In the session's first meeting of the Senate's health committee, among the concerns raised by legislators was that they were "in the cold" regarding developments of the state's health information exchange.
Sen. Jim Denning, an Overland Park Republican, asked Dr. Robert Moser, secretary of the Kansas Department of Health and Environment, to prepare an update on Kansas' health information exchange, which launched in July.
KDHE has proposed assuming authority of the exchange — which enables the sharing of electronic patient records among doctors and other medical providers, and is currently overseen by a public-private body, the Kansas Health Information Exchange, or KHIE.
The KHIE board has agreed to turn over its authority to KDHE, though it has yet to settle on how to do so.
"We need to know what we're into — (staff) budget, technology budget, peer-to-peer communication between exchanges — those things really weigh on my mind," said Denning, who is an administrator for an ophthalmology practice, during Tuesday's meeting of the Public Health and Welfare committee. "We request the chair to have a lengthy discussion on that" in later meetings.
Assuming costs along with authority
The goal of transferring regulatory authority to KDHE is to reduce operating costs. Independent regulation of the exchange was expected to run about $400,000 a year, versus an estimated $54,000 a year under KDHE's purview.
But the move would require some changes in state law, meaning the 2013 Legislature — which has more than 50 new members — would need to be involved.
After the committee meeting, Denning told KHI News Service that he's had "many, many discussions" with concerned doctors about the transition of the exchange authority, "but I've not been able to chat with anyone who knows anything about it, so that's why I brought it up in committee."
He said he wanted to know whether the state was adequately prepared to assume the responsibility of ensuring patient privacy and security over the exchange.
"I want to make sure we know what we're getting into," he said. "Everybody's been kind of left out in the cold. We know a lot more about the health insurance exchange than we do about the health information exchange," Denning said referring to a separate but related initiative that's received much publicity nationwide.
Denning said the recent problems at the Kansas Division of Motor Vehicles illustrate what can result from a poorly executed plan.
"That was not a smooth transition, and I just want to make sure that doesn't happen in the health care industry," he said. "We want to make sure that privacy is one of their most important objectives of the exchange, (and) have the discussion about whether this thing should be public or private."
How to proceed still in question
After months of debate, the KHIE board has yet to settle on the best way to surrender its oversight authority to KDHE.
KHIE chief executive Bill Wallace said the board has at least two options.
"The first being to amend the KHITE legislation and, the second, to enter into a contract with KDHE to have KDHE perform the administrative duties that KHIE now performs," Wallace said.
KHITE refers to the laws passed by the legislature in 2011 giving KHIE authority over the electronic exchange of patient records. Doctors who exchange records via a KHIE-approved network are protected from legal liability should there be a privacy or security breach.
Shifting authority from KHIE requires changing the laws to instead give that authority to KDHE — otherwise doctors who exchange electronic records would be in legal limbo.
"There's nervousness about whether this Legislature would accept the changes and pass it on through," said KHIE board chair Dr. Joe Davison of Wichita. "We want to make sure it passes. The way it stands now, (current law) is better than nothing."
KHIE 2012 Annual Report
The KHIE board is scheduled to next meet on Feb. 13, so any proposed changes to current law are not likely until then, said KHIE's Wallace.
"I believe that any interested entity could try to introduce amendments to KHITE at any time but I am fairly confident that KDHE would not take this step without the endorsement of the KHIE board of directors," he said.
KDHE's liaison to the KHIE board, Aaron Dunkel, said that discussions on how best to proceed were ongoing.
“The KHIE board and KDHE continue to work out the details for introducing legislation amending the KHITE Act and how to best bring KHIE responsibilities into KDHE," Dunkel wrote in an email to KHI News Service.
Coverage of electronic health records in KansasOverview
→ 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)
→ 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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