Cal INDEX Still Faces Legal, Regulatory Challenges, CEO Says
The California Integrated Data Exchange -- a statewide health information exchange created by Blue Shield of California and Anthem Blue Cross -- is on track for success, but the HIE still faces some legal and regulatory challenges, the health information exchange's CEO said in a recent interview with HealthLeaders Media (Cheney, HealthLeaders Media, 3/11).
In August 2014, Anthem and Blue Shield announced plans to develop one of the largest health information exchanges in the U.S.
The two companies are investing a total of $80 million to develop the not-for-profit database (California Healthline, 12/22/14).
Details of Cal INDEX
David Watson, CEO of Cal INDEX, noted that the design of the database differs from many other HIEs. He said most HIEs in the U.S. "started out from the provider perspective," but "[t]he design of Cal INDEX is much different. It is designed to support both payers and providers."
Watson said Cal INDEX now is focusing on outreach to providers.
When asked about data security, Watson said that information stored in the database is "encrypted at all steps."
Meanwhile, Watson said the Cal INDEX's biggest success so far has been hiring a leadership team that "is committed to our vision of completing the system of care in California" (HealthLeaders Media, 3/11).
In November 2014, Cal INDEX hired:
- John Lee, former MedeAnalytics chief technology officer, as its CTO;
- Greg LeClaire -- former chief financial officer of Aetna subsidiaries Medicity, HDMS and Population Health IT -- as CFO; and
- Andrea Leeb, a registered nurse and attorney, as chief privacy officer (California Healthline, 11/20/14).
The HIE's biggest challenge has been with legal and regulatory issues, according to Watson. "State and federal legislation such as HIPAA never contemplated the sharing models that payers and providers are now using to support care coordination and risk-revenue sharing models such as ACOs, nor did they account for organizations such as HIEs that facilitate the otherwise appropriate sharing of health care information," he said. He added, "As a result, financial, operational and legal issues abound that complicate the provision of services and make them more expensive."
Watson said "convergence -- how to blend payer data well with provider data, which can be different from organization to organization" -- also could be a challenge for Cal INDEX. He said, "When we receive provider data, we have to do data mapping and convert [them] into standardized codes," adding, "It's a little bit of a 'one-off' for every health system we touch."
However, he said the challenge also is part of Cal INDEX's "value proposition" because others no longer have to "deal with all that mapping and data verification" (HealthLeaders Media, 3/11).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.