TOPEKA — After nearly four hours of discussion today, the board responsible for regulating digital health information exchange in Kansas postponed its vote on a proposal to dissolve and turn its regulatory authority over to a state agency.

Instead, members of the Kansas Health Information Exchange board decided to form a committee to develop a list of the dissolution proposal's pros and cons and return with a recommendation for the board to consider at its Sept. 12 meeting.

The proposal to fold KHIE's functions into the Kansas Department of Health and Environment would eliminate more than half of KHIE's $400,000 projected annual costs and transfer the rest to taxpayers. Under the proposal, the 17-member KHIE board currently appointed by the governor would become an advisory committee appointed by the KDHE secretary.

"I feel like we haven't fully vetted and understand the long-term implications of making this transition," said board member Karen Braman. "I absolutely agree that we have to look at efficiencies in operations wherever we can. That's going on in every sector, every business, every household in the country right now. And I do think we have to capitalize on the synergies that can be gained in collaboration with KDHE. I think that's been one of the cornerstones of this public-private partnership that we've all been involved in for so long."

Board member Jackie John of the Great Plains Health Alliance asked what assurance there would be that KDHE would continue to ensure the privacy and security of patient health information.

"When the state goes through their budgeting process, how do we know that there's going to be enough value, that this process is going to continue with the resources necessary to provide the quality of services we're committed to?" John said.

"At least until a change in administration, there's a commitment to do this. But I'm not going to sit here and say that we can guarantee things for all eternity — that's just not realistic," said Aaron Dunkel, deputy secretary at KDHE. "At least with this administration, which we're hoping will be a little bit longer, we've got a commitment."

Cost savings

The KDHE proposal would eliminate more than half of KHIE's projected annual costs, including:

• $134,900 in salaries and benefits;

• $49,300 for insurance, office space and other overhead; and

• $44,800 or more in legal and other consulting services.

The estimated one-time cost for transferring KHIE operations to KDHE is about $75,000.

Dissolving KHIE would allow elimination of its chief executive position, which was created in October with the hiring of Bill Wallace, a former executive with Blue Cross Blue Shield of Kansas. The other two KHIE staff members would be offered positions at KDHE.

Dunkel said the cost of regulating electronic health information exchanges among the state's medical providers could be covered by KDHE from existing resources and incorporating it with the agency's existing health information technology programs.

"Because of the ability to combine all these functions into a small office...it's a relatively nominal amount of work," Dunkel said. Likewise, the same office would be able to support the administrative needs of an advisory committee retained to guide policy decisions. "The nominal cost for us being able to help staff an advisory council is basically zero, because we're tying together all those other activities based in our HIT" office, he said.

Dunkel said that under the proposal, there would be no licensing fees assessed to the two private networks that recently began transferring patient data. Those networks are the Kansas Health Information Network (KHIN) and the Lewis and Clark Information Exchange (LACIE.)

KHIE board member Jerry Slaughter, executive director of the Kansas Medical Society and also chair of KHIN, said doctors and hospitals were concerned they would be assessed fees to help fund KHIE operations and that each additional cost would reduce the likelihood the providers would participate in the networks.

Slaughter has endorsed the plan to shift KHIE functions to KDHE.

"The reason most HIEs don't get off the ground frankly is because of the cost," Slaughter said. "You have to step back and look at what the total cost of participation is. To the extent that we make that worse, we've just created an additional barrier" to participating in HIE.

Because of his role with KHIN, Slaughter said he would recuse himself from voting on the proposal.

Next step

The members of the KHIE executive committee were charged with further study of the KDHE proposal. They include Braman, Dr. Joe Davison, a Wichita physician, Michael Atwood of Blue Cross and Blue Shield of Kansas and Janet Stanek of Topeka's Stormont Vail hospital. The study committee also will include Ken Mishler of the Kansas Foundation for Medical Care and representatives from KHIN and LACIE.

The group is scheduled to meet at noon Monday.