How to Join the DxF

Widespread participation across providers, health plans, social services organizations, and more is what allows us to realize the promise of timely, safe, and effective whole-person care for each and every Californian.

We’re excited that you’re here and ready to join the shared commitment to create a Healthy California for All. Begin by familiarizing yourself with the series of steps organizations must take to join the DxF, outlined below.

We’re here to support you along the way. Have questions?

Email our team at dxf@chhs.ca.gov

The Implementation Toolkit provides detailed, step-by-step directions to become an active Participant.

Frequently Asked Questions

Glossary of Defined Terms

Joining the DxF

I’m just getting started I’ve signed the DSA I’m Connected I’m ready to share I’m sharing data and want to do it better

I’m just getting started

Sign the DSA

The DxF Data Sharing Agreement (DSA) is an agreement to share information quickly, securely, and appropriately while following a common set of terms, conditions, and obligations set forth in shared Policies and Procedures (P&Ps).

Signing the DSA is the first step to becoming a DxF Participant!

Many organizations are required by law to sign the DSA. Additional health and social services organizations may choose, and are encouraged, to sign the DSA to participate in secure data sharing under the DxF.

More participants means more Californians will benefit from modern data exchange.

How to Sign the DSA

Create an account in the DSA Signing Portal and register your organization.
Gather the relevant information, including: Name of organization, organization type, address, California state license numbers (if applicable), information about subordinate organizations (if applicable), along with the name, title, and email address of the individual at your organization legally authorized to sign.
Sign the DSA via the method prescribed in the DSA signing portal

→ Step by step instructions are available in the DSA User Instructions

→ You will also need to use the DSA Signing Portal to make your choices in the DxF Participant Directory

More information:

DxF Implementation Toolkit, Page 11

Obligations for Participants after signing the DSA

After signing, Participants will be required to provide access to and exchange health and social services information with every other signatory in real time as specified in the DSA and its Policies and Procedures (P&Ps).

DSA Resource List

I’ve signed the DSA

Get Connected

In order to exchange data with other DxF Participants, your organization must have or obtain the right technology.

Intermediaries can offer services and functions to support the sharing of health and social services information, assisting entities as they create and respond to information requests or send and receive event notifications.

DxF Participants may choose any type of intermediary, or utilize a combination of exchange methods to comply with the DxF DSA and its P&Ps.

Qualified Health Information Organization (QHIO)

A Qualified Health Information Organization (QHIO) is a DxF designated intermediary that meets the exchange requirements of the QHIO program. QHIOs offer services and functions to support Participants in sharing health and social services information.

Nationwide Network or Framework

Any vendor-agnostic health information network or health information exchange framework with nationwide scope, including coverage in California, available to some or all Participants for the exchange of health and social services information that may or may not have signed the DSA.

For questions related to TEFCA, refer to the TEFCA for DxF Primer.

Other intermediaries include any health information exchange network, HIO, or technology vendors that assists a Participant in the Exchange of HSSI and adheres to the standards and policies established by the DSA and its P&Ps as applicable to the services provided to the Participant. These may include, but are not limited to: Community Information Exchange (CIE), Health Information Organization (HIO), Social Health Information Exchange (SHIE), etc.

DxF QHIOs

Below are the nine approved QHIOs. QHIOs offer an accessible path to help Participants meet their DSA P&P obligations.

Choosing the right QHIO depends on your organization’s specific needs—each has unique qualities and attributes to consider as you make your determination.

Below are key details to help you compare QHIOs. Start by narrowing the list based on what’s most important to you, then connect directly with them to learn more.

QHIO Resources List

I’m Connected

Declare Exchange Readiness

Announce to other Participants that you’re ready to share data by entering your exchange selections in the Participant Directory. The directory acts as the DxF’s “phone-book”—listing Participants, and the intermediaries or technologies they have chosen to exchange data with, enabling Participants to find and initiate exchange with one another.

All DxF Participants must enter their selections in the DxF Participant Directory.

→ Participants who are eligible to delay exchange until January 31, 2026 under AB-133 must enter their election to delay Exchange, but do not need to enter choices until they begin Exchange.

How to Make Your Participant Directory Selections

First, sign into your organization’s DSA Signing Portal account to access the Participant Directory.

Be prepared to select your choices of Exchange:

The Intermediaries or technologies you choose for access to and Exchange of Health and Social Services Information.
If your Primary Organization has Subordinate Organizations, the Participant Directory information will need to be completed for each Subordinate Organization.

Refer to the Participant Directory How-to Guide for detailed steps to complete the process of entering your choices.

Participant Directory Resources List

I’m ready to share

Begin Sharing

The final step is learning how to use the Participant Directory. Once you’re familiar, you’re ready to begin securely exchanging data—helping you deliver more coordinated, informed care to everyone you serve.

How to Use the Participant Directory

Refer to the Participant Directory User Guide, which provides direction on how to use the directory in various exchange scenarios.

Congratulations!

You are now an active participant—your commitment is playing a vital role in improving outcomes for each and every Californian.

Participants may encounter unique challenges with data sharing that require thoughtful, tailored solutions. The DxF continues forward with implementation efforts to finalize outstanding items and wants you to be part of the conversation.

Improving data exchange is a collaborative effort. Your on the ground experience and insights are essential to continued efforts. Visit the Participant Center to share feedback, stay informed, and engage with the latest updates.

Resources

DxF Implementation Toolkit: Page 27

I’m sharing data and want to do it better

Participant Center: Follow Program Updates and Help Advance Secure Data Sharing

Participants across California are continuing to drive meaningful improvements in data sharing by identifying challenges and introducing new, collaborative efforts to overcome them.

Find out more about ongoing implementation efforts by visiting the DxF Participant Center.

Resource Library

Visit the resource library page to access all available DxF materials.