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Dec. 13, 2012
TOPEKA A recently approved plan to move the duties of the Kansas Health Information Exchange to the state health department is getting a second look from the KHIE board members because they're uncertain how the 2013 Legislature might deal with it.
"There's nervousness about whether this Legislature would accept the changes and pass it on through," KHIE, Inc. board chair Dr. Joe Davison told KHI News Service after the board met Wednesday. "We want to make sure it passes. The way it stands now, (current law is) better than nothing."
KHIE was the public-private entity created to oversee the digital exchange of Kansans' health records.
In July, KDHE proposed taking over KHIE as a way to save about $350,000 annually, and in September the board agreed to move forward with the proposal. The decision came at the same time that health information exchange was beginning in Kansas.
But the move would require some changes in state law, which means the 2013 Legislature, which will have more than 50 new members, would need to be involved. And some board members expressed concerned that a seemingly simple change in law could become more complicated once legislators got ahold of it.
Board member Jerry Slaughter, an early proponent of the plan to transfer regulatory authority to KDHE, said the controversy in Kansas over a health insurance exchange could complicate educating new legislators about Kansas' existing health information exchange because the two, which are separate but related initiatives, could be conflated or confused for one another.
"I still prefer the decision we made earlier about just a clean transfer (to KDHE). On the other hand, maybe we have to factor in to it the concerns about having to educate a new Legislature — 50 new House members and quite a few new Senate members — on an issue that is tied up with some national issues that complicate it," said Slaughter, who represents the Kansas Medical Society on the KHIE board.
A draft of the required legal revisions was circulated at Wednesday's KHIE meeting, but board members did not address it. Instead, much of the discussion centered around an option that wouldn't require a change in law: Whether KHIE staff and clerical duties be transferred to KDHE, with the KHIE board retaining regulatory authority.
The board's legal counsel, Jeff Ellis, said a hybrid approach could be done without changing the law.
"Everything that's costing money would go to KDHE, everything that's responsible for operations would go to KDHE. A policy board is what (KHIE) would turn out to be," Ellis said. "I think it could accomplish exactly the same economic ends, and also would allow the public input to the extent that public input is desired and necessary for this very important public policy initiative."
KDHE Secretary Dr. Robert Moser, also a KHIE board member, said he would discuss a hybrid option with administration officials, but didn't expect it would be viewed favorably.
"It probably wouldn't be highly encouraged for us to take on the hybrid model — for us (KDHE) to take on the expenses but really have no oversight," Moser said. "But I can't really take a stand on the hybrid, because it wasn't the focus of where we were headed. Let me have those conversations and get back to you about what the possibilities are of going that way."
The board deferred until its January meeting further discussion about whether to approach the Legislature with proposed changes to the law. The January meeting has yet to be scheduled.
In 2011, the Legislature approved the so-called KHITE bill, which harmonized the state's patient privacy laws with the federal privacy law known as HIPPA. The legislation was meant to ease liability fears among Kansas doctors so they would join newly forming digital networks for exchanging patient information.
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