Health IT

Anthem, Blue Shield launch massive California data-sharing effort

Cal Index Art

Anthem Blue Cross and Blue Shield of California announced the formation of the The California Integrated Data Exchange, an $80 million, three-year effort that seeks to share information of some 9 million patients among the state’s top payers and providers in an attempt to bring down healthcare costs and improve outcomes.

The two insurers, along with officials from the state, CaLPERS and Dignity Health, California’s biggest hospital system, said they are putting aside competition to create what they say is one of the largest health information exchanges in the country.

The two insurers also said they hope to add additional payers and providers, large and small, while incorporating some 15-odd HIEs that already exist in California to Cal INDEX as it builds steam.

The effort is similar to the previous formation of a successful ACO that was formed between Blue Shield, Dignity, Hill Physicians Medical Group and CaLPERS, which saved millions of dollars by cutting down on redundancies in care and sharing patient information, said Lloyd Dean, CEO of Dignity, who added the health system has a “deep interest” in Cal INDEX.

By taking the effort across the state, Cal INDEX is poised to be one of the largest health information exchanges in the country, with the goal of better connecting the vast, often disparate healthcare landscape across California.

“Currently in California, the healthcare system is fragmented and complex,” said David Feinberg, president of UCLA Health System, which is also participating in Cal Index. “Much of this is because we remain disconnected. We cannot easily share patient information. In today’s digital age, there’s simply no excuse. There’s an unmet need in California for a secure electronic health exchange.”

The funding of Cal INDEX lasts for three years. The data-sharing effort will charge a subscription fee for each provider, payer and HIE that wants to join and share its data. Specifics on the fee will vary. Cal INDEX will launch before the end of 2014, officials said.

The 9 million members of the two health plans account for about one in four Californians with private insurance, giving providers vast reaches into clinical data that includes claims information and procedures, labs and X-ray information gleaned from EHRs, officials said.

Patients will eventually be able to access their own medical record, and privacy is and will remain a top priority, officials said. Patients who wish to not share their information will be able to opt out of the exchange.

Modeled after a public utility, Cal INDEX has five main goals:
— Improve the quality of care by providing clinicians with a unified statewide source of integrated patient information
— Provide patients with a seamless transition between health plans or across various healthcare professionals and hospitals
— Improve efficiency and reduce the cost of healthcare
— Encourage healthcare technology innovation
— Improve public health by providing de-identified data for medical research.

Dean said San Francisco-based Dignity Health has seen significant progress from the ACO effort with Hill Physicians and Blue Shield, and that taking the concept state-wide will bring savings to the entire system.

“When hospitals and doctors and insurers share information, the people we serve get better care ,” he said, adding that the ACO with CALPERS saved members “tens of millions” of dollars.

“Cal INDEX takes this kind of sharing to the next level. The more we know, the better care we can deliver. We see Cal INDEX speeding up communications between patients and providers,” he said. “Instead of wasting critical time, Cal INDEX puts this information in the patient’s hands in real time. It’s going to reduce the cost of healthcare delivery.”

The database that will house patient data will be overseen by Orion Health, officials said. The information will only be used for clinical purposes. Academic research institutions may be able to use the Cal INDEX de-identified data for research to benefit the public good, such as population health initiatives.

The data may at some point become part of a national effort such as the DirectTrust Transitional Trust Bundle, of which Orion Health is already a part, said Simon Jones, vice president of health information technology for Blue Shield of California.

“We are looking into DirectTrust and some of the other standards and we do intend to participate,” Jones said.