE SOMEWHAT
LIMITED. THERE IS HOWEVER A
DIFFERENT SOLUTION INTO WORK A
TO HELP IDENTIFY AND ADDRESS
HEALTH DISPARITIES. MISTER
CHAIRMAN UNDER YOUR LEADERSHIP
AND THROUGH AN OPEN AND
PARTICIPATORY PROFIT BY
TOSSPOT. THE STATE IS NOW
POISED TO IMPLEMENT THE NEW
CALIFORNIA HEALTHCARE PAYMENT
DATA PROGRAM WHICH INCLUDES A
COMPREHENSIVE DATABASE ON THAT
THAT THE BILL. UTILIZATION COST
AND QUALITY OF HEALTHCARE
SERVICES. BIG DATA BASE WILL
CAP CAPTURE ALL HEALTHCARE
COUNTERS IN CLAIMS OF PROFIT BY
PLAYERS IN THE STATE INCLUDING
PUBLIC PROGRAM. I'M PROVIDE A
COMPREHENSIVE REVIEW OF A WHERE
THE SPIRIT IS THE PATH THEN TO
INFORM POLICY THAT A GREAT BUT-
HIV POLICY TO. LEVERAGE THE NEW
PROGRAM TO HELP ADDRESS OF THE-
TO THE THIRD PARTY AND WE
STRONGLY BELIEVE THAT
ADDRESSING UPPER SOCIAL
DETERMINANTS OF HEALTH AND
SOCIAL HEALTH NEEDS OF
INDIVIDUALS AND THE COMMUNITY.
IS TRULY AT THE CENTER OF VALUE
BASED CARE AND EVERY HEALTHCARE
EDUCATION IN DEVELOPING AN
INNOVATIVE APPROACHES O SOLVE
IT THE- CRITICAL COMPONENT OF
THE SEPARATIST THE INTERACTION
BETWEEN HEALTH PLANS HEALTHCARE
PROVIDERS PUBLIC HEALTH. AND
SOCIAL SERVICE PROVIDERS AND
COMMUNITY BASED ORGANIZATIONS
OR SO CALLED TV ALL THOSE WERE
TOWARD. PLEASE TURN BEING ABLE
TO REFER INDIVIDUAL AT THE
POINT OF CARE BUT HOUSING
SHELTER OR FOOD PANTRY THAT
THEY MEET. THE CBO SO OFTEN
LACK THE MOST BASIC TECHNOLOGY
CAPABILITIES NEEDED TO INTERACT
ELECTRONICALLY WITH PROVIDERS
WITH HEALTH PLAN THAT WITH
PUBLIC HEALTH. I'M TO PROVE
POPULATION HEALTH MANAGEMENT
AND HAVE THE CONNECTIVITY- AND
EXCHANGE OF HEALTH INFORMATION
WITH CBO TO CROSS THE STATE. I
THINK I PRIORITY HIV POLICY
GOAL TO BE THREE BATH IN
ENHANCING AND STRENGTHENING THE
INFRASTRUCTURE AND TECHNICAL
CAPABILITY TELL CBO SINCE
SOCIAL SERVICE PROVIDERS. SO
THEY CAN BETTER COMMUNICATE
WITH OTHER THANK CONNECT TO
ROBOT JERRY NETWORK THAT TODAY.
LASTLY TO YOUR QUESTION NUMBER
FOUR WE STRONGLY SUPPORT HIV
POLITICS AND LEVERAGE AT THE
THAT LEVERAGES COULD BE
NETWORK. WE BELIEVE THAT A
TIGHT SERVICES OF WHETHER
NATIONAL OR REGIONAL ARE
READILY AVAILABLE ANYWHERE.
THERE IS A AFFORDABLE
ACCESSIBILITY TO BROADBAND
INTERNET CONNECTIVITY. AND THAT
THE THAT SHE FOUND THE DATA
SHARING THAT SUPPORT THE WHOLE
PERSON VIEW THAT'S NOT DEPEND
REALLY ON LOCAL REGIONAL
GETTING PATIENT OR DATABASES. I
THINK MENTIONED EARLIER GAPS IN
THE DATA SHARING ARE NOT DUE TO
A LACK OF LOCAL HIV
ORGANIZATION. THE LACK OF LACK
OF TECHNICAL CAPABILITIES AMONG
PROVIDERS LACK OF LOCALLY HR
CONFIGURATIONS FOR INTERPRETIVE
THE- OR AND LACK OF AFFORDABLE
BROADBAND ACCESS. REGIONAL H. I
ORGANIZATIONS ARE A REAL SPENT
CANNOT REALLY ADDRESS. THOSE
MORE FOUNDATIONAL CHILD. TO
CONCLUDE WE BELIEVE IT IS
IMPORTANT TO THE STATE ME.
SETTING UP AN HRA THE NON.
VERSUS SUPPORTING STATEWIDE AND
NATIONAL HIV THE BURBS. A
DIVERSE SET OF A TINY OPTIONS
ALREADY EXIST AND SHOULD
CONTINUE TO BE THAT PROGRESS.
AND WE EXPECT THAT THE FLOW OF
INFORMATION ACROSS THE NETWORK
WILL EXPAND RAPIDLY IN RESPONSE
TO A RECENT FEDERAL MANDATES ON
INFORMATION BLOCKING EXPANDED
INFORMATION SHARING. ANDTHE
USE OF NEWER TECHNOLOGY SUCH A
FIX YOUR APPLICATION
PROGRAMMING INTERFACES OR
API'S. AND HL SEVEN FIRE
TENDERS. THEY ALSO SUCH TRUCE
INACTION HEALTH INFORMATION
EXCHANGE ARE NOT MYSTERIOUS. WE
NEED TO INVEST IN THIS SO
CALLED LAST MILE TO IT ENHANCE
THE CONNECTIVITY OF ALL
PROVIDER BY IMPROVING ACCESS TO
BROADBAND SERVICES SUPPORTING
PRACTICE AND- PRACTICES AND
FACILITY INVESTMENT INTO
TECHNOLOGY. TO ENABLE IMPROPER
ABILITY AND INTEROPERABLE
CONNECTIVITY AND MODERNIZE OUR
PUBLIC HEALTH AND SOCIAL
SERVICES INFORMATION TECHNOLOGY
INFRASTRUCTURE. THANK YOU FOR
THE OPPORTUNITY TO SHARE OUR
PERSPECTIVE WITH THE COMMITTEE.
THANK YOU VERY MUCH- WE'LL GO
AHEAD ND MOVE ON NEXT TO OUR
FINAL PANELIST A PARTNERSHIP
HEALTH PLAN DOCTOR MORE. TO
PROTECT MORE THE CHIEF MEDICAL
OFFICER. THAT'S RIGHT YEAH CAN
YOU HEAR ME OK YES THANK YOU
GREAT THANK THANK YOU DOCTOR
WOULD MEMBERS OF THE COMMITTEE
HI MY NAME IS ROBERT MORE ABOUT
FAMILY PHYSICIAN AND THE CHIEF
MEDICAL OFFICER AT PARTNERSHIP
HEALTH PLAN OF CALIFORNIA WHICH
IS THE COUNTY ORGANIZED HEALTH
SYSTEM PROVIDING ACCOUNT
MANAGED CARE COVERAGE IN
FOURTEEN NORTHERN CALIFORNIA
COUNTIES RANGING FROM SUBURBAN
COUNTIES LIKE MARIN. AND SOLANO
TO RURAL IN FRONT YOUR COUNTIES
LIKE DELBARTON MODOC ON THE
OTHER PANELISTS PROVIDED REALLY
EXCELLENT TESTIMONY IN AN
EXAMPLES OF MANY OF THE CURRENT
CHALLENGES AND CURRENT
SUCCESSES WHICH I WON'T REPEAT
PARTNERSHIP HAS- SOME
UNDERSTANDING OF THE SOCIAL
SERVICE AND SOCIAL DETERMINANTS
OF HEALTH EXCHANGE NEEDS- FROM
OUR WHOLE PERSON CARE
EXPERIENCE- AND ALSO- WE HAVE
EXTENSIVE AND DIVERSE
EXPERIENCES WITH DIFFERENT-
REGIONAL HEALTH INFORMATION
ORGANIZATIONS. SO I WILL BE
FOCUSING MY WAY OUT COMMENTS ON
THOSE THIRD AND FOURTH
POTENTIAL GOALS THAT. DOCTOR
WOULD YOU MENTION AT THE
BEGINNING LOOKING AT. MY
LEARNED. WHOLE PERSON CARE
PILOTS- IN THE SMALLER
COUNTIES- AND ALSO LOOKING AT
THE OPTIMAL SCOPE OF REGIONAL
HEALTH INFORMATION
ORGANIZATIONS. A VERY BRIEFLY
UP THAT THE PARTNERSHIP SERVICE
AREA INCLUDES SIX COUNTIES THAT
PARTICIPATED IN THE WHOLE
PERSON CARE PILOTS WITH SIX
DIFFERENT STRATEGIES FOR
ADDRESSING INFORMATIONAL NEEDS
RELATED TO BEHAVIORAL HEALTH
AND- SOCIAL SERVICES AND SOCIAL
DETERMINANTS OF HEALTH. WE
ANALYZED ALL SIX STRATEGIES AND
DETECTED SOME PATTERNS AND BEST
PRACTICES WHICH I'LL COVER AND
THEN SEPARATELY A PARTNERSHIP
THE PARTNERSHIP SERVICE AREA
ALSO INCLUDES TO CURRENT.
REGIONAL HEALTH INFORMATION
ORGANIZATIONS THE NORTH COAST
HEALTH INFORMATION IMPROVEMENT
NETWORK AND SEXUALLY MET SHARE
WITH CURRENTLY ACTIVE STATE
EXCHANGES WITH BOTH OF THEM. WE
ALSO- HAVE EXPERIENCE WITH
THREE PRIOR HEALTH INFORMATION
ORGANIZATIONS WANT ONE OF WHICH
MERGED WITH SEXUAL IN NATURE A
FEW YEARS AGO IN THE AND THE
OTHER TWO ARE NO LONGER ACTIVE.
IN WONDER WHAT I WOULD CALL A
TRANS STATE H. I. U. THAT THE
COLLECTIVE MEDICAL TECHNOLOGIES
ANY PLATFORM. UNLIKE INLAND
EMPIRE HEALTH PLAN THE PC PC
INSIDERS HAVE BEEN REALLY KEY
TO GETTING HIGH LEVELS OF
HOSPITAL PARTICIPATION IN LOCAL
IN CHINESE AS WELL AS- IN
ADOPTING. EIGHTY WELL BEFORE.
THESE FOR GOING TO JUST BRIEF
ADDRESSED SUPPORT FOR THE FIRST
PROPOSED GOAL OF A STATE WIDE
HIV INFRASTRUCTURE MAKING
INFORMATION AND LOCAL. EACH I
USE AVAILABLE FOR PUBLIC HEALTH
PURPOSES IT'S A REAL WAR THE
GOAL AND- IN THIS CONTEXT IT
CAN HELP WITH PUBLIC HEALTH
EMERGENCIES LIKE COVERT.
EFFECTIVELY JUST AS ONE EXAMPLE
ONE OF OUR H. I. DOES THE SMALL
ONE. NORTH COAST HEALTH
INFORMATION AND RECRUITMENT
NETWORK WORKERS HUMBOLDT COUNTY
PUBLIC HEALTH TO USE THE DATA
AND THEIR H. ID TO. MAP OUT THE
NUMBER AND IDENTITY OF
INDIVIDUALS FALLING INTO
DIFFERENT PRIORITIZATION
CATEGORIES FOR KODAK'S NATION
FOR MOST OF THE POPULATION OF
HUMBOLDT COUNTY. IS A GREAT
EXAMPLE OF THE VALUE PROVIDED
BY LOCAL COMMUNITY PARTNERSHIPS
BETWEEN THE CHINESE AND COUNTY
PUBLIC HEALTH. I'M SWITCHING
GEARS TO USING HA FOR SOCIAL
SERVICES AND SOCIAL CURRENTS OF
HEALTH WHAT IS PARTNERSHIP
LEARN. ABOUT THE INFORMATION
NEEDS- FROM WHOLE PERSON CARE
COUNTIES REALLY THERE'S A THREE
LESSONS ON THAT I THINK THAT
WE'VE WE'VE LEARNED THE FIRST
IS THAT. BRINGING DATA TOGETHER
WITH INTERFACES DOES NOT MEAN
THAT DATA WILL ACTUALLY BE USED
OR USEFUL- ALIGNING INCENTIVES
OF DIFFERENT WHOLE PERSON CARE
PARTNERS WAS CHEATING GETTING
THEM TO USE. A SHARED
COMMUNICATION AND RESOURCE
PLATFORM. ORGANIZATIONS THAT
DEVELOPED EXTENSIVE INTERFACES
BUT HAVE NOT ALIGNING
INCENTIVES FOUND LITTLE VALUE
IN THESE INTERFACES.
ORGANIZATIONS WITH ALIGNED
INCENTIVES DEVELOPING MORE
ROBUST CARE PLANS AND A GOOD
EXCHANGE OF COMMUNICATION
BETWEEN MEMBERS OF CARE TEAMS.
EVEN IF THEY HAD CLASS
INTERFACES BUILT. LESS EXPECTED
EXCHANGE. SO PEOPLE IS THE CAR
OF ALL INTERFACES AND SYSTEMS
MAY VASTLY EXCEED THE TIME
SAVINGS OF JUST HAVING ACCESS
TO THE SYSTEMS EXTRACTING
IMPORTANT INFORMATION FROM ONE
AND BRIEFLY ENTERING INTO
ANOTHER SYSTEM. MEANS TO BE A
PRIORITY PRIORITIZE PACE OF
INTEGRATION OF DATA NOT ASSUME
THAT MORE INTEGRATION MORE
AGGREGATION IS AUTOMATICALLY
BETTER. AND FINALLY I MANY
ORGANIZATIONS DON'T HAVE THE
CAPACITY OR EXPERTISE IN
ANALYTICS TO USE THAT DATA THEY
ALREADY HAVE ACCESS TO GENERATE
NEW KNOWLEDGE AND WISDOM MUCH
LESS ADDITIONAL DATA BROUGHT IN
FROM OTHER SOURCES. BUILDING
ANALYTICS CAPACITY OF THE DATA
WE ALREADY HAVE WILL GENERATE
MORE VALUE. FINALLY LET ME MOVE
ON TO THE QUESTION OF THE
OPTIMAL SCOPE OF COMMUNITY
HEALTH INFORMATION
ORGANIZATIONS- WHAT IS PC LEARN
FROM OUR EXPERIENCE. A ONE KEY
TAKEAWAY I THINK IS THAT
IMPROVING ACCESS TO USABLE DATA
AND INFORMATION ACROSS.
DIFFERENT PROVIDERS AND
HEALTHCARE DELIVERY SYSTEM IS
NOT ACHIEVED BY HAVING A SINGLE
STATEWIDE HEALTH INFORMATION
ORGANIZATION USING A SINGLE
PLATFORM. A STATEWIDE FRAMEWORK
FOR EXCHANGING DATA BETWEEN
ORGANISATIONS AND NGOS WHAT IS
NEEDED NOT A SINGLE STATEWIDE
ORGANIZATION TO BE THE
AGGREGATOR OF DATA THROUGHOUT
THE STATE. FLOOR EXPERIENCE
ORGANIZATIONS SUCCESSFUL IN
COORDINATING EXCHANGE THIS
INFORMATION OUT FOR TRAITS ARE
THE FIRST TO FINANCIAL
STABILITY. AND A SECURE AND
ROBUST TECHNOLOGY PLATFORM. ARE
DEFINITELY FAVORED BY LARGER
ORGANIZATIONS ON. THIS THE NEXT
TO GO A COMMUNITY RESPONSE OF
GOVERNANCE THAT INCLUDES
CLINICAL INPUT THAT ALLOWS.
LOCAL COMPETITORS TO BUILD
SUFFICIENT TRUST TO WORK
TOGETHER. AND THE LAST ONE THE
MANAGEMENT FOCUSED ON THE
OPERATIONAL EFFECTIVENESS IN
MEETING THE NEEDSOF THE USERS.
THEY THEY TEND TO HAVE A
DIMINISHED ON. A DIMINISH
RELATIONSHIP TO SCIENCE SO AND
SO THE SIZE OF THE H. I. O. IS
REALLY IN THE MIDDLE MIDDLE
GROUND WHERE IT'S BIG ENOUGH TO
OF THE FINANCIAL STABILITY
ROBUST TECHNOLOGY PLATFORM BUT
IT'S SMALL ENOUGH TO BE
COMMUNITY RESPONSIVE. AND MEET
THE NEEDS OF THEIR OF THEIR
COMMUNITY USERS. SO I WOULD
AGREE THAT US STATE ACTS SOME
STATE ACTIONS ARE NEEDED NOW
BUT NOT ALL ACTIONS ARE EQUALLY
HIGH PRIORITY I RECOMMEND.
COMMITTEE PRIORITIZE THE AREAS
WHERE THE STATE IS UNIQUELY
POSITIONED TO ADDRESS WITH
STANDARDS. REGULATIONS AND
INCENTIVES ARE TO MAKE OUR
HEALTH INFORMATION EXCHANGE
INFRASTRUCTURE IN THE STATE OF
WORK MORE EFFECTIVELY THANK YOU
DR WAIT FOR THE OPPORTUNITY TO
SHARE THIS INPUT. THANK YOU
VERY MUCH- WE GOT AMOUNT WE'RE
GONNA MOVE ON TO SOME QUESTIONS
ADDITIONAL QUESTIONS NOW. AND
THOSE MEMBERS WHO ARE WATCHING
REMOTELY WHO HAVE A QUESTION
YOU CAN EITHER TEXT ME
DIRECTLY- I KNOW YOU ALL HAVE
MY TAX MY PHONE NUMBER. OR USE
THE CHAT. FEATURE IN THE IN THE
IN THE WEBEX- PROGRAM THERE-
BUT- TO GETTING STARTED I'M
GOING TO GO RIGHT NOW SOME ASK
SOME GENERAL QUESTIONS. AS
FOLLOW UPS HERE AND THEN SOME
SPECIFIC QUESTIONS TO- AS WELL
AS I WAS BEEN TAKING NOTES SO-
THE QUESTION IN ANYBODY. CAN
CHIME IN HERE IF YOU KNOW THE
ANSWER SO- FOR OUR SEVEN PANEL-
SO DO DO NATIONAL NETWORK HAVE
THE- TO PUSH ALERTS TO HEALTH
CARE PROVIDERS SUCH AS- YOU
KNOW HAS A PATIENT FILLED AN
OPIOID PRESCRIPTION OR RECEIVE
A CODE TEST. TO THE NASH SO DO
YOUR TO THE NATIONAL NETWORKS
HAVE THE ABILITY TO DO THAT. I
CAN GET THIS DELORES AND I I'D
BE HAPPY TO SHARE MY THOUGHTS
ON THAT- BASICALLY THE NATIONAL
NETWORKS IT'S A QUERY SYSTEM SO
YOU ARE CLEAR GREEN ONE PATIENT
AT A TIME INFORMATION ON THAT
PATIENT AND SO YOU CAN GET
INFORMATION ON THAT PATIENT.
IT'LL GO OUT AND SEARCH- THE
DIFFERENT SYSTEMS AND PULLED
BACK INFORMATION ON THAT SINGLE
PATIENT WHAT YOU CAN'T DO IS
GET THE INFORMATION SAY ON ALL
YOUR PATIENCE YOU COULDN'T GET
A REPORT THAT SAYS. I HAVE TWO
THOUSAND PATIENTS AND FIVE
HUNDRED OF THEM HAVE GOTTEN
THEIR THEIR VACCINATION AND I
STILL HAVE ANOTHER FIVE HUNDRED
THAT MEET THE CURRENT CRITERIA
THAT SHE THAT I COULD OUT REACH
TO GET IN TO GET THEIR
VACCINATION. OKAY LIVING.
ANYBODY ELSE HAVE ANY ANY
THOUGHT ON THAT THANK YOU THANK
YOU ON THE SCREEN. YEAH THIS IS
WALTER STARTS WITH THE RIGHT TO
PRINT AGAIN- YEAH I THINK THE
ANSWER TO YOUR QUESTION IS YES-
THEY ARE CAPABLE AND THEY'RE
ABLE TO. PUSH NOTICES- I THINK
THE QUESTION IS WHETHER THEY-
ARE CURRENTLY DOING IT FOUR
ONE. AND ALSO TO WHAT EXTENT
THEY PUSH COMES FROM THE
PARTICIPANTS THAT ARE- THE
GAPING DOES NATIONAL- HIV- A
NETWORK. OF BY THE IN REALITY
THEY ARE CAPABLE AND THE FACT
THAT WE'RE GOING TO SEE FOR
EXAMPLE IN THE NEAR FUTURE
STARTING MAY OF THIS YEAR WITH
THAT- REQUIREMENTS. FROM OF-
THE FOR THANK MEDICAID. UNDER
WE CAN REGULATIONS- THE NEED TO
PUSH OR SOMETHING CALL AT T.
ADMISSION DISCHARGE AND
TRANSFER IS VERY SIMPLE AND SO
I THINK I THINK- WE'RE GOING TO
BE A LOT MORE OF- OF. THE
ABILITY TO PUSH OUT- MESSAGES
AND NOTICED THAT- TO ANYBODY
THAT NEEDS AN INCLUDING PUBLIC
HEALTH. OKAY WELL THAT'S
INTERESTING BECAUSE NOW WE HAVE
TWO DIFFERENT ANSWERS WE HAVE
ONE. WE HAVE ONE PERSON WHO
SAID NOW YOU HAVE TO DO IT IS
AN INDIVIDUAL QUERY AND DOCTORS
WERE AS YOU HAVE SAID THAT THAT
THEY CAN A NATIONAL NETWORKS DO
HAVE THE ABILITY TO PUSH ALERTS
OUT SO- THAT CREATES A LITTLE
CONFUSION FOR THE COMMITTEE
HERE. YOU EITHER YOU EITHER
HAVE THE ABILITY AND IS BEING
USED OR YOU HAVE TO DO THE
QUERY SO- NOT REALLY SURE OUT
WILL CONTINUE TO LOOK AT THIS-
I LOOK AT THIS ISSUE HERE BUT
THAT'S A- THERE'S OBVIOUSLY A
DISCREPANCY OR OR OR A
DIFFERENCE OF. OPINION ON THAT
SO- IT YOU KNOW IF THERE ARE
AREAS OF THE STATE THAT DO NOT
HAVE ANY HAVE AN H. ID- THE BAY
AREA FOR EXAMPLE HAS A HUGE
WHITE SPACE WHICH IS. KIND OF
SHOCKING TO ME BECAUSE OF. THE
FACT THAT IT IS A LARGE
METROPOLITAN AREA YOUNG WITH
AND WE ALSO HAVE EASTERN. AND
INLAND NORTHERN CALIFORNIA THAT
HAVE LIMITED PROVIDER
PARTICIPATION IN EXISTING. EHR
EASE. HOW WOULD YOU RECOMMEND A
STATE DEAL WITH THAT. GERMAN
HAPPY TO SHARE SOME THOUGHTS
SAID THIS IS YOUR- LIFE H. P.
NO WE'VE WE'VE FOUND THAT WITH
OUR OUR REGIONAL H. I. APPROACH
THAT. RELATED TO HAVE
MANIFESTED. IF YOU WILL THAT IF
THERE'S AN OPPORTUNITY TO
LEVERAGE ALL OF THOSE
REGIONALLY CHINESE AND TO A
STATEWIDE. A UTILITY OR
STATEWIDE HIV A TO DO THAT KIND
OF WORK OUT WE BELIEVE THAT
THERE IS A FANTASTIC
OPPORTUNITY TO LEVERAGE THE
WORK THAT'S ARE. DONE WITH THE
SO MANY COMMUNITY PARTNERS AND
SO MANY REGIONS AND- THOSE
AREAS THAT ARE COVERED UP BY A
CURRENT REGIONAL HIV CAN
ACTUALLY EASILY BE COVERED. BY
THAT STATEWIDE APPROACH ONCE
ALL OF THOSE REGIONAL IN
CHINESE GET NETWORKED TOGETHER
BECAUSE OF SOME OF THE
INCREDIBLE WORK THAT'S ALREADY
BEEN DONE IN YOUR COMMUNITY SO
WE MAKE A GOOD FIRST STEP TO
MAKE THAT HAPPEN IS TO CHECK
CREATE THAT CONNECTION WITH
THOSE. REGIONAL ENTITIES THAT
HAVE DONE SUCH GREAT WORK WITH
THE SPECIALISTS AND
SENSITIZATION FOR THE HOSPITALS
AND PROVIDER COMMUNITY. AND
THEN LITERALLY BRINGING OUT IN
THOSE REGIONS EITHER AROUND
THEM AND TO THOSE REGIONALLY
CHINESE OR AT WITH THAT TOPIC
THAT MASTER HIV IF YOU WILL AT
THE STATE LEVEL. THAT UTILITY
THAT. CAN ACTUALLY CALL ON THE
REST OF THE STATE. AT THANK YOU
APPRECIATE THAT ANY ANY ELSE
HAVE THOUGHTS WHAT WE MIGHT DO
FOR THESE AREAS THAT DON'T HAVE
ANYTHING. YEP MISTER CHAIRMAN
IF I MAY- DAVID PHARMACY
AMERICA- IF FIRST OF ALL WE
NEED WE NEED TO AGREE UPON WHAT
A WHITE SPACE S. AND THIS IS
WHERE THE DISTINCTION BETWEEN
ANY CHINA EITHER BERMAN H. I
HAVE THEM NOW- BECAUSE- WE SAY
FIRST. THAT THE BAY AREA AS AS
A WHITE SPACE IS ACTUALLY
PROMULGATED BECAUSE ON BAY
AREA- IT JUST THERE'S NOT A
REGIONAL H. I. L. THE SAME
THING IS TRUE OR WHERE WE'RE
SITTING RIGHT NOW IN
SACRAMENTO- YES. IS A LOT OF
DATA EXCHANGE THAT'S HAPPENING
HERE- BUT IT'S UNEVEN AMONG THE
PROVIDERS BECAUSE IT'S LARGER
SYSTEMS THAT ARE USING THE
NATIONAL NETWORKS EXCHANGE WITH
EACH OTHER. MAKES IT DIFFICULT
FOR SMALL PROVIDERS TO
PARTICIPATE- SO THAT'S WHAT WE
YOU KNOW AS WE TRY TO DEFINE
THE PROBLEM TRYING TO SOLVE
FOR. THAT POLICYMAKERS ARE IS
ONE OF THE PROBLEM TRYING TO
SOLVE FOR. IS AREN'T
NECESSARILY DATA EXCHANGE WHITE
SPACES THAT THAT THAT'S
PROVIDERS WHO CAN'T PARTICIPATE
IN THE FORMER DATA EXCHANGE.
THAT'S HAPPENING IN THOSE
REGIONS. WITH YOU JUST KIND OF
MADE IN OUR IN FAVOR OF
SOMETHING MORE COHESIVE AND-
THERE. AT IT. IF THEY CAN'T
PARTICIPATE THEN WE SHOULD BE
GIVING THEM AN OPPORTUNITY TO
FIND SOMETHING THEY CAN
PARTICIPATE IN. ISN'T THAT
CORRECT. YEAH WELL ANYONE THAT
COULD COME IN SEVERAL FORMS I
MEAN THERE COULD BE REGIONALLY
GILES I COMPLETELY AGREE WITH
WITH DOCTOR MORE- THE CLOSER WE
KEEP A CHILD WAS TO THE GROUND.
EASIER IT IS TO BUILD TRUST AND
LOAN- YOU KNOW OR- WE NEED TO
SUPPORT THE PROVIDERS. IN
GETTING ONTO MORE ROBUST
SYSTEMS ALLOW THEM TO
PARTICIPATE IN OTHER FORMS OF
DATA EXCHANGE. OKAY STILL ALL
THOSE TOOLS IN THE TOOLBOX IS.
SENATE JUST OF BRIEF BRIEF WORD
ON THAT YOU KNOW THERE WERE
SOME ATTEMPTS TO CREATE HEALTH
INFORMATION ORGANIZATIONS IN
THE BAY AREA IN THE PAST AND
THEY COULDN'T GET PAST THE
TRUST ISSUES AND THE THING IS
NOT AN EXTERNAL MANDATE ONE
OVERCOME THE TRUST CHALLENGES
IN THE END YOU DO HAVE TO COME
UP WITH A MECHANISM TO GET
COMPETITORS TO. FEEL SAFE-
CONTRIBUTING DATA THAT THEY YOU
CAN SEE WITH EACH OTHER AND
UNDERSTAND THEIR ON THAT THEIR
MUTUAL MUTUAL CHARACTER AND
QUALITY CARE FOR THEIR YOUR
PATIENCE IS AT STAKE SO. I'M
NOT SURE. ELABORATE ON TRUST
FOR ME BECAUSE- AT THE END OF
THE DAY THIS IS THE PATIENTS
INFORMATION. THE MEDICAL RECORD
IS THE PATIENT'S RECORD. THE
PROVIDER IS THE CUSTODIAN OF
THE RECORDS IT'S NOT THE
PROPERTY OF THE PLAN OR THE
DOCTOR OR THE HOSPITAL IT YOUR
CUSTODIAN OF THAT SO ARE YOU
SAYING THAT PART OF THE ISSUE
IS THAT. ENTITIES DON'T WANT TO
TRUST EACH OTHER WITH THE
INFORMATION. BECAUSE IT'S NOT
YOUR IN FOR IT'S NOT YOUR
DECISION TO BE ABLE TO DO THAT
IT'S THE PICK IT SHOULD BE THE
PATIENT'S DECISION AND THAT'S
KIND OF WHAT THE CONSENT IS SO.
HELP ME UNDERSTAND WHAT YOU'RE
TALKING ABOUT BECAUSE I'M- I
DON'T I DON'T UNDERSTAND RIGHT
WELL LET ME. THE WEIGHT HA
STALK THEY DON'T WORK BY ASKING
EACH INDIVIDUAL PATIENT DO YOU
WANT TO CONTRIBUTE. TO THIS H.
ID THAT'S NOT THE WAY WE WORK.
THAT IS SOMETHING THAT WE'RE
LOOKING AT DOING NOW THAT'S
SOMETHING WE'RE LOOKING TO
CONSIDER SO. YES SO IF THAT IS
CONSIDERED IT WILL ACTUALLY
SORT OF IF YOU THINK ABOUT IF
YOU WERE TO REQUIRE. AN OPT IN
FOR ANY H. I EAT IT WITH IT
WOULD DEFEAT THE PURPOSE THAT
YOU'RE TRYING TO ACHIEVE OF
TRYING TO GET THAT KIND OF-
COMPREHENSIVE DATA. SO BECAUSE
YOU'RE GETTING COMPREHENSIVE
DATA WITHOUT PATIENT CONSENT
YOU HAVE TO USE- THAT'S WHERE
THE TRUST COMES IN THERE HAS TO
BE IT HAS TO FIT WITHIN THE
FRAMEWORK OF. OF OF HIPPA. AND
ALSO IN THE FRAMEWORK OF
PRIVACY AND SECURITY- AT THE
END THAT DOES THAT'S WHERE THAT
THE CHALLENGES. ARISE THERE'S
ALSO THERE ARE SOME FRANKLY
THERE ARE SOME ORGANIZATIONS
WORK WE'RE NOT FOR PROFIT WE
DON'T. YOU KNOW HAVE TO HAVE
THIS CONCERN BUT- BUT THERE
ARE- YOU KNOW ORGANIZATIONS WHO
ARE WHO ARE. COMPETITORS IN THE
SAME GEOGRAPHIC AREA WE'RE
WORRIED THAT THE DATA MIGHT BE
MIND TO BE USED FOR- AFRICAN-
COMPETITIVE PURPOSES SO THAT
THAT'S. A CONCERN THAT'S THAT'S
OUT THERE. SO IT A BUSINESS.
ISSUE NOT AT AT THE TRUST ISSUE
THE BUSINESS LAW. NOT IN THE
INTEREST OF THE PATIENT'S
OVERALL HEALTH CONDITION. YEP I
WOULD SAY THAT IT STEP THAT
SOME OF THE MAJOR CERTAINLY
WHEN CINICIANS GET TOGETHER
THEY ALL GENERALLY AGREE THAT
WE NEED TO EXCHANGE DATA TO
IMPROVE HEALTH. ON THE HEALTH
STATUS OF OUR MAP OF OUR OF OUR
PATIENTS WE SERVE. THAT'S
THAT'S NOT IT THAT'S KNOWS NO
DISAGREEMENT THERE BUT THE
QUESTION IS WILL ALL PLAYERS
WHO HAVE ACCESS TO THAT DATA
ONLY BE USING THE DATA FOR THAT
PURPOSE. FOR WITHHOLDING THAT
INFORMATION SO THAT IT CAN'T BE
SHARED. ALL RIGHT I GUESS SO
OKAY. I WILL TAKES IT TAKES
ACTIVE WORK TO CREATE AN
INTERFACE THAT'S NOT IT'S NOT
ACTIVE WORK TO YOU KNOW IT IT
TAKES DOLLARS IT TAKES-
DISCRETIONARY ENERGY TO BUILD
EACH EACH OF THOSE INTERFACES
SO. IT'S NOT JUST IT'S NOT
REALLY WORTH HOLDING AS MUCH AS
DE PRIORITIZING YOU MIGHT SAY.
OKAY OKAY THANK YOU- ACTUALLY
QUESTION FOR DOLORES- IF YOU-
IF YOU'RE A NEW YOU'RE STILL
OUT THERE SO- YOU TALKED ABOUT-
THE SUCCESSES OF YOUR OF YOUR
H. ID DURING- DURING- COATED-
SO. IS EVERYBODY'S
PARTICIPATING IN YOUR H. ID N.
AND IN THE RIVERSIDE AREA THE
WORST. AN EMPIRE- THE MAJORITY
OF HOSPITALS ARE PARTICIPATING
THERE ARE A COUPLE THAT ARE
NOT- BUT AND THEN THE MAJORITY
OF THE LARGE GROUPS ARE
PARTICIPATING AND NOW WE ARE
DOWN TO TRYING TO BRING ON THE
SOLO SMALL GROUP PRACTICE-
PHYSICIANS WHICH BRINGS ITS OWN
CHALLENGES BECAUSE OF THE COSTS
THAT THE A EHR VENDORS. MAY
CHARGE THAT THE PRACTICE TO DO
THE WORK ON THEIR END ALTHOUGH
THE- PARTICIPATION IN OUR H. I.
E. S. AT NO COST FOR THE
AMATORY PROVIDERS BUT IT TAKES
A LOT DID YOU HAVE TO BUILD THE
INTERFACES THE INTERFACES ARE
EXPENSIVE- I HAVE ONE-
PEDIATRIC PRACTICE THAT HAS
THREE PEDIATRICIANS AND IT. AND
WHEN THEY WANTED TO SEND THE- A
PATIENT ROSTER TO THE H. I EAT
IN ORDER TO GET ALERTS ON THEIR
PATIENTS WHAT HAPPENS TO THEM
OUTSIDE OF THEIR FOR AT THEIR
OFFICES THE EHR VENDOR WANTED
EIGHT THOUSAND DOLLARS TO-
PROGRAM A PATIENT ROSTER- AND-
HE ACTUALLY THROUGH OUR- H. I.
ELLO I AM SENDING OUR PEOPLE
OUT AND IN FIVE MINUTES. WAS
ABLE TO DEVELOP THE SPREADSHEET
TO SEND THE PATIENT ROSTER TO
THE H. I EAT PARTICIPATE SO
THOSE ARE THE TYPE OF
CHALLENGES THAT THE SMALL
PRACTICES HAVE THEY DON'T HAVE
THE I. T. EXPERTISE THEY DON'T
HAVE EIGHT THOUSAND DOLLARS AND
THAT WAS JUST FOR ONE REPORT
LET ALONE SAID THE THEIR- THEIR
DATA INTO THE H. I. E. SO
THERE'S A LOT OF CHALLENGES FOR
THE SOLO SMALL GROUP PRACTICE
TO PARTICIPATE- AND A LOT OF
THAT. HAS TO DO WITH THE DATA
BLOCKING THAT HOPEFULLY WILL BE
RESOLVED BUT- AMONGST LONG
ANSWER AND I APOLOGIZE SO I
WOULD SAY THAT MOST OF THEBIG
PRACTICES ARE PARTICIPATING A
98% OF THE HOSPITALS ARE
PARTICIPATING- AND NOW WE'RE
WORKING. ON THE SMALLER
PRACTICES. SO HOW MANY PROVIDE%
ALL DO YOU HAPPEN RIVERSIDE
COUNTY DO YOU KNOW ROUGHLY. I'M
WELL IN THE INLAND EMPIRE SO
I'M INCLUDING RIVERSIDE IN
SAMBAR DINO COUNTIES THERE'S
ABOUT FOUR THOUSAND PRACTICING
PHYSICIANS AND THIRTY SEVEN
HOSPITALS. OKAY SO ARE YOU AT
LIBERTY TO SAY WHO WHICH
HOSPITALS ARE PARTICIPATING IN
YOUR H. ID ARE YOU COMFORTABLE
WITH THAT. HE WROTE YES- SO NOT
HAVING A DIRECT CONTRACT WITH
THE R. H. I. E. IS THAT KAISER
HOSPITALS BUT THEY ARE ACCESS
THROUGH THE NATIONAL- EXCHANGE
AND VICE VERSA- THE KAISER
FACILITIES LOCALLY ACCESS-
INFORMATION- THROUGH THROUGH A
MANIFEST WHICH IS OUR LOCAL H.
I EAT- TO RECIEVE DATA ON A
PATIENT BY PATIENT BASIS. BUT
NOT SENDING YOU KNOW ALERT SIR
OR CASH CHARGE TRANSFERS LAB
RESULTS THAT KIND OF STUFF INTO
THAT THAT REPOSITORY. OKAY
THANK YOU VERY MUCH- MR
FORWARD- JUST CURIOUS YOUR YOUR
ORGANIZATION WAS APPEARED TO BE
GENERALLY SUPPORTIVE OF THE HIV
BUDGET PROPOSAL LAST YEAR- WHAT
HAPPENED WHAT IT WOULD CONSIDER
WHAT CHANGED THAT CAUSE YOU TO
CHANGE. YOUR POLICY ON THAT.
MMHM YOU KNOW I THINK THERE'S
BEEN A COUPLE THINGS- THAT
HAPPENED- INTER HAVE MIDDLE
LAST YEAR AND ARE VERY UNUSUAL
LEGISLATIVE SESSION- THERE WERE
MULTIPLE DISCUSSIONS AROUND.
OKAY NO. CALLING A STATEWIDE AJ
EVEN WAS TALK OF AN EXECUTIVE
ORDER ONE POINT AROUND DATA
EXCHANGE- AND YOU KNOW THE ONLY
THING THAT ALL THOSE EFFORTS-
HAVE IN COMMON IS THAT THEY
WERE UNSUCCESSFUL. AND YOU KNOW
IT CMA LOOKED AT THIS YEAR WE
TOOK A STEP BACK IS THAT OKAY
WHAT ARE THE ABSOLUTELY
ESSENTIAL PIECES THAT WE THINK
NEED TO HAPPEN- NO MATTER HOW
WE NEED FOR NINETEEN EXCHANGE
WE DO A FEDERATED MODEL WITH.
OTHER STATES THE OTHERS TALKING
STATEWIDE HIV. THE CENTRAL
COMPONENT THAT I LAID OUT
EARLIER IN MY TALK NEED TO
HAPPEN NO MATTER WHICH OF THOSE
RIGHTS WILL TAKE. AND THAT'S
REALLY WHERE CNN'S NOT RIGHT
NOW WE'RE LOOKING AT THOSE
REALLY FOUNDATIONAL THINGS THAT
AS YOU YOU KNOW AS AS A
CONFERENCE HERE YOU DON'T A LOT
OF US OF SAYING ROUGHLY THE
SAME THINGS. PUBLIC HEALTH DATA
FEDERAL FUNDING. SUPPORT FOR
SMALL PRACTICES. AND SO I DON'T
YOU KNOW I DON'T THINK WE'VE-
CHANGED POSITION AS MUCH AS WE-
TOOK A STEP BACK AND SAID ONE
OF THE ESSENTIAL COMPONENTS IN
ONE OF THE ESSENTIAL BUILDING
BLOCKS BEACH IS TO PUT IN
PLACE. TO REALLY LOOK AT
EXCHANGE FORMER- I FOUND IT
INTERESTING. WHEN YOU WERE
TALKING YOU TALKED ABOUT- DATE
WITH THAT WITH THE QUESTION
THAT WAS COVERT RELATED YOU
TALKED ABOUT WITH THAT WE GREAT
FOR PRACTICES TO HAVE THE
ABILITY TO ACCESS CAL READY-
AND- AT THE ACCESSIBLE AT A
POINT AT A POINT IN THE
PRACTICE. BUT THAT'S KIND OF A
ONE WAY FLOW OF INFORMATION FOR
A DOCTOR TO ACCESS ACCESS. SO
ARE YOU AGAINST THE- THE FLOW
OF INFORMATION THE OTHER WAY
BECAUSE BECAUSE IT YOU KNOW
IT'S GREAT IF YOU WANT TO QUERY
IF THE DOCTOR WANTS TO UERY
AND FIND OUT IF THIS PATIENT
THERE BUT WOULDN'T IT BE NICE
TO BE ABLE TO HAVE THE
INFORMATION FLOWING YOU KNOW TO
YOU. THROUGH AN ALERT OR
SOMETHING. OH OH OH ABSOLUTELY.
I MEAN THE PROBLEM WITH THE
PROBLEM WITH THE CDPH DATA
TODAY. IS THAT IT ONLY FLOWS
ONE DIRECTION WE HAVE PROVIDERS
WHO ARE PUTTING PEOPLE INTO THE
SYSTEM AND YOU CAN'T GET
ANYTHING BACK OUT- YOU KNOW
CDPH HAS IT AND YOU KNOW I
MIGHT SORT OF DOWNTIME WHICH
SHE COMMENT ON THIS. CD PH HAS
NHL YOU CAME WHEN WHAT WITH
THIS GOVERNMENTS AND DEMOCRATS
THAT. J. GATEWAY ONLY SWINGS
ONE WAY. AND SO IT'S GREAT TO
DEMAND BUT IT DOESN'T GET DATA
BACK TO THE POINT CARE NOW I
THINK YOU KNOW THE QUESTION IS.
HOW DO WE GET THAT DATA IN THE
POINT OF CARE. AND AGAIN.
MULTIPLE TOOLS IN THE TOOLBOX.
THE YOU KNOW SOME OF THE BIGGER
SYSTEMS ARE CONNECTED DIRECTLY
AT ICE- KEPT OUR PUBLIC HEALTH
DATA. OTHER SMALLER PRACTICES
ARE GOING TO NEED REGIONAL
HEALTH INFORMATION
ORGANIZATIONS AGGREGATE AND
STUFF AS AN INTERMEDIARY. ON
THAT DATA IS ALL DIFFERENT WAYS
WE CAN DO THIS BUT WE NEED TO
REALLY ENHANCE THAT ABILITY FOR
DAVID A FLAWED SYSTEM. AND IT'S
I'VE FIND IT JUST A GENERAL
COMMENT- SEVERAL PEOPLE OF FOLK
HAVE HAVE TALKED ABOUT SMALL
PRACTICES AND- A SENSE OF.
HAVING BEEN SOMEONE WHO WAS
ACTUALLY IN A SMALL PRACTICE.
AS A DENTIST- YEAH I I'VE I SAW
THOSE CHALLENGES AS WELL AND IT
WAS IT WAS A CHALLENGE FOR ME
AS A PROVIDER TO ADOPT. A
CERTAIN KINDS OF TECHNOLOGIES
BECAUSE OF MY LOCATION OR AND
THE ABILITY TO SERVICE THOSE
TECHNOLOGIES AND SO ON SO. SO I
RECOGNIZE THAT IN WHATEVER WE
WORK ON YOU CAN BET THAT I'M
GOING TO BE LOOKING AT MAKING
SURE THAT SMALL PROVIDERS- ARE
ABLE TO DO THIS. BUT I DON'T
WANT TO SEE SMALL PROVIDE THE
SMALL THE SMALL PROVIDER ISSUE.
AS BEING AS AN IMPEDIMENT FOR
US TO DO SOMETHING I THINK
THERE ARE SOLUTIONS FOR THAT
AND I THINK THAT- I THINK EVERY
EVERY PROVIDER NEEDS TO BE ABLE
TO BENEFIT AND SHOULD BE A
HAPPY ABLE TO ACCESS. THE SAME
INFORMATION BECAUSE AT THE END
OF THE DAY THIS IS ABOUT
QUALITY OF CARE APPROPRIATE
CARE NON DUPLICATIVE CARE CARE
THAT DOESN'T INVOLVE ERRORS-
BECAUSE YOU DON'T HAVE ALL THE
INFORMATION- AND I THINK THAT
THAT PUTTING ALL THAT TOGETHER.
IS REALLY IN THE BEST INTEREST
OF THE PATIENT AND SO- I WANT
TO KEEP COMING BACK TO THE
PATIENT BECAUSE IT IS REALLY
ALL ABOUT THE PATIENT. AND THE
DATA IS THEIR DATA AND ALL THE
ALL THE SYSTEMS AND ALL THESE
OTHER PEOPLE. ARE THE
CUSTODIANS SO NEVER FORGET THAT
PART OF IT- AND I THINK THAT
THAT'S A REALLY A REALLY
IMPORTANT THINGAND I THINK
IT'S- YOU KNOW IT I THINK JUST
A GENERAL COMMENT HERE ABOUT
THAT IS IT. IT IS- IT IS
DISCONCERTING. TO NOTE THAT I.
COULD GO TO ANOTHER PART OF THE
STATE THE STATE. AND HAVE TO
SEE A MEDICAL PROVIDER THAT IS
OUTSIDE OF MY CURRENT MEDICAL
SYSTEM THAT HAS A PRETTY GOOD
HAS A REALLY GOOD ROBUST.
RECORD SYSTEM WITH IN THAT
SYSTEM. AND THAT PROVIDER MAY
HAVE A DIFFICULT TIME ACCESSING
THAT INFORMATION ESPECIALLY IF
I WAS UNCONSCIOUS AND THEY
DIDN'T KNOW WHERE I CAME FROM-
BUT THEY WOULD THEY WOULD MIGHT
KNOW MY NAME AND MY AND BE ABLE
TO ACCESS INFORMATION THAT WAY
BUT- BUT THE LACK OF ABILITY
FOR INFORMATION TO FLOW IN A
WAY. THAT ALLOWS PEOPLE TO- TO
GET THE APPROPRIATE CARE AT THE
APPROPRIATE TIME IS WHAT IS
DRIVING- DRIVING THIS THIS
MIGHT MY DESIRE TO DO
SOMETHING- SOMETHING MORE ABOUT
THAT- AND YOU KNOW PEOPLE MOVE
AROUND IN THE STATE AND- AND
THEY- AND IN JUST BECAUSE THEY
DO DOESN'T MEAN. THEY SHOULD.
HAVE TO NOT GET THE OPTIMAL
MEDICAL CARE BECAUSE A DOCTOR A
HOSPITAL OR CLINIC OR WHATEVER
CAN'T GET THE INFORMATION ABOUT
THEIR HEALTH HISTORY IN A
TIMELY WAY THAT'S COMPLETE
ENOUGH TO PAINT A PICTURE TO
ALLOW PROPRIA CARE DELIVERY TO
HAPPEN SO- THAT'S I WANT PEOPLE
TO UNDERSTAND THAT THAT IS.
THAT IS WHAT'S DRIVING YOU KNOW
WHAT I'M WHAT I'M LOOKING AT
LOOKING AT HERE SO HIS HIDE
SORRY I WENT UP A LITTLE BIT ON
A RANT THERE BUT- BUT THAT'S
LIKE I WANT TO BRING IT BACK TO
THAT- AND- TO MAKE SURE PEOPLE
UNDERSTAND WHAT WE'RE TALKING
ABOUT. SO MY I HAVE A QUESTION
FOR A C. PAN. I THINK IT'S A
SANTA SANTA SANTA THINK OF IF
I'M RIGHT CAN'T RMEMBER I
APOLOGIZE- SO THE INTEGRATION
OF. HEALTH SERVICE. SERVICES IS
THE CENTRAL FOCUS OF CALAMP.
AND THAT'S A THAT'S AN
AMBITIOUS PROJECT WE'RE USING
TO ROUTE TO REALLY RE ORGANIZE
OUR MEDICAL SYSTEM HERE IN
CALIFORNIA- ON THAT. THROUGH
THE DEPARTMENT HEALTHCARE
SERVICES. SO TO WHAT EXTENT
SHOULD WE BE THINKING OF
EXPANDING HEALTH INFORMATION
EXCHANGE TO INVOLVE
NONTRADITIONAL PROVIDERS SUCH
AS HOUSING AGENCIES. FOOD
BANKS. AND THINGS THAT- THAT WE
WOULD WANT TO BE ABLE TO USE AS
TOOLS TO ADDRESS THE SOCIAL
DETERMINANTS OF HEALTH. THANK
YOU FOR THAT QUESTION I THINK
THAT'S A GREAT. QUESTION WITH
THE POPULATION HEALTH
MANAGEMENT AND CONVERSATION-
AND WE'RE SEEING THESE TYPES OF
YOU KNOW COMMUNITY EXCHANGES
ALREADY- IN THE INVOLVEMENTS
WORLD AND- YOU KNOW WE LOOK A
WHOLE PERSON CARE AND WE LOOK
AT THE WAY. ON SOME OF THESE
SYSTEMS ARE BEGINNING TO
COMMUNICATE- ACROSS MEDICAL
RECORDS YOU KNOW WITH- SOCIAL
SERVICES AND HELPING FOLKS TO
MAKE THOSE LINKAGES AND HEALTH
INFORMATION EXCHANGE TECHNOLOGY
IS A GREAT. WAY TO- A VEHICLE
PERHAPS TO THE EXTENT THAT- I
THINK YOU KNOW THEM AS I
MENTIONED BEFORE JUST. YOU KNOW
BEARING IN MIND AND THERE ARE
YOU KNOW- APPLICATION- PROGRAM-
API TECHNOLOGY THAT'S IMPORTANT
SHE UTILIZED IN THE SITUATION
SO THAT. YOU KNOW OUR OUR
COMMUNITY HEALTH WORKERS ARE
MEDICAL SYSTEM AND- THE FOLKS
WHO ARE PART OF THE HEALTHCARE
TEAM CAN ACCESS THE INFORMATION
THAT THEY NEED. TO DO THEIR
JOBS AND CONNECT PEOPLE TO THE
SERVICES. PARTICULARLY YOU KNOW
WE'RE TALKING ABOUT CALLING IN
THE NEW AND LOUIS SERVICES THE
INTENSE CARE MANAGEMENT
SERVICES- THAT WILL HELP
IMPROVE THEIR CARE AND THEIR
OUTCOMES SO- ABSOLUTELY I THINK
THIS IS A GREAT- USED FOR
HEALTH INFORMATION EXCHANGES
REALLY THINKING ABOUT. THIS
COMMUNITY- DATA SHARING AND
THESE OPPORTUNITIES AND TO. YOU
KNOW CONNECT- PATIENTS WITH
ASPEN THE SOCIAL SERVICES AND
SUPPORT. THANK YOU SO MUCH I
APPRECIATE THAT THANK YOU- IF I
HOPE A MISTER MCNAUGHTON IF
YOU'RE STILL ON I DO HAVE A
QUESTION I KNOW- YOU MIGHT. YOU
KNOW MIGHT NEED TO JUMP OFF
SOON BUT. I HAD SOME IF YOU'RE
STILL OUT THERE. HE'S GONE OKAY
OKAY- THAT'S THAT'S FINE I WILL
FOLLOW UP WITH HIM LATE SO-
QUESTION I HAVE SOME QUESTIONS
FOR A DOCTOR'S JUAREZ- IF
YOU'RE STILL THERE. HI YES- YES
DOCTOR WITH A SINGLE PAYER
THANK YOU SO. THE WAY I HEARD I
HEARD FROM FROM RIVERSIDE WE
HEARD FROM THE RIVERSIDE
MEDICAL ASSOCIATION THAT YOUR
HOSPITAL DOESN'T PARTICIPATE IN
THEIR SYSTEM THERE- SO JUST IN
GENERAL HOWWOULD KAISER NO IF
A KAISER. IN ROWLEY RECEIVED
CARE LET'S SAY KOBE TEST
OUTSIDE YOUR CURRENT SYSTEM.
WELL I WANTED TO MAKE A POINT
ABOUT THAT- COMMENT BECAUSE I
THINK- WHAT DID THE- EXCHANGES
HIGHLIGHTING IS THE ABILITY FOR
AN ORGANIZATION TO BE A PART OF
FOR EXAMPLE IN NATIONAL-
NETWORK A NATIONAL HRD NETWORK
LIKE EHEALTH EXCHANGE YOUR AIR
QUALITY OR- COMMA WELL OR ON
ONES. AND STILL BE ABLE TO
CONNECT THROUGH THAT WITH THE-
LOCAL REGIONAL HIV THAT IS.
ALSO CONNECTED TO THAT NATIONAL
NETWORK- SO THAT IS A WAY THAT
WE- SEE AT THE- VIABLE WAY IN
THE FACT THAT THE WAY WE-
CONNECT TO MANY OF OUR
PROVIDERS TO- THE DIFFERENT
NATIONAL NETWORKS THAT EXIST
AND- WITH SOME OF THE REGIONAL
NETWORK AS WELL SO- SO I THINK
I THINK. MY POINT WHAT PRETTY
TO HIGHLIGHT HOW. STILL THERE
IS AN OPPORTUNITY TO
INTERCONNECT THE CHINESE I'M
THRILLED THAT INTERCONNECTION
AVE TAKE PARTICIPANTS TOOK TO
EACH OTHER AND SO THAT. EACH OF
THE PARTICIPANT DOESN'T HAVE TO
REALLY PARTICIPATE IN EVERY ONE
OF THE HIV THAT COULD NOT
HAPPEN IN A PARTICULAR LOCATION.
SO RIVERSIDE COULD GET YOUR
INFORMATION. BUT THEY HAVE TO
GO THROUGH A THIRD PARTY THIRD
PARTY ESSENTIALLY AN AND THEY
COULD BRING THEIR BORDERS SO
YEAH I MEAN IT JUST LIKE- ANY
PROVIDER INSIDE DATA IN THEM
THE RIVER SIDE H. ID LIKE TO GO
THROUGH THEY RIVERSIDE HIV AS A
THIRD PARTY INTERFACE. OR
NETWORK. HI THERE CONNECT TO A
NATIONAL NETWORK. I'M THROUGH
THE CONNECTION BETWEEN THOSE
TWO HIV IS THAT THE RIVERSIDE
PROVIDER CAN TALK TO THE
CHRYSLER PROVIDER OR VICE VERSA.
SO WHY NOT JUST WHEN I JUST
PARTICIPATE WITH WITH RIVERSIDE
WHITE WHITE WHITE WHY DON'T WHY
DON'T YOU PARTICIPATE. WELL I
THINK WE DON'T CONNECT TO
RIVERSIDE- WE ALSO CONNECT TO
THE NATIONAL NETWORK AND IF THE
QUESTION BECOMES REALLY WHICH-
VEHICLE DO YOU USE TO.
AUTOMATICALLY REACH THE OTHER
PROVIDER THAT YOU NEED TO REACH
TO- WHETHER YOU USE IT TO DO DO
IT THROUGH DAVIS- HIV TO HIV
CONNECTIONS OVER THEY DO JOIN A
PARTICULAR HIV. AND EXCHANGE
DATA WITH THEM- AND SO THOSE
ARE YOU KNOW. TO BUY A WEIGHT
OF- EXCHANGING THE INFORMATION
AT THE END AS YOU POINTED OUT
DR WITH IMPORTANT THING IS TO
BE ABLE TO DO IT ALL. BASICALLY
DELIVER THE RIGHT CARE TO THE
RIGHT PERSON AND CHIEVING THAT
INTERCONNECTION AND ACHIEVING
THAT EXCHANGE OF INFORMATION-
BY CONNECTING YOU KNOW THE
DIFFERENT HIV- IT'LL COMMITTEE
WHAT. WOULD WHAT. WOULD SERVE
DOUBLE SPACING. IT FEELS A LOT
CONTRA- IT DOESN'T FEEL VERY
SEAMLESS. SO LIKE I GUESS I
GUESS. THAT'S IT JUST DOESN'T
IT DOESN'T FEEL VERY SEAMLESS
SO- SO AND IT JUST. KIND OF YOU
KNOW THERE. AND IT DIDN'T JUST
TO FOLLOW UP THE OTHER
INTERESTING. ASPECT OF THE
TECHNOLOGY NOWADAYS IS THAT-
THROUGH NEWER TECHNOLOGY AND TO
YOUR TO YOUR EXAMPLE THAT YOU
GAVE ABOUT A PATIENT- GOING TO
A POVIDER AND THE PROVIDER
TRYING TO ACTIVATE A FROM
ANOTHER PROVIDER I THINK WITH
THE NEW REQUIRE- TECHNOLOGY
CAPABILITIES- THAT THE FEDERAL
GOVERNMENT REGULATIONS ARE ARE
MANDATING SPECIFICALLY THE USE
OF API. AND THE REQUIREMENT TO
EXPOSE START TO MAKE AVAILABLE
VIA API TOPIC CALL THE U. S.
SIDII AY OR THE UNITED STATES
COURT DATA FOR INTER
OPERABILITY WHICH CONSTITUTE
BASICALLY HEY- DETAILED SUMMARY
OF THE- MEDICAL RECORD OF A
PATIENT. I THINK- YOU KNOW
PROVIDE ARE GOING TO BE ABLE
TO. ACTON DATA IN REAL TIME
THROUGH THE STATE YEAH I FROM
OTHER PROVIDERS. BECAUSE
PROVIDERS ARE GOING TO BE
REQUIRED TO MAKE THAT DATA
AVAILABLE AND THEY'RE GOING TO
BE REQUIRED TO IMPLEMENT AN API
PLATFORM THAT ALLOWS OTHERS TO
ACT. I THINK I THINK WE'RE
WE'RE WE'RE GOING TO CHANGE IN
THE NEAR FUTURE- A DESTRUCTIVE
CAPABILITY. THROUGH API TO
ACTIVE IN REAL TIME DATA ABOUT
ANYONE IN A SECURE MANNER- WITH
THE APPROPRIATE- YOU KNOW. A
PROTECTION PLAN ON ALL THAT SO
I THINK THAT IS A VERY
DIFFERENT WAY. OF CONSIDERING
BATES TRADITIONAL CONCEPT OF.
SENDING A QUERY AND WAITING FOR
A RESPONSE TO COME BACK. OR ITS
SUMMARY DATA TO COME BACK INTO-
COMPLEX- DATA STRUCTURE FORMAT.
AND HAVING TO RECEIVE THAT DATA
AND OPEN IT AND REVIEW IT. IN
ANOTHER CHRONIC- OF BIO AT THE
OTHER END I THINK BIG MEAL API
TECHNOLOGIES ARE USING
'UALLY
YOU AT TI ARE GOING TO. THEY'RE
VERY QUICKLY DESCRIBE WAY.
WORTH THINKING THAT THE YOU
KNOW TRADITIONAL MODELS OF HIV.
SO HOW HOW NOW DO YOU AT WITH
KAISER INTEGRATE NETWORK
SERVICES- OUT OF NETWORK
SERVICES WITH YOUR ENROLLEE SAY
SOMEONE GOES OUT OF NETWORK FOR
SOMETHING BEHAVIORAL HEALTH
RELATED HOW DO YOU EXCHANGE
INFORMATION BACK AND FORTH
THERE THAT DOES THAT DOES THAT
DOES IS THAT CAN THE PROVIDER
ACCESS INFORMATION ABOUT THE
PATIENT DO YOU GET DO YOU GET
INFORMATION FROM THE PROVIDER
HOW DOES THAT WORK- SENT IT IN
IN. YES WELL YES WE DO CONNECT
TO OUT OF NETWORK PROVIDERS
THAT THEY MENTIONED WE- HAVE
OVER TWENTY SIX HUNDRED- OUT OF
NETWORK PROVIDER OR NON KAISER
PROVIDERS- WE USE- HORRIFIED.
SEVERAL DIFFERENT TYPES OF WE
USE FOR EXAMPLE SOMETHING
CALLED DIRECT EXCHANGE- TOOLS-
COMMUNICATE WITH SOME OF THE
PROVIDERS WE USE THE. WE NEED
TO HEY- PROVIDER THAT IS USING
ALSO THE SAME- YOU KNOW
ELECTRONIC HEALTH RECORD SYSTEM
THAT WE USE- MEANING BASICALLY
AN EPIC PRODUCT WE USE THE EPIC
NETWORK TO CONNECT TO THEM AS
WELL SO WE HAVE WE REACHED THE
PROVIDERS THAT WE NEED TO
COMMUNICATE WITH- IN DIFFERENT
WAYS- AND- IN A MANNER THAT
THEY ARE ABLE TO COMMUNICATE
WITH THAT. AND SO DID YOU KNOW.
BY I SAID WE HAVE. A HUNDRED
AND FIVE MILLION- INSTANCES OF
EXCHANGING DATA GAP IN
CALIFORNIA YEP IN TWENTY
TWENTY- THROUGH THE VARIOUS
NETWORKS YOU KNOW USING. FAQ
HEALTH EXCHANGE WHICH IS THE
NATIONAL NETWORK DIRECT
EXCHANGES- CAREQUALITY- AND ALL
THOSE OTHER ENTITIES THAT AE
IN ALL THE OTHER. ARE ABLE TO
COMMUNICATE BACK WITH UP SO
THIS. TRULY WORKING I MEAN IF
THAT IF THAT IS THE REALITY. SO
YEAH I IN YOUR IN YOUR COMMENTS
YOU SAID THAT YOU BELIEVE THE
SYSTEM IS AND I QUOTE. WHAT I
HEARD IS ROBUST AND WORKS WELL.
BUT YET YOU JUST ILLUSTRATED
FOR DIFFERENT. WAYS THAT AN
OUTSIDE OF OUT OF NETWORK
PROVIDER MIGHT HAVE TO
COMMUNICATE WITH YOU THAT
DOESN'T FEEL VERY SEAMLESS. AND
I'D NOT SURE THAT. THAT WHAT
WOULD BE THE WHAT IS THE
OBJECTION THEN TO AN INTEGRATED
STATEWIDE HEALTH INFORMATION
EXCHANGE. THAT IS A SINGLE
POINT. OF INFORMATION. WELL I
THINK THEY DIDN'T GET BETTER I
MEAN I THINK THAT TURNITIN OR
THEIR OPPORTUNITY FOR THE- TWO-
ELIMINATE ALL THE NETWORKS AND
YES THAT LEAVES ONE- THAT
EVERYBODY USES IN THIS STATE
AND I THINK. WE HEARD
THROUGHOUT THE TESTIMONY OF
SEVERAL OTHER PEOPLE AS WELL.
HOW THAT. I MEAN THAT THAT'S I
MEAN BASICALLY EVERYBODY TALKED
ABOUT THE NEED TO LEVERAGE DAY
INVESTMENT THAN THE PERSPECTIVE
THAT WE'VE DONE. AND EVEN
THOUGH IT DOES NOT SEEM LESS I
THINK IT IS MORE SIMPLIFIED
THAT NEED. IT IS THE PERCEIVED.
I'M I THINK IT WITH THE NEWER
TECHNOLOGIES THE NEW YORK I DID
USE OF IT REQUIRE API INTERFACE
AND- HM SEVEN FIVE STANDARDS
AND- AND THE DATA THAT THE U.
S. T. I. DATA SAID. I THINK
IT'S EVEN GOING TO BE MORE
SEAMLESS TO. ACHIEVE THAT AND
SO PEOPLE AT THE END ARE GOING
TO BE ABLE TO. RIGHT NOW WE
COMMIT WE CONNECT TO FOR FIVE
DAYS OF THE BIG MAJOR NATIONAL
NETWORK. I THINK ONE OF THE
GOALS IN THE FUTURE THROUGH
NATIONAL EFFORTS BIKE- THE
TRUSTED EXCHANGE FRAMEWORK. AND
COMMON AGREEMENT EACH THAT
PEOPLE WILL HAVE THE ABILITY
TO- YOU KNOW JOIN ONE. HIV THE
LAW H. I. ORIGINALLY YES THEY
THEY TELL YOU. HIV I WILL BE
ABLE TO COME. WITH ANYBODY ELSE
NOT JUST THE ONE LOCAL.
REGIONAL OR STATE OKAY BUT A
THE NATION SO- IT IN REALITY
THE CONNECTIVITY BETWEEN THE
NETWORKS. IS WORKING IN WORKING
MOST MORE SEAMLESSLY THAT IT.
APPEARS IT IS PERCEIVED TO BE
COMPLEX BECAUSE THERE'S
MULTIPLE NETWORKS CONNECTED
BUT- THERE ARE MANY I GET
EXAMPLES IN OTHER INDUSTRIES
WHERE DEATH IS THE PAINT
MULTIPLE NETWORKS CONNECTED TO
EACH OTHER AND STILL WORKING-
SO ANYWAY I BELIEVE THAT- FROM.
OUR PERSPECTIVE- THAT THERE IS
REALLY NO NEED TO RIP UP REFUND
REPLACE ALL THESE EFFORTS THAT
HAVE HAPPENED AND DEDICATE THE
READY NOT LIKE TO RIVERSIDE AND
LIKE ALL OTHER ONES- I'M TRYING
TO CREATE. A NEW STATEWIDE
SINGLE CENTRALIZED SYSTEM. THAT
WORKS PRIMARILY WITHIN
CALIFORNIA. I'M WHENEVER
THERE'S SOMETHING OUTSIDE OF
CALIFORNIA THEN THAT MIGHT BE
CONNECTED TO OTHER NETWORK OF
WELL WHAT THAT'S ALREADY
HAPPENING. WITH THE NATIONAL
NETWORK. I THINK THAT THE CHAO
IS AND I GO BACK TO- THE FACT
THAT THERE ARE AREAS OF THE
STATE THAT ARE NOT IS
INTEGRATED AS AND THAT THE
SYSTEM ISN'T AS ROBUST AND
ISN'T WORKING AS WELL AS YOU AS
YOU. AS AS YOU HAVE SAID. OUR
TO THE BAY AREA ARE NOT
CONNECTED. THEY'RE NOT THEY
DON'T COULD THEY DON'T
COMMUNICATE WELL PARTS OF
NORTHERN CALIFORNIA IN THE
INLAND EMPIRE ARE NOT CONNECTED
AND THEY DON'T THEY DON'T WORK
REALLY WELL. SO IN SPITE OF
YOUR BELIEF THAT THE SYSTEM IS
ROBUST AND WORKS WELL IT'S NOT
WORKING WELL FOR EVERYONE IT
MIGHT BE YOU KNOW YOUR SYSTEM
MAY BE WORKING WELL FOR YOU.
AND OTHER HEALTH SYSTEMS MAYBE
WORKING WELL FOR THEM BUT IT'S
NOT ALL WORKING WELL FOR
EVERYBODY IN CALIFORNIA. YOU
SAID YOU YOU **** YOU YOU YOU
CONTRACT OUT WITH ARE YOU WORK
AT WITH TWENTY SIX HUNDRED
OUTSIDE PROVIDERS I BELIEVE
THAT WAS THE NUMBER YOU GAVE ME.
OVER TWENTY. TWENTY SIX
HUNDRED. RIVERSIDE MEDICAL
ASSOCIATION HAS FOUR THOUSAND.
DOCTORS WE PROBABLY HAVE IN THE
STATE. SIXTY SEVENTY EIGHTY
THOUSAND MEDICAL PROVIDERS. BUT
YOU'RE ONLY TALKING TO TWENTY
SIX HUNDRED YOU SAID. YOU ONLY
CUT SO ON THAT DOES IT FEEL
TERRIBLY COLLABORATIVE SO
THAT'S THE POINT. SO WHAT. AND
WHEN I THINK TWENTY SIX HUNDRED
ON THE TWENTY FIFTH THE
DIVISIONAL POSITION- I MEAN FOR
RIVERSIDE HAS MORE HOUSING SITE
HAS FOUR THOUSAND SO. YEAH I AM
GOING TO SPEND SOME SOME OF
THESE PROVIDERS ARE PROVIDER
GROUPS THAT HAVE MULTIPLE
PHYSICIANS OR OTHER.
PRACTITIONERS THAT ARE PART OF
A- PROVIDER GOING TO GO THAT WE
CONNECT- I ALSO KNOW FROM
PERSONAL EXPERIENCE WITH
FRIENDS THAT YOU KNOW YOUR EVEN
YOUR SYSTEM DOESN'T COMMUNICATE
WELL WITH ONE ANOTHER NORTHERN
CALIFORNIA DOESN'T COMMUNICATE
VERY WELL WITH SOUTHERN
CALIFORNIA. AND SO IF YOU'RE
MOVED TO SOUTHERN CALIFORNIA
ARE YOU MOVED TO NORTHERN
CALIFORNIA GETTING YOUR HEALTH
RECORD LINKED UP WITH YOUR
SYSTEMS ISN'T SEAMLESS EITHER
SO EVEN WITHIN YOUR OWN SYSTEM
YOU HAVE CHALLENGES- SO. YEAH
IT WILL BE LOOKING AT A GROUP
THAT GIVE IT IS IT. A CHALLENGE
IT IS A- KNOWN PROBLEM. AND THE
REASON IT IS AND NOT BECAUSE OF
THE SYSTEM'S NOT BEING ABLE TO
INTEGRATE ITSELF THEMSELVES
IT'S ACTUALLY. BECAUSE OF- MORE
OF A TRAINING ISSUE WITH OUR
PROVIDERS MANY OF OUR
PROVIDERS. DON'T SEE A PATIENT
ACROSS REGIONS- THAT OFTEN AND
SO YOU KNOW THEY MIGHT SEE ONE
EVERY SIX MONTHS AND- WHATEVER
THEY SEE A NEW ONE A NEW ONE-
THEY DON'T. REMEMBER EXACTLY
WHAT IT DID WORK FLOW PROCESS
THEY HAVE TO GO THROUGH IN
ORDER TO ACCESS THE RECORDS
THAT THE DIRECTORS BEHIND IT
SCENE TOP THREE HUNDRED
EIGHTEEN THE MEETING BASICALLY
ON THE BACKGROUND. ARE
ELECTRONICALLY CONNECTED THAT
THE ISSUE IS REALLY IN THE
FRONT AND THE PROVIDER NOT
NECESSARILY NOT THE RIGHT
WORKFLOW AYE DADDY THINK
TRAINING ISSUE THAT WE ARE.
CONSTANTLY WORKING ON AND I
NEEDED TO AN UNDERSTANDABLE TO
QUESTION THAT WE HAVE HEARD
FROM MANY MEMBERS AND WE ARE
TRYING TO ADDRESS IT IN. THE IN
THAT WAY IN MAKING SURE THAT
OUR PROVIDERS REMEMBER
UNDERSTAND ALL HOW TO INTEGRATE
THE TWO RECORDS I NEED THIS
HAPPENS. NOT JUST BETWEEN
NORTHERN CALIFORNIA SOUTHERN
CALIFORNIA HAPPENS BETWEEN. OUR
DIFFERENT REGIONS ACROSS THE
UNITED STATES SO- BUT ANY OF
THAT SITUATION THAT YOU HAVE TO
DO MORE WITH- TRAINING AND THE
YOU KNOW THE ABILITY FOR
PROVIDED TO DO IT BUT IT IT IS
YEAH WELL YOU KNOW. A GOOD
POINT THAT AND CERTAINLY
SOMETHING THAT WE. UNDERSTAND
IT THAT. SO I GUESS IT I GUESS
TO ME I GUESS IT'S MAKES THINK
THE MAYBE A SINGLE SAYS. THAT
EVERYBODY PARTICIPATED IN MIGHT
ACT. SOLVE PROBLEM FOR YOU AND
SOLVE OTHER PROBLEMS FOR
EVERYONE ELSE AS WELL BUT- JUST
JUST JUST MIGHT JUST MY
THOUGHTS SO- SO THANK YOU I
APPRECIATE PREFIGURE ANSWERS
VERY MUCH THANK YOU. AND THEN A
QUESTION FOR- I'M WITH PARK
PARTNERSHIP IF- YOU MISTER
MORRIS IF HE'S STILL THERE. DR
SIR ROGER MOORE WE'RE SORRY MY
APOLOGIES. SO JUST ENTER ON
WHOLE PERSON CARE- CAN YOU
ELABORATE ON. ON SOME OF YOUR
EXPERIENCES. WITH WHOLE PERSON
CARE AND HEALTH INFORMATION
EXCHANGE. SO- SIX OF OUR
COUNTIES ARE PARTICIPATING IN
WHOLE PERSON CARE AND SO WE ARE
DOING OUR- PLANNING BECAUSE AS
OF JANUARY FIRST WE WILL BE
NEEDING TO TRANSITION THEM INTO
THE- AND HAVE CASE MANAGEMENT-
PORTION OF CAL AIMS SO IN
PREPARATION FOR THAT WE'VE
WE'VE GOT WE'VE ALWAYS
MAINTAINED CONTACT BECAUSE
THERE'S SOME DATA EXCHANGE WE
ALREADY- NEED THEY NEED CERTAIN
DATA FROM US WE SEVEN ON A
REGULAR BASIS- THAT TO BE ABLE
TO HELP STRATIFY THEIR PATIENTS
AND FIGURE OUT WHO THAT THEY
NEED TO ASSIGN SO WE'VE BEEN
DOING THAT. ALONG BUT- WE'RE
LOOKING TOWARDS THE FUTURE AND
LOOKING AT- WHAT KINDS OF DATA
EXCHANGE WE NEED TO DO TO
OVERSEE THE ENHANCED CASE
MANAGEMENT- BENEFIT THAT'S
COMING ON IN JANUARY WITH THE
WHOLE PERSON CARE COUNTIES
DURING THAT PROCESS WE'VE
INVESTIGATED. I YOU KNOW WHAT
EXACTLY WHAT DATA EXCHANGES DO
THEY HAVE SO FOR EXAMPLE IN-
IN- IN MARIN COUNTY THEY HAVE A
DATE CHANGE WITH THE LOCAL
HOSPITAL TO GET TO FIND OUT
WHEN THE PATIENTS HAVE BEEN-
ADMIT ADMITTED DISCHARGED AND
THEY HAVE AND THAT'S REAL
IMPORTANT FOR YOU KNOW DOING
FOR THESE HIGH RISK PATIENTS
AND THEN THEY ALSO HELP US AT
THE EXCHANGE WITH THEIR
HOUSING. MANAGEMENT INFORMATION
SYSTEM- AND SO THEY THEY THEY
FOUND OUT THAT THOSE ARE SORT
OF A TWO CORE INTERFACES DAY
THAT THEY MOST NEED NOW- THAN
CONGRESSIONAL MY COUNTY
INTERFACE WITH A NUMBER OF
COUNTY LEVEL- A SOCIAL SERVICE
FUNCTIONS THAT ARE WITHIN THEIR
COUNTY SYSTEMS AND THEY STILL
HAVE A LONG. LIST OF FUTURE
ONES THEY'D LOVE TO DO BUT
THEY'VE DONE A LOT OF THEM AND
REALLY FOCUSED ON THAT BUT THEY
BEGIN THE THING I'D LIKE TO
POINT OUT IS THAT IF YOU HAVE A
BASIC CASE MANAGEMENT FUNCTION
YOU'RE TRYING TO DO AND THEN
YOU SPEND A LOT OF EFFORT TO
BRING IN LOTS OF DIFFERENT DATA
STREAMS. IT DOESN'T MEAN THAT
THAT DATA WILL BE USED OR OR
REVIEWED REGULARLY ARE ACTED
UPON IT THAT DATA ALONE WILL
NOT CHANGE OUTCOMES THAT NEEDS
TO BE IN THE IN IN THAT IN THE
CONTEXT OF A INFRASTRUCTURE.
THAT'S ABLE TO ANALYZE THE DATA
THE- END OR- PRESENTED. IN A
WAY THAT. YEAH USER FINE. THAT
MEANING- FINDS YOU. AND OF. AND
SO THAT'S WHAT I THE THINGS
WE'VE- IS THE- THE DESIRE FOR
DATA TO BE- AND- IN. JUST SO.
SHE OUTCOME. DOESN'T LEAD TO
THAT CHANGED OUR COMMUNITY TO
ACTUALLY HELP THE UNDERLYING
SYSTEMS OR COURT IT'S BETTER TO
HAVE FEWER EXCHANGES. WITH A
ROBUST SYSTEM THAN A LOT OF
EXCHANGES WITH THE LESS. LESS
ALIGNED. INCENTIVES UNLESS A
ROBUST SYSTEM. SO FEWER
SYSTEMS. SAVING HERE TO
GREATNESS YES YOUR
INTERPRETATIONS SO IT'S SO
SINGLE SYSTEM WOULD BE MORE
BENEFICIAL TO YOUR MODEL. WHOLE
PERSON POPE PERSON CARE MODEL
CORRECT WELL HERE'S THE THING-
SO- EVERYONE OF THE WHOLE
PERSON CARE COUNTIES THEY'RE
FUNDAMENTALLY CASE MANAGEMENT
SYSTEM SO SIMILAR TO- AND SO
THAT CASE MANAGEMENT SYSTEM
COULD BE A STANDALONE SYSTEM
LIKE ELECTRONIC HEALTH RECORD
SYSTEM BUT JUSTICE CASE
MANAGEMENT OR MIGHT BE PART OF
ANOTHER SYSTEM ONE COUNTY- USED
THEIR PRIMARY CARE. HEALTH
CENTERS IS THERE A PARTICULAR
CONTRACT DIS AND THEY USE A
CASE MANAGER SYSTEM THAT'S
IMBEDDED IN THERE LIKE TRONIC
HEALTH RECORD SYSTEM SO THOSE
ARE THE END PRODUCTS SYSTEMS
AND I KNOW WITH EACH AYE YOU'RE
NOT PROPOSING THAT WE ALL
THROUGHOUT OUR EIGHT YEAR
MARCIN USE THE SAME PMR SURVEY
THIS IS LIKE THEM HAVING THEIR
OWN EMR. AND THE QUESTION IS
HOW DO THEY INTERFACE WITH WITH
OTHER- OTHER ENTITIES WITHIN
THEIR WITHIN THEIR THEIR AREA
IN THE PRIORITY I THINK IS THAT
THAT HOSPITAL- JUST CHARGE
ADMISSION INFORMATION IT'S ALL
PART PARTNERSHIP STRATEGY A
STEP NUMBER I MENTIONED A THIRD
IT'S THE TRANCE STATE H. ARE
YOU THAT- THE COLLECTIVE
MEDICAL TECHNOLOGIES- EVERY
PLATFORM WHICH REALLY IS
FOCUSED ON EMERGENCY ROOM
HOSPITAL ADMISSION DISCHARGE
TRANSFER WITH SOME CASE
MANAGEMENT FUNCTIONALITY ON TOP
OF IT. THAT'S GOOD DOT ONE
INTERFACE- IT'S THE ONE THAT
WERE PARTNERSHIP'S GONNA TRY TO
PROMOTE YOUR WHOLE PERSON CARE
AND NINETY CM A PROVIDERS.
BECAUSE THAT WILL GIVE THEM.
YOU JUST HEARD ST ON ALL BUT-
TWO HOSPITALS THAT ARE. NETWORK
PLUS- MOST HOSPITALS AND CAL.
ALTHOUGH IN OREGON ALL
HOSPITALS IN WASHINGTON STATE
AND MANY HOSPITALS THROUGHOUT
THE WESTERN AND- CENTRAL UNITED
STATES SO IT'S A MUCH. BROADER
CONSIDERING WONDER FACE WITH A
MARIN COUNTY HOSPITAL FOR
EXAMPLE THAT ONE INTERFACE WILL
THEN GRAB TRICK BROWN CALL THAT
EACH YEAR PERMISSION. FROM
MULTIPLE MULTIPLE STATES
POTENTIALLY SO THEY CAN GET
ALERTS IF THE PATIENT IS A
MATTER SHOWS UP IN THE
EMERGENCY ROOM ANYWHERE. SO
THAT'S THAT'S THE KIND OF
STRATEGY WE'RE LOOKING AT IS TO
REALLY LEVERAGE. CRITICAL
INFORMATION EXCHANGES THAT ARE
MOST NEEDED BUT NOT TRY TO GRAB
THIS HUGE NET OF GATHERING. YOU
KNOW AND- ADDITIONAL
INFORMATION THAT THEY DON'T
FIND IS THIS. HIGH VALUE AND
WHAT THE ACTUAL. OKAY THE THANK
YOU- I PREFACE THAT THAT ANSWER
VERY MUCH THANK YOU. I'M
LOOKING TO SEE DO WE HAVE ANY
QUESTIONS FROM OUR MEMBERS ARE
WATCHING REMOTELY. NOT THIS
POINT OKAY ALL RIGHT SO OKAY-
THAT BEING SAID- I SAY THANK
YOU VERY MUCH TO OUR- OUR
PANELISTS- TODAY I AM VERY MUCH
APPRECIATE- APPRECIATE YOUR
YOUR THOUGHTS IN YOUR INPUT-
THANK PEOPLE WHO HAVE WATCHED
ME BEFORE KNOW THAT- I ASK OUR
QUESTIONS- AND ASKING FOR- FOR
REASON AND- WHAT DRIVES ME ON
THIS PARTICULAR ISSUE IS. THE
ABILITY FOR PATIENTS TO GET THE
HIGHEST QUALITY MOST
APPROPRIATE CARE- WITH THE
LEAST DUPLICATION OF SERVICES
POSSIBLE. BUT IT ALSO WHAT
DRIVES ME ON THIS ISSUE IS. THE
CHALLENGES THAT WERE SEEN IN
KOBE- WERE WERE UNABLE TO
EXCHANGE BASIC DATA- I A I DO
WONDER- AND SMALLER PRACTICES-
YOU KNOW WITHOUT PATIENCE
REALLY TELLING THEIR DOCTORS-
ABOUT YOU KNOW THEIR
EXPERIENCES WITH COATED- THAT
THEY MAY HAVE HAD- HOW DOES
THAT INFORMATION GET
TRANSFERRED- DOES THE DOCTOR
KNOW WHICH VACCINE THEY GOT-
AND I LOOK AT. I LOOK AT- A
POTENTIAL FOR A SYSTEM WHERE.
WE'RE WHEN EVERYTHING IS SAID
AND DONE WE'RE ALL VACCINATED
OF THOSE OF US WHO WHO CHOOSE
TO BE VACCINATED. AND AND WE
NEED TO WE'RE GONNA NEED TO
KNOW- HOW LONG THAT VACCINE
LAUGHS AND- AND SO THE DATA
THAT COULD BE AVAILABLE TO US-
IS REALLY REALLY IMPORTANT. WE
CAN'T QUERY WE CAN'T. DEVELOP
POPULATION- HEALTH DATA WELL IN
THE STATE RIGHT NOW WE CAN'T DO
IT- AND SO CONSEQUENTLY WE
DON'T KNOW WHAT'S HAPPENING. IN
COMMUNITIES OF COLOR WE CAN'T
QUERY A SYSTEM THAT SAYS YOU
KNOW WHAT IS THE INCIDENCE OF
DIABETES IN THIS- ETHNICITY IN
THIS COMMUNITY- AND WHAT ARE
THE OUTCOMES WE CAN'T DO THAT
KIND OF THING AND THAT'S WHY.
THE INFORMATION THAT WE COULD
POTENTIALLY GATHERED TO HELP IN
THE LONG RUN- WITH HEALTH
OUTCOMES IS A VITAL COMPONENT
OF WHAT WE'RE TRYING TO LOOK AT
AND THE CHIEF HERE SO- YOU KNOW
I APPRECIATE THAT SOME OF THE
OPTIONS FOR MOVING. AND H. I.
E. FORWARD AND WHETHER YOU WANT
TO THE VERB A NOUN I REALLY
DON'T CARE AT THIS POINT- COULD
BE DISRUPTIVE TO THE STATUS QUO.
AND THAT'S THE CHALLENGE WE
ALWAYS FACE IN THIS BUILDING
BECAUSE WE ARE DISRUPTORS- BUT
IT'S MY DESIRE TO FOCUS ON HOW
WE CAN BEST SERVE THE STATE. OF
CALIFORNIA AND ALL
CALIFORNIANS. ARE REMAIN
OPENING TO HEAR FROM ALL
STAKEHOLDERS BUT ALSO WANT TO
EMPHASIZE THAT FURTHER STUDY.
WARN APPROACHES SOLELY
PROTECTING ONE'S BUSINESS
INTERESTS IS OF ABSOLUTELY NO
CONCERN TO ME. OUR PRIORITIES
ABOUT FINDING A BETTER WAY TO
ADDRESS PATIENT CARE. AND MORE
COORDINATED WAY. AS WELL AS
OBTAINING GREATER POPULATION
HEALTH DATA. SO WITH THAT I'D
LIKE TO OPEN THE LINES TO
PUBLIC COMMENT WELL THAT'S
MEMBERS OF THE PUBLIC TO KEEP
THEIR COMMENTS TO TWO MINUTES
OR LESS- AND- WE ALSO WILL NOTE
THAT WE ARE WE WILL ACCEPT A
WRITTEN COMMENTS. TO THE
COMMITTEE AS WELL AND I WILL GO
BACK I DON'T KNOW IF THE LAW WE
GO BACK AND SEE IF I CAN FIND
THE FRONT PAGE OF MY NOTES TO
GIVE YOU THOSE NUMBERS AGAIN.
WHAT HAPPENS WHEN YOU'RE
WRITING YOUR NOTES. HERE WE GO
SO ONCE AGAIN THE CALL IN
NUMBER FOR PUBLIC COMMENT FOR
THIS HEARING IS EIGHT SEVEN
SEVEN. SIX NINE TWO EIGHT NINE
FIVE SEVEN AND THE ACCESS CODE
IS. TWO FOUR TWO SIX TWO THREE
SEVEN NOW READ THAT AGAIN.
877-692-8957 AND THE ACCESS
CODE IS. TWO FOUR TWO SIX TWO
THREE SEVEN SO WITH THAT- TO
OUR GOOD TOUR OPERATOR AND ASK
IS THERE ANY IS THERE ANYONE IN
THE QUEUE. WHO WOULD LIKE TO
ASK- MAKE PUBLIC COMMENT. SURE
THANK YOU LADIES AND GENTLEMEN
AGAIN IF YOU WISH TO ASK- SHARE
A COMMENT PLEASE PRESS ONE THEN
ZERO ON YOUR TELEPHONE KEYPAD
YOU MAY WITHDRAW YOUR COMMENT
AT ANY TIME BY REPEATING THE
ONE ZERO COMMAND. IF YOU ARE
USING A SPEAKERPHONE PLEASE
PICK UP THE HANDSET BEFORE
PRESSING THE NUMBERS ONCE AGAIN
IF YOU'D LIKE TO SHARE A
COMMENT PLEASE PRESS ONE THEN
ZERO. AT THIS TIME AND OUR
FIRST COMMENT COMES FROM LINE
THIRTY TWO BY THIRTY TO YOUR
LINE IS OPEN. GOOD AFTERNOON MR
CHAIRMAN MEMBERS COUNTY DELGADO
ON BEHALF OF COLLECTIVE MEDICAL
WANT TO THANK YOU FOR THE
DISCUSSION TODAY. AND ONE OF
THE LARGEST CARE COORDINATION
PLATFORM IN CALIFORNIA
CONNECTING HUNDRED FIFTY A
CALIFORNIA HOSPITAL. AN
EXPANSIVE AND AN EXPANSIVE
NETWORK OF FQHCS TO BE ABLE
HEALTH ORGANIZATION SKILLED
NURSING FACILITIES AND HEALTH
PLANS. COLLECTIVE MEDICAL IT
ONLY SUPPORTED A STATEWIDE H.
I. E. INFRASTRUCTURE APPROACH
WHICH CONNECTS. THE NETWORK OF
EIGHT CHINESE. WITH THE STATE
OF CALIFORNIA. AT COLLECTED
MEDICAL THE PROVIDERS. THEY
SERVE HAVE ACTIVELY CHOSEN TO
UTILIZE COLLECTIVE CARE
COORDINATION SERVICES. BECAUSE
THEY HAVE SEEN IT. CONNECTICUT
INCLUDE PATIENT OUTCOMES AND
REDUCE. THE COST OF HEALTHCARE
SYSTEM. COLLECTED NOT RECORD.
THE STATE TAKEN INCLUDES
APPROACH. THE DEFINITION OF
HEALTH AND- EXCHANGE ONE ON
FIFTY DIVERSE COMMUNITY. AND
THE EXISTING NETWORK MADE TO
SUPPORT PATIENT CARE. WE
BELIEVE ANY STATEWIDE APPROACH.
TO HEALTH INFORMATION EXCHANGE
SHOULD TAKE ADVANTAGE OF IT AND
PRESERVE EXISTING PROVIDER AND
COMMUNICATIONS INFRASTRUCTURE
BUILDING A WITH ALREADY-
PRESENTLY EXISTS. AND CREATING
IMPROVE NETWORK OF NETWORKS
WHICH ALLOW PROVIDERS TO
LEVERAGE H. I. T. AB HELPED IT
INVESTMENTS ALREADY MADE.
ENHANCE THE COORDINATION AMONG
PROVIDERS TO IMPROVE PATIENT
CARE AND CONTROL OF THE SYSTEM
OF CARE THAT ARE UNIQUE TO EACH
COMMUNITY WITHOUT PUTTING AN
UNDUE BURDEN. AND STRAIN ON THE
ALREADY OVERBURDENED PROVIDER
PATIENT POPULATION. FURTHERMORE
COLLECTED MEDICAL RECOMMENDS
THAT THE STATE ADOPTS THE
FEDERAL DEFINITION OF H. I. E.
WHICH IS INCLUSIVE OF MANY OF
THE STATE. OF MANY OF THE
SYSTEMS IN PLACE THROUGHOUT
CALIFORNIA TODAY THANK YOU VERY
MUCH THANK YOU VERY MUCH. OUR
NEXT CALLER PLEASE. THANK YOU
THAT COMES RELY FOR ONE PLEASE
GO AHEAD. GOOD AFTERNOON ARE
CARING SARKISSIAN WITH ANTHEM
BLUE CROSS WE THANK THE
CHAIRMAN THE COMMITTEE FOR THE
DISCUSSION TODAY AND WE
APPRECIATE THE ADMINISTRATION
AND LEGISLATURE ONGOING EFFORT
TO ESTABLISH A STATE WIDE. HIV
WE CONTINUE TO SUPPORT
PROPOSALS WHICH WILL HELP
IMPROVE HEALTH OUTCOMES. REDUCE
COSTS THROUGH THE SHARING OF
HEALTH INFORMATION AND
TRANSFORM CALIFORNIA'S COMPLEX
HEALTHCARE SYSTEM INTO ONE THAT
IS COORDINATED TRANSPARENT AND
DELIVERS HIGHER QUALITY CARE TO
ALL CALIFORNIANS WE ARE
COMMITTED TO MAKING HEALTH CARE
SIMPLE. AFFORDABLE AND
ACCESSIBLE FOR CONSUMERS AND
LOOK FORWARD TO WORKING WITH
THE LEGISLATURE AND
ADMINISTRATION IN THE COMING
MONTHS. ON THESE IMPORTANT
EFFORT AIMED AT STRENGTHENING
CALIFORNIA'S HEALTH CARE AND
INFRASTRUCTURE. AND DELIVERY
SYSTEM THANK YOU. THANK YOU
VERY MUCH MOVE ONTO OUR NEXT
CALLER PLEASE. AND THAT COMES
FROM LINE TWENTY NINE PLEASE GO
AHEAD. HI AT THANK YOU CHAIR
MEMBERS THE COMMITTEE I'M
JENNIFER STOLE. EVEY PEER
GOVERNMENT RELATIONS FOR OCEAN
WHERE NATIONAL NONPROFIT HEALTH
INFORMATION TECHNOLOGY AND
RESEARCH NETWORK COMPRISED AT
HEALTH COMMUNITY HEALTH CENTERS
PUBLIC HEALTH DEPARTMENT'S
RESCUE FACILITIES IN. THESE
LAST YEAR- TO MEMBERS OVER A
MILLION PATIENTS IN CALIFORNIA
THROUGH OVER SEVENTY UNIQUE
HEALTH CENTERS AND WE MOVED
OVER A HUNDRED AND FIFTY ONE
MILLION CLINICAL CARE SUMMARIES
CAN PROVE COORDINATED CARE FOR
A PATIENT. SO IF YOU WANT TO
THANK THE COMMITTEE FOR THAT
THE TAKING ON THE COMPLEX TOPIC
OF HEALTH INFORMATION EXCHANGE
AND ARE EXCITED TO BE ABLE TO
WORK WITH STAKEHOLDERS. TO HELP
SET A STRONG A PATH FOR
INFORMATION EXCHANGE FOR THE
STATE OF CALIFORNIA- WE MOVE A
LOT OF DATA AS I MENTIONED AND
WE EXCHANGED ACROSS FORTY SEVEN
STATES SO AFTER THE REVISED
CONVERSATION FROM THE PANEL
TODAY WE WANT TO ADD A FEW
POINTS- FOR CONSIDERATION FOR
THE COMMITTEE AND THE NUMBER
ONE THING THAT WE LIKE THE
STATE TO CONSIDER IS ENSURING
THAT ALL FEDERAL FUNDS. TO
HELP- MALL RURAL AND
UNDERSERVED COMMUNITIES ACCESS
HIGH QUALITY EHR SYSTEM OUGHT
TO BE ABLE TO BE OPERABLE NEVER
MIND INTEROPERABLE IS REALLY
REALLY IMPORTANT THAT
FOUNDATION HAVE TO BE THERE
DOESN'T MATTER HOW STRONG YOUR
INTERFACES IF YOU DON'T HAVE A
STRONG EHR FIELD EXCHANGE DATA
WITH. ITS AND THE POINT SO WE
REALLY ENCOURAGE THE STATE TO
LOOK FOR ALL FEDERAL FUNDS THAT
ARE GOING TO COME DOWN THE PIKE
AND I'M TO BE ABLE TO SUPPORT
THIS WORK. ALSO MANY OF THE
PROGRAMS ARE OVER TEN YEARS OLD
AND SO MANY PROVIDERS ARE STILL
ON OBSOLETE SYSTEMS. SO H. I.
T. INFRASTRUCTURE IS
FOUNDATIONAL TO INFORMATION
EXCHANGE AT THE OTHER THING
THAT WE WOULD LIKE TO TALK
ABOUT IT OTHER FUNDING SOURCES
TO HELP SUPPORT COMMUNITY
PROVIDERS IN THIS EFFORT AND
ALSO TO ENSURE THAT PROVIDERS
ARE HELD HARMLESS FROM
CONNECTING TO. COMMUNITY AND
HEALTH INFORMATION EXCHANGE
ORGANIZATIONS- MANY EACH TIME
THEY ARE COVERED AND THERE ARE
PRICE. IS AND SO WE AND THE-
PROVIDERS ARE HELD HARMLESS
FROM EXT. TO DATE EXTRA.
FINALLY AT A DIRECT WEBER THE
OF AN- AT STANDARDS AS MUCH AS
POSSIBLE FOR- INSURE PROVIDE
SECOND. WITH OUR IF I. A
COMPLEX AND STATE LEGAL RIGHT.
AND INCREASINGLY. EXCHANGE IN
CALIFORNIA THANK YOU FOR
LISTENING AND- WE LOOK FORWARD
TO BEING PART OF THE
CONVERSATION THANK YOU. THANK
YOU VERY MUCH NEXT CALLER
PLEASE. THANK YOU AND THAT
COMES ONE THIRTY EIGHT. PLEASE
GO AHEAD. GOOD AFTERNOON MR
CHAIRMAN MEMBERS MURRAY A
FORMER ON BEHALF OF THE
CALIFORNIA HOSPITAL ASSOCIATION
WHICH THANK YOU FOR ASSEMBLING
AN INFORMATIONAL HEARING ON
SUCH A COMPLEX ISSUE. REALLY
APPRECIATE THE DIALOGUE WE TO
BELIEVE OF STRONG SECURE
EXCHANGE OF HEALTH INFORMATION
DATA CAN BE A POWERFUL TOOL TO
IMPROVE HEALTH CARE OUTCOMES
REDUCE REDUNDANT CASTING AND
LOWER HEALTHCARE COSTS OVERALL
NCHA RECOGNIZES THE GREAT VALUE
AND THAT'S THE QUESTION WE MUST
EVALUATE WHAT CURRENT SYSTEMS
EXISTING CALIFORNIA ACCOUNT FOR
INFORMATION EXCHANGE GAP AND
ANGEL LINE BY THE FEDERAL
GOVERNMENT ATTENDED. MANY
HOSPITALS AND SYSTEMS REGIONAL
HEALTH INFORMATION ORGANIZATION
PRIVATE VENDORS AND OTHERS IN
CALIFORNIA CURRENTLY EXCHANGE
HEALTH INFORMATION SECURELY AND
PRIVATELY BANKS TO SIGNIFICANT
INVESTMENTS MADE IN THE LAST
DECADE THAT ALLOW FOR THE
SHARING OF CLINICAL RECORDS
THEIR OWN SYSTEM AND EACH OTHER.
SH EFFORTS OF THIS AND FEDERAL
LEVEL TO ENHANCE FROM EXCHANGE
ARE WAY I COULD PROVIDE A LOOK
PATH CAL. BUT IF BLOOD THAT
ENSURE AND FOR WILL ALWAYS BE
PROTECTED TO THAT END THE
CALIFORNIA HOSPITAL ASSOCIATION
RECOMMENDS THAT CALIFORNIA
LEVERAGING ADVANCED NATIONAL
STANDARDS FOR CLINICAL
INFORMATION EXCHANGE WHICH WILL
ENSURE ALL PARTICIPANTS AND THE
HEALTHCARE DELIVERY SYSTEM CAN
DRAW ON CURRENT TECHNOLOGY
INVESTMENT TO BETTER SERVE
PATIENTS. THIS WILL ENGENDER
CONFIDENCE THAT WHEN EXCHANGING
HEALTH INFORMATION THE
INFORMATION WILL BE USED FOR
PERFECT PERMITTED PERFECT WITH
THE CORPORATE PRIVACY AND
SECURITY CONTROL WE LOOK
FORWARD TO WORKING WITH THE
COMMITTEE AS YOU EXAMINE
NETWORK TO ENHANCE PATIENT CARE
AND PROTECT THE RIGHT TO
PRIVACY THANK YOU VERY MUCH.
THANK. YOU VERY MUCH NEXT
CALLER PLEASE. THANK YOU AND
THAT COMES FROM FOR FOUR LIVE
FOUR YEAR LINE IS A- THANK YOU.
WOULDN'T MEMBERS OF THE
HEALTHCARE FELIX WITH. ACCOUNT
TODAY ON HERE CRYSTAL DOT THE
MOMENT ACT ON. A STATE WIDE HIV
IN. AND REQUIREMENTS SHOULD IN
NOW. AS A NON HEALTH SERVING
OVER FORTY CAL. ACROSS MEDICARE
MEDICARE HAVE A CALIFORNIA AN
IMPORTANT MARKET. YOU SEE THE
IMPERATIVE AND THE VALUE OF
CREATING A HEALTH RECORD FOR A
MEMBERS. THAT PROVIDE ACTIVE
RELIABLE INFORMATION AND
IMPROVE SAFETY CARE
COORDINATION AND PATIENT
EXPERIENCE. THIS IS A GAME
CHANGER FOR EVERY CALIFORNIA TO
HAVE A HEALTH HISTORY SHARED
RELY WEEKS BETWEEN THE CARE
PROVIDERS. AND HAVE A MORE
PERSONALIZED. EXPERIENCE WITH
THEIR HEALTH PLAN. IT IS
HAPPENS AFTER WHY OF THE MOST.
IMPORTANT THINGS WE CAN DO TO
MODERNIZE THE HEALTHCARE SYSTEM
AND IMPROVE PATIENT CARE. WE
DEEPLY APPRECIATED LEADERSHIP
AND AUTHORING LEGISLATION DR
WHAT AND FULLY SUPPORT THE
GOVERNOR'S ONLINE VISION IN HIS
JANUARY BUDGET PROPOSAL. AS
DISCUSSIONS ON APPROACHES
CONTINUE WE ARE FRIENDLY WAY TO
CERTAIN KEY CONCEPTS. FIRST
EVERY PARTICIPANT IN THE CARE
CONTINUUM FROM MAJOR PROVIDER
SYSTEMS TO HELP PLANTS LIKE
OURSELVES SHOULD BE REQUIRED TO
SHARE ALL THE DATA NECESSARY.
TO FORM A COMPLETELY
STANDARDIZED PATIENT HISTORY.
WE THINK THEY SHOULD BE BUILT
INTO CONTRACTS FOR
PARTICIPATING IN MEDIC CALCUTTA
CALIFORNIA CALPERS AS WELL AS
THE APPROPRIATE FINANCIAL
TECHNICAL SUPPORT. FOR SMALL
PRACTICES TO CONNECT. SECOND
THEY NEED TO H. LIKE AND TO
CLEAN AND PREPARE THE DATA WHAT
IT IS RECEIVE DIRECTLY PROVIDER
AND PLANS OR THROUGH. REGIONAL
NETWORKS THAT CONNECT TO THAT
ENTITY. AS WELL TO MAXIMIZE
FEDERAL FUNDS TO ADVANCE THIS
PRIORITY AS AN INFRASTRUCTURE
INVESTMENT. LOOK FORWARD TO
WORKING WITH YOU IN THE
LEGISLATURE TO MAKE THIS
CRITICAL REFORM OR REALITY
THANK YOU. THANK YOU VERY MUCH-
NEXT CALLER PLEASE. THANK YOU
AND AGAIN IF YOU WOULD LIKE TO
SHARE A COMMENT PLEASE PRESS
ONE THEN ZERO AT THIS TIME. AND
OUTLINED FORTY SEVEN PLEASE GO
AHEAD. THANK YOU VERY MUCH THIS
IS DEVIN MCGRAW AND THE CHIEF
REGULATORY OFFICER AT A
TECHNOLOGY COMPANY CALLED
CITIZEN WHICH IS LOCATED HERE
IN CALIFORNIA. WHERE A PLATFORM
THAT ENABLES PATIENTS. TO
GATHER ALL THEIR HEALTH
INFORMATION SO THEY HAVE AT
THEIR FINGERTIPS THINKING SEEK
ADDITIONAL CARE OPTIONS. SHARE
INFORMATION WITH THEIR TREATING
PHYSICIANS ARE LEFT ONCE OR
EVEN TO CONTRIBUTE THEIR DATA
FOR RESEARCH PURPOSES. PATIENTS
OF COURSE SHOULDN'T HAVE TO BE
THE ONES TO HIS SHERPA AROUND
ALL OF THEIR DATA TO ALL OF
THEIR CARE PROVIDERS. ON THE
OTHER HAND MANY PATIENTS DO YOU
WANNA PLAY A VERY ACTIVE ROLE
IN THEIR CARE PARTICULARLY WHEN
THEY ARE VERY SICK. THEY HAVE
LOVED ONES WHO WANT TO HELP ONE
TO HELP THEM FIND TREATMENT
OPTIONS. AND PATIENTS SHOULD BE
ABLE TO ACCESS THEIR DATA BUT
THIS IS VERY HARD FOR PATIENTS
TO DO TODAY BECAUSE- THEY HAVE
MANY PROVIDERS AS YOU POINTED
OUT SO IT'S TOO EARLY- DURING
THE HEARING DOCTOR WOULD AND
YET- HOW EASY HOW MUCH EASIER
WOULD IT BE FOR THEM IF THEY
CAN CONNECT INTO AN EIGHTEEN AT
WORK. CAN BE ABLE TO ACCESS
DATA FROM ALL THEIR PROVIDERS
VERSUS. HAVING TO GO POINT TO
POINT TO POINT. BUT EVEN
WORKSTATION ARE NOT. IN IN IN
THIS WOULD HAVE THEIR OWN AND
PRINT. IT IS. CRITICAL FOR
THERE TO BE A STATEWIDE HIV
NETWORKING CALIFORNIA SO THAT.
DATA CAN BE LEVERAGED FOR
INDIVIDUAL AND POPULATION
HEALTH. I WAS VERY- EVIDENT
FROM THE HEARING. MUCH OF WHAT
BARS THAT. IF THE IF THE STATE
WIDE EXCHANGE OF DATA THAT
NEEDS NOT JUST PRIVATE
INTERESTS BUT THE INTERESTS OF
THE PUBLIC. IN SHARING DATA IS.
BUSINESS TRUST. NOT NECESSARILY
PRIVACY BUT BUSINESS TRUST
WHICH IS ALL THE MORE REASON
WHY. WHY THE LEGISLATION YOU'RE
CONSIDERING IS IT IS ALL THE
MORE IMPORTANT- BECAUSE IT WILL
TAKE IN THE AGE. FRANKLY AND
SOME STRONG INCENTIVES OR SOME
SORT OF MANDATE FOR THIS TO
HAPPEN. AND WE KEEP UP WITH
THAT GOING ON BUT RESPECTED THE
FEDERAL LAWS AND ESSENTIALLY
WHAT IN WHAT IS BEING
CONSIDERED HERE IN CALIFORNIA
IS. IS UNLIKELY TO MAKE THOSE
FEDERAL LAWS WORK BETTER.
BECAUSE ON PROVIDERS ARE ALL
CONNECTED INTO EACH CHINESE.
VAN H. I. USED AGAIN CAN BE
THAT FIRST ATTRACTED DATA. FOR
A RANGE OF IMPORTANT PURPOSES.
THE STATE OF THE ART. TO MAKE
THE DISAPPEARING IN I
APPRECIATE THAT THANK HAVE THAT
HEARING AND I'M FORWARD CAN.
THE GUY. THANK YOU. THANK YOU
VERY MUCH. NEXT CALLER THANK
YOU EN ROUTE. TO LINE FORTY SIX
PLEASE GO AHEAD. HI EVERYBODY
THANK YOU SO MUCH FOR THIS
HEARING THIS IS CLAUDIA
WILLIAMS AND THAT'S PO OF
MANIFEST MAX AND I REALLY JUST
WANTED TO UNDERSCORE SOME OF
THE THINGS THAT HAVE ALREADY
BEEN THAT BY OTHERS IN IN THE
HEARING- I THINK THE CHALLENGE
AHEAD OF US HAS LESS TO DO WITH
MOVING DATA I THINK API THE
NATIONAL NETWORKS. WILL MAKE
THAT PROCESS EASIER AND EASIER
TO DO OVERTIME IT HAS TO DO
WITH POINT EDITED TOGETHER AND
DR MARK SAID SO ELOQUENTLY EACH
AND PULLING OUT THE INSIDER
IMPORTANT SO- MANIFEST MINEX
THE REASON WE WERE ABLE TO RUN
A FULL REPORT OF THE COUNTY. OF
RIVERSIDE IN JUST OVER A COUPLE
DAYS TO HELP THE VACCINATORS
TARGET THE PLUG THAT IN THAT
MOMENT IT BECAUSE WE WERE
ALREADY COLLECTING CONTACT
INFORMATION WE WERE ALREADY
COLLECTING HOSPITALIZATION WE
ALREADY HAD ALL OF THE AND
HEALTH INFORMATION AT OUR
DISPOSAL. AND AS WE THINK ABOUT
THE USE CASES THAT JONAS-
HIGHLIGHTED THEY WILL ALL
INVOLVED IN MANAGEMENT- SORTING
MATCHING ATTRIBUTION CLEANING
UP DATA FROM MANY SOURCES TO
CREATE CLEAN AND UNIFIED RECORD
AND THEN CREATING POPULATION
LEVEL INFORMATION FUND THAT.
THAT'S THE THING I WANT THE
STATEWIDE ENTITY TO CREATE FOR
THE STATE AND I THINK THEY'RE
SMART WAYS FOR THAT TO BUILD ON
THE EXISTING INFRASTRUCTURE
THAT WE ALREADY HAVE THEIR
SMART WAYS TO ACQUIRE DATA
SHARING I THINK IT WILL
REQUIRE. MANDATE AS WELL AS IN
SAM. AND THEY'RE SMART WAYS TO
DEPEND ON FEDERAL FUNDING BUT I
DO WANT TO MAKE SURE WE'RE
SOLVING THE RIGHT PROBLEM I
AGREE COMPLETELY WITH WALTERS
FLORIDA SHOULDN'T REPLICATE THE
NATIONAL NETWORK BUT WHAT WE
NEED TODAY IS A ROBUST STATE
LIKE GETTING CHARITY THAT
CONSERVES. THE CRITICAL USE
CASES THAT JOHN THAT- THAT
JENNA JENNA FRENCH THANK YOU SO
MUCH I LOOK FORWARD TO
CONTINUING- CHIU SUPPORT AND
I'M SO EXCITED ABOUT OF ALL
THAT YOU'RE DOING SHERMAN WOULD
AND FOR THIS CONVERSATION. IN
CALIFORNIA TODAY THANK YOU
THANK VERY MUCH- NEXT PLEASE.
HEY WE HAVE NO ONE ELSE CAN
KEEP. OKAY ALL RIGHT WELL THANK
AS AS A THANK YOU AGAIN TO A
OVER WITH ARE FOR THE DISK- YOU
KNOW AS THE GOAL OF THIS WAS TO
TALK ABOUT PRIORITIES I
RECOGNIZE THAT THERE ARE
DETAILS AROUND PRIVACY AND
SECURITY AND THOSE KINDS OF
THINGS THAT REALLY. IS A
DISCUSSION FOR ANOTHER DAY BUT
IS REALLY ABOUT THE PRIORITIES
AND HOW WE CAN- LOOK AT WHAT'S
REALLY IMPORTANT AND THAT'S-
PATIENT DATA FOR QUALITY OF
CARE- THE LESS DUPLICATION.
ELIMINATION OF ERRORS JUST
MAKING SURE THAT PEOPLE CAN GET
THE MOST APPROPRIATE CARE AT
THE TIME THAT IS AT IT WHERE
THEY ARE WHERE THEY ARE
WHEREVER THEY ARE IN THE STATE
REGARDLESS OF THEIR IN
SOMEBODY'S NETWORK OR OUTSIDE
OF THE NETWORK SO. SO WITH THAT
AND I KNOW THE DISCUSSION WILL
CONTINUE- AND I WANT TO THANK
ALL THE PARTICIPANTS AND WITH
THAT WE WILL GO AHEAD AND
DURING THE MEETING. THANK YOU
AGAIN. THANK YOU AND LADIES AND
GENTLEMEN THAT DOES CONCLUDE.