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High-Profile Initiative To Pool Medical Records Lags In California

Cal INDEX, a highly touted database of patient medical records backed by two of California’s largest health insurers, is searching for a new chief executive as it tries to overcome a slow start.

The previous CEO, David Watson, lasted less than two years, departing in May to work in the private sector. An executive search firm has been hired to find a replacement, and there have been two interim CEOs in the meantime.

The nonprofit California Integrated Data Exchange was announced with great fanfare in 2014 by insurers Blue Shield of California and Anthem Blue Cross. The two companies said they were investing $80 million in the project.

It’s an ambitious initiative to give California hospitals and doctors a single place to get patient information culled from medical records and insurance claims. State leaders and other supporters of Cal INDEX say giving an emergency room or a surgeon the ability to instantly access a patient’s medical history can improve the quality of care, help avoid medical errors and reduce wasteful spending.

The involvement of Blue Shield and Anthem was designed to give Cal INDEX an early boost by providing records on millions of Californians who have insurance coverage through the two companies. The organization has data on 11.7 million people now.

But previous efforts across the country at creating these digital databases or health information exchanges often have hit technical snags and industry turf battles. And Cal INDEX has faced its share of challenges.

One has been uncertain leadership. Watson, a former executive at tech giant Oracle Corp., now advises a venture capital firm on health technology. He declined to comment on his departure.

Cal INDEX said Watson left to “return to the profit side of health care.”

Jean Fraser, former head of the San Mateo County Health System and chair of the Cal INDEX board, served briefly as interim CEO this summer and now the organization’s general counsel, Jerry Peters, is filling that role temporarily.

Peters said a number of highly qualified CEO candidates are being interviewed as part of the search process led by Heidrick & Struggles International.

Another difficulty is persuading other health plans and medical providers to supply patient data and pay fees to access the information. Bringing together a wide array of insurers and providers can be difficult since they’re competitors and adversaries much of the time.

“While progress has been slower than we hoped, we are continuing to work with several providers and payers and look forward to adding new participants in the near future,” Peters said.

He said the organization determined its pricing was too complex and introduced a simpler fee structure this year. “We remain committed to working with current and prospective participants to address their business, legal or financial concerns,” he said.

So far, participation among hospital systems in the California initiative has been spotty.

Dignity Health, the state’s largest hospital chain, agreed to participate late last year. Initially, it shared clinical data from five Sacramento-area hospitals and Sierra Nevada Memorial Hospital north of Sacramento.

Even though Michael Murphy, CEO of Sharp Healthcare in San Diego, serves on the five-member board of Cal INDEX, his health care system doesn’t participate in the database, according to a company spokesman.

Sharp said it is part of a regional health information exchange “that is supporting our current needs.”

Some Medi-Cal patients may be in Cal INDEX through a privately run managed care plan, but the California Department of Health Care Services said it “does not have a direct business relationship with Cal INDEX at this time.”

Cal INDEX said it only shares patients’ clinical data, not their financial information. And users cannot sell any of the data, nor use it to set provider rates.

At this time, consumers can’t review their own records in the database. Cal INDEX said access is currently limited to participating providers, hospitals and insurers. There’s an opt-out provision for consumers on the Cal INDEX website, which if selected would mean their information would not show up.

Over the years, dozens of similar health information exchanges across the U.S. have shut down or scaled back because of funding or logistical woes. Many organizations struggled with interoperability – getting disparate electronic medical records systems to work together. Keeping users interested and on board as paying members is another common challenge.

One of the most successful examples has been the Indiana Health Information Exchange, which holds records on more than 12 million people and participation by more than 100 hospitals and 12,000 medical practices.

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