Q&A: Manifest MedEx CEO Erica Galvez on California’s Interoperability Progress

Leader of state's largest health information network says health data utilities can meet local ambitions and needs that extend far beyond what TEFCA will do anytime soon

Erica Galvez is CEO of Manifest MedEx, the largest nonprofit health data network in California and one of nine Qualified Health Information Organizations under the state’s new Data Exchange Framework. She sat down with Healthcare Innovation last week to discuss the expanding role of her organization as the implementation phase of the framework begins.

Healthcare Innovation: During an online panel discussion you hosted recently, Krishna Ramachandran of Blue Shield of California used the Gartner Hype Cycle concept to say that we are somewhere between the trough of disillusionment and the slope of enlightenment when it comes to the state’s Data Exchange Framework. I'm wondering if you agreed with that, because I thought it seemed early in the process to be disillusioned yet.

Galvez: I actually thought it was an OK assessment, because there has been a lot of hype and expectations for massive data sharing as soon as the January 31, 2024, deadline hit, which came out of the effectuating legislation, AB 133. I don’t think we had that expectation, because we've been doing this for a very long time, and we know it takes time to implement and get all the cranks turned in the right direction, and get data flowing as it should. But we have had many stakeholders, who have not historically been part of national networks, who thought the deadline would hit and everybody would share data, and that did not happen, and it still has not happened.

Our assessment is very similar to that of Adam Davis, our physician colleague from Sutter Health on that panel, that much of the exchange that we are facilitating today is exchange that we were facilitating before the Data Exchange Framework, and has not really been augmented or disrupted by the Data Exchange Framework. I think we will see increases as a result of the Data Exchange Framework. I just don't know how long it will take for those to materialize.

HCI: When we look at payers like Blue Shield of California, what's the potential business improvement use case if the data does start flowing better?

Galvez: Well, I think they stand to get a lot out of it. The Data Exchange Framework requires data sharing for operations purposes, and that, I think, is part of what has created some of the hype and the energy, at least in the health plan space — that clinical data could give them real boosts on things like HEDIS measures. It could inform insights in their quality improvement efforts and risk adjustment, to the extent they run lines of business that rely on risk adjustment for payment.

Read the full article published in Healthcare Innovation.