WHEREAS all Californians should have all appropriate personal health information available to them, and also to their treating professionals in the medical office, hospital, pharmacy or emergency room; and

WHEREAS the aftermath of Hurricane Katrina demonstrated the need for timely, secure and accessible health information, particularly for our nation’s most vulnerable – elderly, disabled, and low income populations – and the potentially life-threatening effects of that failure; and

WHEREAS the control of health care costs is key to a long-term strategy of reducing State expenditures and maintaining the ability of California’s large and small employers to provide health care coverage to their employees; and

WHEREAS health information technology offers great promise as one means of enabling a goal of affordable, safe and accessible healthcare in California by: (1) ensuring health information is available at the point of care for all patients while protecting the confidentiality and privacy of the information; (2) improving safety, reducing medical errors and avoiding duplicative and unnecessary medical procedures; (3) improving coordination of care among hospitals, clinics, skilled nursing facilities, home care agencies, pharmacies, physicians and other health professionals; (4) providing consumers with their own health information to encourage greater participation in their health care decisions; and (5) ensuring access to specialists in a more timely manner for rural and underserved areas through technologies such as telemedicine; and

WHEREAS the federal Department of Health and Human Services estimates that, in addition to improving the quality of chronic care management and reducing errors, increasing health information technology could reduce duplicative care and lower health care administrative costs, achieving potential savings of $140 billion per year or close to 10% of total health spending in the United States; and

WHEREAS California has established a goal to achieve 100% electronic health data exchange among payers, health care providers, consumers of health care, researchers, and government agencies in the next 10 years; and

WHEREAS State leadership can promote and encourage legislative and regulatory actions, encourage coordinated efforts in the private health care sector, further public and private partnerships for the development of a statewide health information infrastructure, and maximize federal and regional financial participation to support the goal of adopting an eHealth information infrastructure; and

WHEREAS California and other states should collaborate and assume a leadership role nationally in the establishment of health information technology standards and implementation priorities; and

WHEREAS there are numerous different and conflicting standards in collecting and reporting personal health information within the health care community that currently makes it impossible to properly share patient health care information.

NOW, THEREFORE, I, ARNOLD SCHWARZENEGGER, Governor of the State of California, by virtue of the power and authority vested in me by the Constitution and statutes of the State of California, do hereby issue this Order and direct as follows:

  1. The Secretaries of the Health and Human Services Agency and Business, Transportation and Housing Agency and the State Chief Information Officer shall convene a California eHealth Action Forum to solicit input and participation in the development of a state policy agenda to improve health and health care through the rapid implementation of health information technology.
  2. The Secretaries of the Health and Human Services Agency and the Business, Transportation and Housing Agency and the Director of the Department of Managed Health Care will devise financing strategies to allocate at least $200 million in investment funds and $40 million in grant monies previously secured from California health plans to benefit the diverse needs of rural communities, medical groups, and safety net providers, and shall also oversee the implementation of a mix of public/private financing alternatives to facilitate rapid adoption and sustainability of health information technology for hospitals, physician groups, physicians, and other health care providers.
  3. The Secretaries of the Health and Human Services Agency and the Business, Transportation and Housing Agency, the Director of the Department of Managed Care and the State Chief Information Officer will work with public and private sector stakeholders to develop a sustainable business model for an eHealth network connecting rural health clinics to medical centers throughout the state using telemedicine and other technology.
  4. The eHealth Action Forum will develop a comprehensive State policy agenda for health information technology by taking the following actions:
    • Define the goals and values of health information technology for the purposes of State policy and planning.
    • Inventory the various initiatives underway in the State related to health information technology and assess opportunities for building on those efforts, and replicate those projects that prove the feasibility and business case for health information technology and health information exchange.
    • Identify the appropriate role of State government in the development of health information technology and health information exchange versus those activities more appropriately coordinated through other entities.
    • Facilitate statewide adoption of standards and interoperability requirements for e-Health to enable the secure exchange of health information across the State and nation.
    • Identify areas where State laws and regulations hinder, rather than facilitate, adoption of health information technology, and recommend strategies to remove such barriers.
    • Identify and develop strategies for the continued protection of confidentiality and privacy of health information in an electronic environment.
    • Identify opportunities and strategies for a public/private partnership approach to create financially viable and sustainable business models for health information technology projects in the State.
    • Develop options for advancing the implementation of health information technology through the State’s role as a major purchaser, provider (State facilities) and regulator of health care services.
    • Develop with stakeholders performance metrics to measure the success of the implementation of health information technology throughout the State.
  5. The Secretaries and the Chief Information Officer will report back to me within 60 days after the Forum and present an action plan that outlines how the State of California will implement a comprehensive health information technology program by July 1, 2007.


IT IS FURTHER ORDERED that agencies under my direct executive authority shall cooperate in the implementation of this Order. Other entities of State government not under my direct executive authority, including the Insurance Commissioner, the University of California, the California State University, California Community Colleges, constitutional officers, and legislative and judicial branches are requested to assist in its implementation. In particular, the California Public Employees Retirement System is the major purchaser of health care for State active and retired employees and is in a unique position to facilitate the use of health information technology in the delivery of care. Therefore, the California Public Employees Retirement System is requested to participate in the Forum and assist the Secretaries and the Chief Information Officer in the implementation of this Order.

This Order is not intended to, and does not, create any rights or benefits, substantive or procedural, enforceable at law or in equity, against the State of California, its departments, agencies, or other entities, its officers or employees, or any other person.

IT IS FURTHER ORDERED that soon as hereafter possible, this Order shall be filed with the Office of the Secretary of State and that widespread publicity and notice shall be given to this Order.