Calif. switches contractors for info exchange

UPDATED: 5:15 p.m. ET

In California, a land renowned for upheaval, the ground has shifted once again under federal and state efforts to promote health information exchange.

The California Health and Human Services Agency is switching contractors for implementation of the exchange programs, according to a CHHS news release (PDF). The agency is the recipient of nearly $38.8 million in federal funds under the American Recovery and Reinvestment Act of 2009 to promote statewide health information exchanges.

Taking over is the Institute for Population Health Improvement at the University of California-Davis.

The previous contractor running the California HIE program was Cal eConnect. According to a five-page question-and-answer section (PDF) on the Cal eConnect website, the state's move to switch partners was precipitated by a Cal eConnect board decision to terminate its grant agreement with the state.

"The Cal eConnect Board determined that as a start-up with a large board, it was not able to move fast enough to implement approved programs," the Q&A statement said. "It recommended that in the best interest of the state an organization with more experience be available to continue implementation of HIE programs."

In March 2010, Cal eConnect became California's state-designated governance entity under an info-exchange cooperative agreement program run by the Office of the National Coordinator for Health Information Technology at HHS. Cal eConnect had been awarded the state contract when California's long-time exchange leader, CalRHIO, disbanded after it failed in its bid to become the state-designated federal grant contractor following a battle with upstart rival the California eHealth Collaborative.

What Californians will get with the switch is a seasoned administrator with health IT experience in the public and the private sectors, Dr. Kenneth Kizer, the Institute for Population Health Improvement's director.

Kizer is board chairman and former president and CEO of Medsphere Systems, Carlsbad, Calif., a developer of an open-source electronic health-record system based on the Veterans Affairs Department's VistA EHR. Kizer founded and served as president of the not-for-profit National Quality Forum, and from 1994 through 1999, he was undersecretary for health at the VA. Before that, Kaiser served as director of California's health services department.

The future of Cal eConnect is now in limbo, according to the group's board co-chairman, David Lansky, president and CEO of the Pacific Business Group on Health.

It "will be up to the board to decide if there is any other work that Cal eConnect should be pursuing,” Lansky said in an interview.

About $5 million of the $38 million in federal money has already been spent, Lansky said, with most of the money going to five regional health information exchanges in the state. Those grants will be unaffected by the transfer of leadership to the institute, he said.

"The work plan remains the same," he said. It was the paperwork, he said, that did Cal eConnect in, leading to the board’s decision to hand over administration of the program to an organization with an administrative infrastructure equipped to handle it.

"The main message is we realized there is so much compliance activity to administer state and federal grants, we were spending more time on that than we wanted to," Lansky said.