Asked Questions About the Oklahoma State Health Information Exchange (OKSHINE)
How Did We Get Here?
The original HIE effort was first announced by the Health Care Authority back in 2020. At that time, the Health Care Authority contracted with an out-of-state platform called Orion to set the program up, but OHCA intended to run the program in house, which would have required every provider in the state to adopt that new system. Legislation (SB 574) to formalize this agreement was passed into law in May 2021. However, shortly after the OHCA’s selection of Orion was announced, MyHealth filed a complaint against the bidding process, pointing out their bid was approximately $30 million lower than Orion’s. After several months of negotiation and legal wrangling, OHCA and MyHealth reached an agreement under which the state would still use the Orion platform, but the data would flow through MyHealth. The legislature passed a measure (SB 1369) in 2021 to implement the framework of this agreement.
What Does the Law Say?
SB 1369 requires all licensed health care providers in the state to report health care data to MyHealth.
Why Did the State Want an HIE?
The goal of the health information exchange is to improve patient outcomes by allowing for greater sharing of data. Physicians will have the ability to better manage and coordinate care by being able to see patient medication lists, be notified of admissions, discharges or transfers from hospitals, improving care coordination and avoiding redundant testing.
What Do Physicians Need to Do?
MyHealth is already compatible and sharing data with many major electronic medical records (EMR) systems. For physicians whose office or hospital is already using those systems, the transition should be relatively seamless. However, for physicians without a compatible EMR, meeting the bill’s requirements will be more complicated. Physicians can either implement a compatible EMR or can contract directly with MyHealth.
What Will This Cost?
For those physicians with a compatible EMR, there should be no additional costs. For those contracting directly with MyHealth, costs could be up to $5,000 for initial setup. The Legislature has appropriated $30 million to fund these costs. We have been told OHCA plans to pay MyHealth directly and that physicians will not be required to pay for the initial setup and then be reimbursed. However, as of this writing, OHCA has not put out anything officially saying how this process will be handled.
What is the Penalty for Not Participating?
The law does not contain any specific penalty for noncompliance.
What Does This Mean for Patient Privacy?
The law specifically says data will be collected only in accordance with relevant state and federal privacy laws, including HIPAA. However, the lack of specificity has raised concerns, particularly among those in the mental and behavioral health fields, where compliance with the privacy protections of CFR 42 are paramount. Any patient may opt out of having their health records shared by filling out this form.
Can a Physician Receive an Exemption?
OHCA rules do allow physicians to apply for an exemption from the mandate based on “type of health care provider, financial hardship, size, or technological capability of a health care provider or organization.” The Oklahoma Health Care Authority (OHCA) recently established an updated set of guidelines regarding various types of HIE exemptions that can be provided for physicians who may not need to be included. Waivers may be requested by filling out this application. However, please note the OHCA rules specify the exemption is not permanent and must be renewed annually.