DxF in Action: Uniting California's Health Systems Through Seamless, Real-Time Data Exchange

California's AB 133 law, signed in 2021, mandates the creation of the nation's first statewide bidirectional data exchange—**the CalHHS Data Exchange Framework (DxF). This initiative establishes a single data-sharing agreement with standardized policies to enable real-time health data exchange across healthcare entities and government agencies, while upholding privacy protections and patient data rights.

A Connected Future for California's Healthcare

Starting in 2024, all health plans, hospitals, physician organizations, and clinical laboratories across California will be mandated to participate in the state's new Data Exchange Framework (DxF), which aims to enable the secure and seamless sharing of health information to improve care coordination, patient outcomes, and public health.

Value to healthcare

Enable Real-Time, Connected Care

Break down silos and share health information instantly—empowering providers with the right data at the right time.

Unify Access Across the Care Continuum

Seamlessly exchange data between hospitals, clinics, labs, and care teams—supporting coordinated, informed decisions across every setting.

Transform Operations with Actionable Intelligence

Leverage structured health data to streamline workflows, enhance outcomes, and reduce administrative burden across the system.

Entities required to sign the DxF DSA.

Under AB 133, all mandatory signatories must sign the DSA by January 31, 2023. Some of these organizations, such as smaller physician practices and clinics, rehabilitation, long-term acute care, psychiatric, and critical access hospitals, and smaller rural acute care hospitals, will have until January 31, 2026, to fully implement the Data Exchange Framework even though they signed the agreement in January 2023.

General Acute Care Hospitals, defined by Health and Safety Code Section 1250.
Physician Organizations (e.g., Independent Practice Associations that exchange health information) and Medical Groups.
Skilled Nursing Facilities, as defined in Health and Safety Code Section 1250.
Health Plans
Health Care Service Plans and Disability Insurers provide hospital, medical, or surgical coverage regulated by the California Department of Managed Healthcare or the California Department of Insurance.
Medi-Cal Managed Care Plans that have signed a comprehensive risk contract with the Department of Healthcare Services under the MediCal Act1 or the Waxman-Duffy Prepaid Health Plan Act2 and that is not regulated by the California Department of Managed Healthcare or the California Department of Insurance.
Clinical Laboratories, as defined in Business and Professions Code Section 1265 and, are regulated by the California Department of Public Health.
Acute Psychiatric Hospitals, as defined in Health and Safety Code Section 1250.

What are Qualified Health Information Organizations (QHIOs)?

A Qualified Health Information Organization (QHIO) is a DxF-designated intermediary that meets the requirements for secure data exchange and other criteria. These intermediaries offer services and functions to support sharing of health and social services information. DxF Participants may choose to use a QHIO or another intermediary to meet some or all of their Data Sharing Agreement (DSA) requirements for secure data exchange.

Secure and trusted

California Legislative Information

California is establishing a Health and Human Services Data Exchange Framework to facilitate and require the sharing of health information among healthcare entities and government agencies, using national standards and policies, to improve health outcomes.

DxF in Action: Uniting California's Health Systems Through Seamless, Real-Time Data Exchange

A Connected Future for California's Healthcare

Value to healthcare

Value to healthcare

Entities required to sign the DxF DSA.

What are Qualified Health Information Organizations (QHIOs)?

Secure and trusted

Secure and trusted

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