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Why California is Leading the Way in Health Care: 10 Things to Know about Cal INDEX

The Cal INDEX and IEHIE announced in January 2017 a planned merger that will create one of the nation's most comprehensive nonprofit health information exchanges (HIEs). Currently, Cal INDEX is connecting doctors, nurses, and hospitals, and allowing them to share patient information to change the medical field in more ways than one.

Here is a list of the top 10 things you need to know about the Cal INDEX and what the new merger means for everyone:

1. What is the Cal INDEX and IEHIE merger about?
Blue Shield of California and Anthem Blue Cross came together to create the largest Health Information Exchange (HIE) effort to date, which is the Cal INDEX; an “independent, non-profit organization developing a statewide, next generation HIE.” Cal INDEX is an online database, available to all providers and insurers who contribute clinical data, that stores electronic patient records of California residents. The merger with IEHIE is expected to be completed in the first quarter of 2017 and will operate as a tax-exempt public benefit corporation under a new name.

2. What do Cal INDEX and IEHIE stand for?
California Integrated Data Exchange and Inland Empire Health Information Exchange.

3. Who is affected by the Cal INDEX + IEHIE merger?
The new HIE will combine the 11.7 million claims records from Cal INDEX (Blue Shield of California and Anthem Blue Cross enrolled patients) with the 5 million clinical patient records of IEHIE and its 150 participating partners.

4. Who does Cal INDEX + IEHIE benefit?
The Cal INDEX website claims that three main groups will benefit from this new HIE: providers, individuals, and researchers.

5. What is the Cal INDEX + IEHIE merger offering?
This new HIE offers providers a comprehensive view of a patient’s health information across multiple medical history records and insurance carriers. It also provides physicians with electronic tools to manage patient care and giving them the health information they need, whenever they need it.

Patients have the opportunity to receive safer, higher quality care. Their health data will be available to health care professionals in emergencies, which is especially important in cases where patients don’t have the ability to communicate this information. Patients will also be able to avoid repeated, unnecessary tests and duplicate or dangerous drug interactions because that data will be accessible to their caregivers.

Researchers will have a large source of de-identified patient data for medical research, encouraging health care technology and innovation and enabling an improvement among public health institutions.

6. How is Cal INDEX being funded?
Cal INDEX is privately funded by Anthem Blue Cross and Blue Shield of California, combining $80 million in seed funding for their first three years of operation. After the initial first three years, Cal INDEX will be a subscription based service for participating providers and insurers.

7. Privacy issues
Privacy issues are an all too common concern these days, especially when it comes to new technology that contains sensitive and personal information. Anthem Blue Cross itself accidentally posted the social security numbers of about 24,500 doctors in California. However, Cal INDEX advertises using “advanced and up-to-date security systems, including physically secured systems, complex passwords, and modern encryption techniques.” There are some skeptics out there who still have privacy concerns, and Cal INDEX is trying to address those concerns in a few ways. They are restricting access of patient information to only providers directly related to the patient and prohibiting the download or printing of patient information.

8. Who has access to Cal INDEX + IEHIE records?
The new HIE records will be accessible to any subscribed health official directly related to the patient. This includes the patient’s primary doctors and nurses, as well as any emergency room personnel that are caring for the patient.

9. Who is on board with Cal INDEX so far?
Anthem Blue Cross and Blue Shield of California members will be automatically enrolled in Cal INDEX. Dignity Health has also signed on adding their 32 participating California hospitals. St. Joseph Hoag Health joined up with Cal INDEX in December of 2016.  If more hospitals, providers, and insurers participate, Cal INDEX will continue to significantly grow, especially now with the new IEHIE merger in place.

10. Can I opt out of Cal INDEX?
Please visit the Cal INDEX website at for additional opt-out information.

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