TOPEKA — A bill that would clear the way for the regulatory duties of the Kansas Health Information Exchange to be transferred to the state health department was introduced today in the Senate Public Health and Welfare Committee.

Aaron Dunkel, deputy secretary of the Kansas Department of Health and Environment, told committee members that the move was a good idea because the policy making duties assigned to KHIE when it was created have largely been completed and it now would be cheaper for the state to regulate the exchange networks that have begun linking hospitals, doctors and other medical providers.

Cutting costs

"When KHIE was originally designed and put in the state plan, the idea was that this organization would be running the technology and basically doing all the work that is primarily being done now by the (exchange networks) in the state. The component that's really left that KHIE has been working on...has been policy development," he said.

"At this point most of those policies have been developed. At this point they're really moving in more of a regulatory kind of phase of existence. The (KHIE) board has made a decision — after looking at sustainability and cost of providing that service — to request that the responsibilities of the Kansas Health Information Exchange, Inc. be put back in KDHE, which is where those responsibilities were originally. At that point the agency would predominantly take on the regulatory function," Dunkel said.

In July, KDHE officials proposed taking over the quasi-governmental KHIE as a way to save money, and in September the KHIE board agreed to move forward with the proposal. The decision came at the same time that health information exchange was beginning in Kansas.

Folding KHIE's functions into KDHE would eliminate about $350,000 of KHIE's nearly $400,000 projected annual costs and transfer the rest to taxpayers.

Expenses that would be eliminated include:

• $134,900 in salaries and benefits to KHIE employees;

• $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.

KDHE officials have said the annual cost of regulating the exchange could be covered by KDHE without lawmakers adding to the agency's budget by merging it with the agency's existing health information technology programs.

Under the plan, the 17-member KHIE board currently appointed by the governor would become an advisory committee appointed by the KDHE secretary.

The bill authorizing the transfer hasn't yet been assigned a number or scheduled for hearing.

Questions from committee members

Dunkel gave committee members a half-hour overview of the development of health information exchange in Kansas, and fielded a dozen or so questions.

Sen. Mary Pilcher-Cook, the Shawnee Republican who chairs the committee, asked about the security and privacy of patient health information on the exchange.

"This network doesn't exist over the internet, does it?" she asked.

"It's on the internet but it's encrypted traffic, so it's protected," replied Michael McPherson, KDHE's health information technology project leader.

"So you have strong confidence that this system could not get hacked into?" Pilcher-Cook asked.

"They're taking every precaution they can to make sure that doesn't happen. I don't think there's anything that's unhackable unless you don't plug into the wall," Dunkel said.

Pilcher-Cook also asked if the data on the exchange could be accessed in bulk, sometimes referred to as "secondary data use."

"In other words, can you use this for a keyword or a category search or something like that?" she asked.

Mike Dittemore — chief executive of LACIE, one of the two networks licensed to exchange digital patient data in Kansas — answered: "No, senator, there's no way to go in and do a mass search at one time. It's patient by patient."

Sen. Mitch Holmes, a St. John Republican, who is a computer programmer, asked for clarification on that point.

"Did I hear that right, that you can't go in and gather statistics?" Holmes asked. "You can't go in and say, for example, how many patients do we have using a certain medication across the state...or across the system?"

"No, not across the state...not even across the system right now," Dunkel said. "There's some discussion around the public health reporting kind of items and how that reporting might happen, but we're just not there yet."

Holmes asked: "Is that in the future? I would see that as valuable information to have — not personalized, just aggregated."

"That's the direction we're headed," Dunkel said. "The discussion right now is how you standardize those things at the federal level, and then with the technology, how do you extract that information."