Aug 5 Blue Shield of California and Anthem Blue
Cross, two rival health insurance providers, announced on
Tuesday a collaborative plan to build a non-profit
health-information exchange for California residents.
The California Integrated Data Exchange, or Cal Index, would
become one of the largest exchanges of its kind, amassing
electronic health records of some nine million California
patients, a quarter of the state's population.
The firms estimate they'll spend $80 million in the initial
3-year phase. Afterward, Cal Index will charge a subscription
fee to care providers and insurers who use the service. The
index is expected to be operational by the end of 2014.
"We have a very diverse medical system in California with
many complexities," said Diana Dooley, Secretary of California
Health and Human Services Agency, during Tuesday's announcement.
"This is easy to talk about but very hard to do."
Anthem Blue Cross President Mark Morgan said the two
companies "spent years working through the privacy concerns and
As a health-information exchange, or HIE, Cal Index would
provide a network of patient records that could be securely
shared between care providers. In the past, some HIEs have
struggled in the face of a complex web of security and technical
challenges, as well as budget constraints.
But officials predicted that Cal Index would succeed where
others have stumbled, thanks to its access to massive amounts of
claims and clinical data.
One of the greatest hurdles is sharing information between
different data systems that do not communicate effectively with
each other, making it difficult for doctors to gain access to
patients' medical records in emergency situations. As a result,
doctors routinely order duplicate tests or prescriptions, with
insurers often covering extra costs.
Blue Shield and Anthem plan to work out partnerships with
hospitals, insurance providers and doctors across California in
the coming months. The service will be open to any patient
But the largest electronic health record providers, such as
Epic Systems, have not yet been directly approached to discuss
the initiative, company officials said. It was not clear whether
those vendors would cooperate.
Dave Minch, HealthShare Bay Area president and California
Association of Health Information Exchanges board chair, remains
cautiously optimistic about Cal Index's prospects, believing
shared patient information will prove beneficial to both
patients and providers.
Minch, who expects to hear from Blue Shield representatives,
said data from community and larger-scale HIOs could be used in
concert with Cal Index claims data to alert physicians when a
patient "falls outside of expected treatment parameters."
"This can be a powerful tool for patients, their doctors and
all their healthcare providers to make the best possible
decisions about their health," said Dooley.
Patients can prevent information from being shared, said
Blue Shield President Paul Markovich, but he said he did not
expect that many would do so.
(Reporting By Christina Farr and Robin Respaut; Editing by Ken