Health information exchange arrives in Kansas

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keyboard stethoscope_webThe push toward electronic exchange of health information is on. On July 8, 2010, then Governor Parkinson issued Executive Order 10-06. The Executive Order laid the ground work for creating a not-for-profit corporation called Kansas Health Information Exchange, Inc. (KHIE). KHIE's mission is to create a reliable, credible system that physicians and other health care providers can use to exchange health information electronically throughout the state.

Such a system will utilize private vendors, called health information organizations, to supply the technology needed to electronically exchange health information among various health care providers. Ideally, in its finished stage, physicians, hospitals, and other health care professionals will be able to electronically access critical health information from a variety of health care professionals about any patient. For instance, if a patient who regularly receives treatment in Garden City needs treatment unexpectedly in Topeka, the Topeka physician could immediately access health information electronically about the patient from a variety of health care professionals, including the health information about the patient from Garden City.

To that end, in 2011, the Kansas Legislature passed the Kansas Health Information Technology and Exchange Act (the Act). Under the Act, KHIE (the not-for-profit corporation referenced above) will approve and monitor health information organizations (HIOs). HIOs are entities that provide the technology, procedures, and processes physicians and other health care professionals will need to electronically access and disclose relevant health information.

The Act also harmonizes Kansas's patchwork of existing health privacy laws with HIPAA. As of July 1, 2011, when the Act became effective, physicians and other health care professionals need only comply with one set of rules, the HIPAA Privacy and Security Rules, when using and disclosing health information.

Finally, the new law identifies the process physicians and other health care professionals will use to notify patients about the exchange of health information via the HIOs. Patients who do not want their health information disclosed or used on such an exchange will have the option to "opt out."

By partnering with the Kansas Medical Society, the Kansas Hospital Association and others, like Kansas Health Information Network, Inc., KHIE is working to establish a sustainable system that will allow effective electronic exchange of health information. Through a certification process, KHIE will require HIOs to demonstrate they have sustainable technology to permit physicians and other health care professionals to reliably exchange health information electronically. In addition, KHIE will require approved HIOs to confirm their use of appropriate physical, technical, and administrative safeguards in place designed to protect the integrity, confidentiality, and availability of the health information being exchanged.

So what should physicians do now? Below are a few suggestions for physicians regarding health information exchanges:

  • Decide whether to play. Physicians and clinics must decide whether they want to be able to access key patient health information electronically from other health care professionals and whether they want other health care professionals to be able to access health information about their patients. By participating in an electronic health information exchange network, physicians and clinics may find themselves better able to access health information regarding their patients and confirm other physicians and health care professionals have critical data about their patients.

  • Sign Up As A Participating Provider. If physicians or clinics decide to be participating providers with a health information exchange network, they will need to become a "participating provider" by entering into a "participation agreement" with an HIO approved by KHIE. (The process for approving HIOs is currently underway.)

  • Amend Clinic's Existing Privacy Notice. Participating physicians and clinics will need to amend existing Notice of Privacy Practices, notifying patients about their participation in the electronic exchange and listing the steps patients will need to take if they do not want their individual information shared via the exchange, i.e. notice to the patient on how to "opt out". KHIE has developed standard language that physicians and clinics can use to amend existing Notice of Privacy Practices. The language should also be posted on the waiting room walls of the physicians' offices. (Resource for policy language.)

  • Assemble Opt Out Information for Patients. Clinic administrators should understand and develop a practical process for giving patients the information patients will need in the event a patient decides to "opt out". (Resource for policy language.)

  • Self-Study. Finally, physicians and staff should take advantage of educational offerings about accessing and disclosing health information through health information exchanges. The Kansas Medical Society will be providing information on available educational opportunities as it becomes available.

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