Network dispute slowing move to digital patient records

Written by Phil Cauthon

Local hospitals nearing transition to digitalKansas? health information exchange has been years and millions of dollars in the making, but because of an ongoing dispute between its two networks, it still lacks the capability to handle the exchange of digital patient records across the entire state.

Negotiations aimed at resolving those differences have so far failed to produce a data-sharing agreement. The two sides have significant ground to cover if network officials hope to meet the deadline for interconnectivity.

The two networks are: the Lewis And Clark Health Information Exchange (LACIE), which primarily serves providers in the Kansas City area; and the Kansas Health Information Network (KHIN), which serves most of the rest of the state.

LACIE and KHIN were given a year to connect under terms of the licenses granted to them by the state?s regulatory authority. That July 2013 deadline was extended this spring to Dec 31.

At stake is this:

n If LACIE and KHIN are not connected by the deadline, $1 million in grants earmarked for them could be forfeited. The federal funds are part of $9 million granted to Kansas in 2009 for setting up a health information exchange;

n If the networks are not connected by the end of the year, they could lose their licenses to operate in Kansas. Doctors and hospitals who transfer records over a licensed network are protected from liability should inadvertent breaches of patient privacy occur; and

n Until the networks connect, most doctors and hospitals in the Kansas City metro area cannot remotely obtain patient records from providers elsewhere in Kansas, and vice versa.

Without the connection, for example, an emergency room doctor in Wichita or Pratt seeking patient records from a Kansas City specialist will be left with the options they had for obtaining records before the exchange. Namely, they must rely on paper records transferred by fax machine, discs, mail or patients themselves.

Compromising care

Although difficult to quantify, patient care is potentially being compromised every day that the networks remain unconnected, said the state?s chief regulator of the exchange.

?The one thing we miss for every day that they don?t connect is that ability to exchange all the data that?s readily available? through each network, said Aaron Dunkel, head of KanHIT, the state?s health information exchange regulatory arm at the Kansas Department of Health and Environment.

?The day-to-day data that is collected at this point just isn?t available during transitions of care or referrals from a KHIN provider to a LACIE provider, or vice versa,? Dunkel said. ?They still have access to the paper record format, but we?re just not receiving that benefit yet of being able to do that transition of care or being able to do that referral through electronic means.?

Eventually, digital health information exchange is expected to take the place of paper records.

The hope is that quicker access to more complete patient information will improve patient care, help cut medical costs by avoiding redundant and ineffective treatments, as well as reduce errors?although critics say such benefits have yet to be demonstrated.

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