TOPEKA — The minimum annual cost of operating the Kansas Health Information Exchange as an independent entity would be $390,600, according to the board’s budget projections.

Among other things, that would pay salaries of three staff members, office space, utilities and a service desk to handle complaints and process patient requests to withhold data from the exchange.

The board in June approved a plan to pay for operations by assessing fees to the networks on the exchange, proportionate to the market share of each network. There are two networks — sometimes called HIOs — that comprise the statewide exchange: the Kansas Health Information Network (KHIN) and the Lewis and Clark Information Exchange (LACIE), which is based in St. Joseph, Mo., but extends into northeast Kansas.

Spokespersons for the doctor and hospital associations, which formed KHIN, have said they are concerned the network fees would be passed through to their members as part of the fee for connecting to the exchange.

Dr. Jennifer Brull, a Plainville family practice doctor who serves on the KHIE board, asked the network representatives to bring their fee estimates to the Wednesday meeting.

"I would like to have information from KHIN and LACIE about what they anticipate will be the cost passed onto providers and hospitals, if KHIE was to remain independent. I know that takes a little guesswork, but if they both start with the 'worst case' scenario…that would give us a ballpark number," Brull wrote in an email to fellow board members.

Network officials told KHI News Service that about 85 percent of the exchange's costs could be passed on to hospitals and 15 percent to participating doctors not affiliated with a hospital. Forty-five hospitals and between 500 to 800 doctors will be connected to the Kansas exchange after its first year, according to projections.

Based on those figures:

• The average per year cost for hospitals would be $6,817.

• The per year cost for unaffiliated doctors would be between $73 and $117.

Jerry Slaughter, executive director of the Kansas Medical Society, serves on the board of KHIE and is chair of KHIN.

He said a guiding principle of KHIE has been to minimize the barriers providers face in implementing electronic health records. Charging doctors and hospitals fees for connecting would add an unnecessary barrier.

"I know some people have said what's $400,000 or $500,000 spread among the hospitals and doctors of the state. Well, it's easy for them to say because they're not paying it. Number two, it's $400,000 or $500,000 today. What's it going to be in a few years? And that's only a fraction of the costs providers are going to have to pay to make this thing operational in the future," Slaughter said.

"It just begs the question: if we can get the same job done, have the same engagement, the same ability for stakeholder voice and participation, why wouldn't we try to do it in an environment that saves $400,000 or $500,000" a year? he said.

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