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Nov. 9, 2011
TOPEKA The remaining nine of 10 policies considered necessary to ensure patient privacy and network security were approved today by the board responsible for overseeing health information exchange in Kansas.
The first policy was approved last month.
KHIE, Inc. board of directors chair Karen Braman said today's steps gave her a sense of great accomplishment.
"We've finally made some significant and tangible progress towards creating the infrastructure for the exchange of health information in Kansas, that will allow providers to share and access information for the care of their patients, and will improve the quality of care in our state," Braman said. Her work on developing electronic health information exchange goes back to being project leader for the Health Care Cost Containment Commission created in 2005.
"It felt like some doves should have been released. This is big for Kansas," said Michael Aldridge, director of the Kansas Regional Extension Center, or REC, which was set up to help doctors and other medical providers implementing the use of electronic health records.
• KHIE, Inc. — The Kansas Health Information Exchange: The state regulatory body overseeing health information exchange (HIE) in Kansas. It is currently managed by a 15-member board and a chief executive.
• HIO — A Health Information Organization, an entity that facilitates health information exchange, such as Kansas-based KHIN or Missouri-based LACIE.
• KHIN — The Kansas Health Information Network: An initiative to bring together various regional exchanges — such as the Wichita Health Information Exchange — as well as individual providers into a single network.
• ICA — Informatics Corporation of America: The software vendor contracted by KHIN to develop the state-based network connecting participating providers.
• EHRs, or EMRs — Electronic Health Records, or Electronic Medical Records: Digital medical files. Like the traditional paper files they replace, they're also stored locally with a patient's provider(s), and potentially exchanged across networks. Some providers will select EHR systems that store files on in-house servers, while others will chose systems that store the files remotely on the software vendor's servers.
• ONC — Office of the National Coordinator for Health Information Technology: The federal agency coordinating state-based efforts to implement health information technology (HIT). Responsible for certifying "meaningful use."
• Meaningful Use, or MU — Criteria set by the ONC defining standards for EHR technology. Providers who achieve MU benchmarks are eligible for federal Medicare- and Medicaid-based subsidies.
• REC — Regional Extension Center: The state's support service for helping providers select new EHR systems, or use their current systems, to achieve meaningful use.
Putting the pieces in place
Among the policies passed today were those outlining the application process for groups to become approved Health Information Organizations, or HIOs.
Health care providers who exchange information via an approved HIO are granted some immunity from lawsuits should they inadvertently breach patient privacy while exchanging electronic health records.
They are the only two organizations expected to initially apply and each will do so immediately, according to spokespersons.
KHIN has participation agreements signed with 17 providers and one has already connected to the network to exchange test data, said KHIN Executive Director Laura McCrary.
"We already meet the requirements that (KHIE, Inc. has) put forth," McCrary said. "We should be approved in plenty of time, before anyone's ready to go live" with exchanging data.
LACIE representative Mike Dittemore said his network would also apply right away. LACIE is working with two Kansas providers — St. Luke's Health System and Shawnee Mission Medical Center — both of which, he said, preferred to wait until LACIE became an approved HIO before connecting to the network.
Providers that connect to an exchange and meet federal "meaningful use" standards for exchanging health data can qualify for subsidies.
Here's a summary of the adopted KHIE policies:
Policy 1 — defines what activities will be subject to oversight by KHIE, Inc.
Policy 2 — outlines how patients will be notified that their health information will be exchanged electronically and creates a process for patients who want to opt-out of the system.
Policy 3 — identifies who can access approved HIOs — such as providers, certain state agencies and health plans.
Policy 4 — sets forth the conditions of participation with approved HIOs, including those dealing with access, privacy, security, quality and what data should be exchanged.
Policy 5 — regulations for user access.
Policy 6 — regulations for authenticating user-allowed access to patient health information.
Policy 7 — establishes procedures for monitoring HIOs and identifying unauthorized access of patient health information.
Policy 8 — establishes procedures for fielding complaints regarding HIOs and their users.
Policy 9 — outlines standards for becoming an approved HIO.
Policy 10 — outlines application and certification processes for HIOs.
Legal consultant Martie Ross, who did much of the work writing the policies, said Kansas was now on track to have one of the nation's first statewide exchanges.
"There's no definitive explanation out there of what every state is doing," Ross said. "You would have to be on the ground in every state to figure out what's going on. But in terms of the true statewide approach that we've been pursuing, I think we're going to be right up there in the front. I don't know if we'll be first, but we'll be in the first round of entrants."