At the third meeting of California’s Data Exchange Framework (DxF) Stakeholder Advisory Committee, the conversation moved beyond platitudes and board goals, more connected organizations, more useful information and better coordinated care. Instead, the committee tackled more complicated topics: where the current system falls short, what a statewide network will need to deliver, and how to get there.
The committee’s role is to provide information and advice to HCAI on information technology issues and to make recommendations for updates to the DxF and its policies and procedures, including the (Qualified Health Information Organization) QHIO program. The committee also serves as an advisory body and forum for stakeholders and public engagement on policy decisions, while fostering accountability and transparency. Here’s the link to our summary of the first meeting, and you can find more information on the second meeting here.
Two major themes stood out: California is taking a serious look at what data exchange needs to become, and HCAI is offering realistic ways to move the work forward.
Here are some of the most important takeaways.
- The Future Requires an Honest Look at Today’s Gaps
QHIOs shared they need more support to fully achieve two central goals: creating a statewide network for exchange and helping participants meet their data-sharing obligations. QHIOs support requests for information for treatment, for example, but support for other purposes and for information delivery between QHIOs remains limited.
Event notifications show why these gaps matter. They can tell a care team when a patient is admitted to or discharged from a hospital, creating an opportunity for timely follow-up. Yet only about one-third of the connections needed to share rosters and events between QHIOs are active. Among surveyed participants, 45% receive notifications, while another 40% are interested but do not yet have the capability.
The discussion went beyond whether data can move. Participants considered whether notifications arrive reliably, contain useful information and fit into care teams’ workflows. They also raised the costs of large rosters, duplicate alerts and managing exchange across many organizations.
- HCAI Put Practical Steps on the Table
HCAI identified six issues affecting the QHIO Program: sustainability, service gaps, reciprocity, trust, voluntary adoption and limits on oversight. It also laid out a sequence for addressing them, beginning with event notification, then considering alternatives and recommendations for the broader program before reviewing implementation plans.
That approach creates room to examine how proposed changes would affect hospitals, QHIOs, physician practices, counties and social service organizations. For instance, smaller clinic may face very different costs and technical demands than a large health system. Any workable solution will need to account for those differences while setting clear expectations for exchange.
The committee also discussed the role of organizations that support data exchange outside the QHIO Program. Their participation matters when considering how to maintain access to event notifications and avoid disruptions to existing services. As California considers changes, the goal is to strengthen statewide exchange in ways that participants can put into practice.
- A FHIR Roadmap Can Connect Ambition to Action
The committee unanimously supported convening a standards workgroup in 2026 to draft a roadmap for adopting Fast Healthcare Interoperability Resources (FHIR), with advisory committee review expected in early 2027. FHIR could support more precise and flexible ways to exchange information, but a roadmap will need to address more than the technical standard itself. (LANES is already supporting FHIR; explore what they’re doing with L.A. Care here.)
The discussion called for attention to actual use, measurable progress, federal timelines and the capacity of organizations expected to participate. Members also raised the possibility of starting with established use cases and allowing longer implementation timelines for organizations with fewer resources. QHIOs could help participants meet future requirements as they build their own capabilities.
This is the kind of planning the next phase of the DxF demands. California can set a direction for modern exchange while being clear about what it will cost, who needs support and how progress will be measured.
Next Steps
The meeting marked a shift toward decisions about how California’s data-sharing infrastructure should work in the years ahead. HCAI’s proposed work on event notifications, the QHIO Program and a FHIR roadmap for all gives the community concrete opportunities to shape that future.
Read more details about this meeting and future meetings on the DxF Website: https://dxf.chhs.ca.gov/2026/07/stakeholder-advisory-committee-meeting-3-august-20-2026-1000-am-400-pm-pt/