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Feb. 9, 2010
TOPEKA Members of the Kansas e-Health Advisory Council on Tuesday heard a detailed proposal for creation of a non-profit corporation to oversee and manage the state's health information exchange efforts.
But Roderick Bremby, secretary of the Kansas Department of Health and Environment and the chairman of the council, said the plan wasn't ready to be presented to the Legislature.
He said the Kansas Health Information Exchange, Inc. or something like it, would instead be created through a governor's executive order once the entity's "governance" plan is refined.
As spelled out by Jeff Ellis, head of the council's working group on legal matters, the corporation would have a 17-member board appointed by the governor and the Legislative Coordinating Council.
Six members would be chosen from among names submitted by the Kansas Medical Society and the Kansas Hospital Association. Consumer representatives would have two seats on the new authority and "payers" or insurance companies would have one seat. Pharmacists, employers and local health departments also would each have one seat on the board.
The board also would include the KDHE secretary, the executive director of the Kansas Health Policy Authority and the governor, or a designee.
It also would include two non-voting members; one from the University of Kansas Center for Health Informatics and one from a regional health information technology center.
Ellis said the non-profit corporation would have many of the powers of a private entity but would be subject to the Kansas Open Meetings and Open Records laws.
With 17 members, he said, "it will be small enough to be nimble and make decisions in a fast moving environment."
The board would decide if its members would be compensated.
The new corporation would be the sole entity with legal authority to authorize and approve health information exchanges within Kansas. It also would have the power to seek and spend grants and donations.
It would have at least one advisory council.
Inconsistent privacy laws
Various committees, commissions and working groups have worked for years to plan or develop a Kansas health information exchange that would allow the transfer of digitized patient information among medical providers. Local exchanges have already been created in Wichita and Kansas City.
But the effort to create a statewide information exchange became supercharged with passage of last year's federal economic stimulus package.
That legislation included billions of dollars to encourage nationwide adoption of electronic health records with the goal of every American having one by 2014. Also in the American Recovery and Reinvestment Act were incentives for doctors, hospitals and other providers to have digital systems that, for example, would allow a heart specialist in Kansas City access to the records of a patient who lived in Colby.
Proponents of electronic health records say they will make the practice of medicine more efficient and will allow the collection of mountains of data that when properly mined will reveal which treatments are most effective.
There is considerable pressure from provider groups and others for Kansas to have a functioning exchange up and running, sooner not later, in order to meet some of the deadlines set in the federal stimulus. In 2015, the incentives available for providers who adopt health information technology will be replaced by penalties for those who have not.
Ellis' legal work group also has concluded that there are multiple impediments in Kansas law to creating a functional exchange. Ellis in the last three meetings of the council has told members he considers it an "urgent" priority to present the Legislature with a bill that would remove the legal barriers, which he has described as inconsistencies in the state patient privacy laws.
But Bremby told the group that Attorney General Steve Six had questions about some provisions in the draft that would relieve medical providers who adhered to federal privacy laws from criminal or civil liability under Kansas law. Ellis said the proposed legislation wouldn't go the Legislature until the attorney general's vetting was finished.
Brad Williams of the council's technical working group unveiled a network schematic for how private providers using the commercial Internet and the state's Kan-ed and KanWIN networks could be interconnected providing the infrastructure for the digital exchange.
Kan-ed is a broadband network that connects hospitals and schools across the state. It currently is used for video conferencing and other information exchanges. KanWIN is the common network used by the various state agencies.
The council is scheduled to meet again next month.