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Designing a Technical Infrastructure for
Health Information Exchange in California

Under the federal HITECH legislation, California received a $38.8 M contract to develop a statewide infrastructure to facilitate health information exchange (HIE). The California Health and Human Services Agency (CHHSA) and the California designated entity for HIE (Cal eConnect) engaged Sujansky & Associates to facilitate the technical design of this infrastructure through a multi-stakeholder collaborative process.

The process entailed managing a technical advisory committee and a working group comprised of executives and technical experts (respectively) representing key California healthcare industry stakeholders. Based on a "straw man" architecture proposed by Sujansky & Associates, these groups designed a technical infrastructure intended to accommodate the HIE needs of large and small organizations in all regions of the state.

The design was subsequently submitted to the federal government as part of California's deliverables under the HITECH funding. Sujansky & Associates subsequently developed the detailed functional requirements and technical specifications for this design.


Sujansky & Associates' role in this project included:

  • Design of a "straw man" architecture for HIE services in California, which were largely incorporated into the Technical Infrastructure submitted to ONC
  • Management of a Technical Advisory Committee and Technical Working Group that each met weekly and included 15 - 25 stakeholder representatives
  • Research and preparation of a "gap analysis" of California's existing infrastructure for HIE relative to the requirements of HIE for meaningful use.
  • Development of detailed Functional Requirements and Technical Specifications for the core HIE services proposed in California.

Relevant documents:

  •  Technical Infrastructure for HIE in California

  •  Functional Requirements and Technical Specifications for Core HIE  Services in California

  •  Cal eConnect Web Site
    • Highlights
    • The proposed technical infrastructure creates a "trust framework" enabling secure HIE transactions between any two healthcare organizations in California. The framework consists of a set of "core" shared services that provide identity management, authentication, and directory services for participating organizations.

    • The infrastructure accommodates additional "non-core" services to provide value-added functions, such as a service to facilitate lab-result routing and standardization.

    • The Technical Architecture design document was delivered to CHHSA on schedule, integrated into the state's Operational Plan, and submitted to the Office of the National Coordinator for Health IT.

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