KHIE board members get cold feet on legal changes

Concern expressed over possible complications if Legislature becomes involved

0 | HIE-HIT

— 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.

Coverage of electronic health records in Kansas

Overview
Kansas breaks ground on statewide digital health network (5/28/12)
The pros and cons of health information exchange: An interview with Dr. Joe Davison (5/28/12)

More coverage
KanHIT Advisory Council to craft 'secondary data use' policy (2/18/14)
Kansas HIE networks connected ‘live’ for first time (12/23/13)
Network execs confident they will meet looming deadline (12/16/13)
Patient health exchange networks agree to connect (11/12/13)
The Kansas insurance marketplace that might have been (10/21/13)
Security and privacy of patient data subject of regulatory hearing (9/30/13)
Deadline looming for state's patient record exchange (8/26/13)
KDHE begins day-to-day duties of HIE regulation (7/19/13)
Network execs squabble over issue of exchange connectivity (5/23/13)
KU Hospital, Shawnee Mission going live on statewide health record exchange (5/9/13)
Governor signs HIE bill transferring regulatory authority from KHIE to KDHE (4/18/13)
This is why health IT systems aren't keeping up (3/19/13)
Senate panel hears bill to move HIE regulatory authority to KDHE (3/13/13)
Bill introduced to transfer regulatory authority from KHIE to KDHE (2/12/13)
Legislators request 'lengthy discussion' on HIE developments (1/16/13)
KHIE board members get cold feet on legal changes (12/13/12)
KHIE defers details of transition to KDHE (10/10/12)
KHIE board turns over regulatory duties to state (9/12/12)
HIE board delays decision on turning authority, costs over to state (8/8/12)
Regulators of health information exchange to consider ceding authority to state (8/6/12)
The cost of independent regulation of health information exchange (8/6/12)
KHIE board presented with proposal to dissolve the organization by August (7/11/12)
Far fewer than projected patients opting out of health information exchange (6/14/12)
Public awareness campaign begins for health information network (5/23/12)
Networks granted temporary licenses to exchange patient data (4/11/12)
KHIE committee changes course on funding scheme (3/26/12)
Rural Kansas doc featured as national technology leader (8/17/11)
State Medicaid officials announce new schedule for digital health records exchange (7/25/11)
Kansas health care providers get first look at exchange implementation (2/4/11)

Full coverage of health information technology in Kansas



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