California has taken a significant step on the road to health data interoperability. Nine health information exchange organizations have signed the California Data Use and Reciprocal Support Agreement (CalDURSA), a multi-party trust agreement designed to eliminate the need for point-to-point agreements and custom technologies, while ensuring patient privacy and data security. The CalDURSA was approved by the California Association of Health Information Exchanges board of directors at its meeting in July 2014.
The nine organizations will work to set up the California Trusted Exchange Network (CTEN) to enable and promote exchange among otherwise unaffiliated providers through a set of common policies, procedures, and lightweight technologies. The CTEN supports mechanisms to:
- Send and receive Direct secure messages between individual or organizational participants;
- Query for and retrieve health records from participating organizations using the Exchange specifications maintained by Healtheway; and
- Look up individual and organizational provider information, including how to exchange health information with them.
“The CalDURSA and CTEN blast away major barriers standing in the way of health data interoperability,” said Bill Beighe, CIO of the Santa Cruz HIE and general manager of Axesson, in a prepared statement.
The nine organizations to sign the CalDURSA are:
- California Association of Health Information Exchanges
- RAIN Live Oak HIE and Telemedicine Network
- Redwood MedNet, Inc.
- San Diego Health Connect
- North Coast Health Information Network
- Santa Cruz Health Information Exchange
- Orange County Partnership Regional Health Information Organization
- Axesson
- Dignity Health
Those organizations will convene as the California Interoperability Committee and adopt the draft policies and procedures for onboarding to the network prepared by CAHIE members. All nine organizations will complete the onboarding process and begin to interact with one another following the launch of the CTEN.
In July Healthcare Informatics interviewed Robert (Rim) Cothren, executive director of the California Association of Health Information Exchanges, about the increasing maturity of the state’s HIEs. Unlike a few years ago, he said, “all these organizations are exchanging information with each other. It shows that HIE is maturing beyond regional exchange and is starting to cross regional boundaries. The industry is feeling more comfortable with the concept of sharing information as well as the legal requirements and policies that need to be in place.”
“It is exciting to see all of our work finally coming together in creation of the California Network,” said David Minch, president and board chair of CAHIE, in a statement. “Through the CTEN, HIE-capable organizations of all sizes and capabilities will be able to communicate with each other, using whichever approved protocols their software vendors have provided. While there is much work yet to be done to achieve widespread interoperability, this is a significant milestone for California.”
The CalDURSA is designed to be compatible with the federal DURSA, and participants in CTEN can participate in eHealth Exchange, or utilize other existing trust frameworks such as the National Association for Trusted Exchange (NATE), DirectTrust, or Blue Button+ trust bundles to exchange with organizations inside or outside of California as well.
“The CalDURSA has opened organizations in California to real health information exchange by providing an essential framework that ensures trust,” said Timothy Tyndall, Director of RAIN Live Oak HIE and Telemedicine Network, in a prepared statement. “Combined with the CTEN, the CalDURSA establishes an HIE ecosystem that provides a dynamic method for diverse organizations within the State to engage in HIE between agencies knowing all participants are taking appropriate security and policy measures. For a small Health Information Network such as RAIN Live Oak this has meant that we can engage new agencies rapidly and safely in our network, reducing costs and maximizing exchange.”
