BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 598
                                                                  Page  1

          Date of Hearing:   May 20, 2009 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                  AB 598 (De La Torre) - As Amended:  May 5, 2009  

          Policy Committee:                              Health Vote:13-5

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill establishes the California Health Information Network  
          (network), with a specified advisory board within the California  
          Health and Human Services Agency (HHSA). Requires the network to  
          adopt health information exchange standards (HIE) by July 2010  
          and address a dozen goals including standardization of health  
          transactions, gathering health data statewide, reducing  
          administrative burdens on government, increasing uniformity of  
          information exchanged between providers and health care  
          settings, and providing health consumers access to health  
          information.

           FISCAL EFFECT  

          1)Unknown costs in the range of $300,000 (GF) for HHSA and the  
            network advisory board to complete substantial  
            California-specific work on numerous objectives in a short  
            time period. 

          2)This bill may help California access incentives included in  
            the Health Information Technology for Economic and Clinical  
            Health (HITEACH) Act, a component of the federal American  
            Recovery and Reinvestment Act (ARRA). HITEACH provides $36  
            billion (federal) over six years for HIT infrastructure and  
            provider adoption incentives. Estimates have identified more  
            than $3 billion in funding that California providers will  
            access in the next several years. This bill helps provide  
            specificity to California planning efforts and statutory  
            changes.

           COMMENTS  









                                                                  AB 598
                                                                  Page  2

            1) Rationale  . This bill requires HHSA to oversee the network to  
             adopt health information exchange standards that ensure the  
             uniformity of in the electronic exchange of clinical health  
             information. Examples of health information exchange  
             standards include messaging standards to ensure sharing of  
             patient data, order entry, and appointment scheduling.  
             Another example is standard connections that allow providers  
             to plug into hardware and software to monitor data through  
             telehealth services. 

            2) California Health Information Technology  . The Legislative  
             Analyst's Office (LAO) and RAND have each recently evaluated  
             the impact of HIT adoption, such as electronic health records  
             and personal health records. The LAO confirmed that  
             paper-based medical records contribute to cost and quality  
             concerns in health care by reducing efficiency and increasing  
             medical errors that harm health. The LAO identified the many  
             benefits of HIT and the numerous efforts within California  
             and nationwide in both public and private sectors. Both RAND  
             and the LAO have provided estimates of savings following  
             adoption of technology solutions in health care. RAND  
             estimates net annual savings following adoption of $34  
             billion nationally. LAO estimates, based on research in other  
             states, fee-for-service Medi-Cal savings in California of up  
             to $300 million annually by increasing coordination and  
             reducing duplication across a variety of patient service  
             areas

            3) Related Legislation  . AB 1011 (Jones), pending on the  
             Suspense File of this committee, requires the Office of  
             Health Information Integrity (OHII) within HHSA to report to  
             the Legislature on health information technology and medical  
             privacy issues.


           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081