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Laura McCrary Ed.D
Congratulations to all who have been working to achieve health information exchange in Kansas. We are really getting there! I was recently reminded that many of you reading this article have been working on health information exchange in Kansas since 2000. More than 11 years have passed and now we are beginning to see all of the hard work and dedication to this vision finally coming to pass.
This summer has seen a series of "firsts" for the Kansas Health Information Network: the KHIN exchange site is now live and can be accessed by members; KHIN staff provided web training to 84 providers in how to utilize the exchange; the first eligible provider exchanged clinical data through KHIN (see story below); the first live data is in the process of being tested and KHIN received its first payment from a provider.
There may have been even more "firsts" but these are what have really stood out for me this month. No longer are we going to just talk about exchange efforts in Kansas. We have now demonstrated that health information exchange is real and is occurring. While we still have a long way to go it is nice to no longer discuss IF exchange is going to occur in our state. Now we can talk about WHAT is the timeline for each participant to begin to exchange data in Kansas.
On August 22, 2011 Eric C. McPeak, an optometrist, in Hiawatha became the first eligible provider to exchange clinical data through the Kansas Health Information Network. "Because optometry is an integral part of the overall health care delivery system, I really like the idea that I can securely communicate with my patients' other health care providers about diabetes and other systemic conditions so we can work together to have the best possible outcomes for the patient, " said Eric C. McPeak, OD.
Dr. McPeak has two office locations one in Hiawatha and one in Falls City, Nebraska. He uses an EHR product called MedFlow Electronic Records for eyecare. Dr. McPeak plans to meet all meaningful use requirements for Medicare and will attest during 2011.
Dr. McPeak graduated from Northeastern State University College of Optometry in Tahlequah, OK in 1999. He followed that up with a one year optometric residency at the Fayetteville, AR VAMC that was focused on primary care. Dr. McPeak worked in Topeka and Kansas City prior to starting his practice in the Hiawatha/Falls City area in 2003. Dr. McPeak was born in Hiawatha; when he was young he moved to Wamego, KS. Dr. McPeak grew up there and graduated from high school there prior to attending Kansas State University and graduating in 1995 with a BS in Life Sciences. In his spare time, Dr. McPeak enjoys spending time with his wife, Leah, and daughter, Aya. He also enjoys running and attending sporting events.
In August 2011 the Kansas Health Information Exchange (KHIE) Board of Directors, began working on key issues that must be resolved before wide spread health information exchange occurs in Kansas. Of particular interest to the group was how the "opt-out" provisions of the Kansas Health Information Technology and Exchange Act would be enacted. The KHIE Policy committee is led by Joe Davision, MD (Family Medicine-Wichita).
Under the Kansas Health Information Technology and Exchange Act legislation passed during the 2011 legislative session Kansas is an "opt-out" state in regard to health information exchange. Thus, a person's health information is in the exchange unless they exercise their right to not participate in the exchange.
Exchange participants, such as a hospital or physician practice will be required to provide their patients notice that they participate in the health information exchange. KHIE has developed proposed wording for this notice and it will be available soon. KHIE has suggested that it be incorporated into the HIPAA Privacy Notification.
Kansas hospitals and eligible providers had expressed concern that they were not equipped to manage the physical process required to assist patients who choose to opt-out of the exchange. After some discussion the KHIE policy committee concurred with this assessment and made plans to establish a centralized system where patients can email their decision to opt-out of health information exchange in Kansas.
However, consumer groups expressed concern that some patients would not have access to email or would have difficulty accessing email due to their age or disability. KHIE also concurred and included provisions for health care providers to assist patients who did not understand health information exchange or did not have access to a computer with email. The process to assist patients with limited access is still developing.
For more information or to comment please contact Michael McPherson. Additional efforts are underway to establish a telephone help line that would provide general information to consumers regarding the pros and cons of health information exchange and information on how they can opt out of the exchange. KHIE plans on conducting a consumer awareness campaign in the upcoming months.
On September 2, 2011 the KHIN Board of Directors voted to award the KHIN Help Desk contract to ISG Technology. The KHIN Help Desk staff will be located in the ISG Wichita office. The KHIN Help Desk will begin formal operations in mid-October 2011. A toll free phone number and email will be available for all KHIN participants.
ISG has offices in Kansas, Missouri and Oklahoma and is a nationally recognized IT solutions provider, delivering business value and measurable results to organizations of all kinds through advanced technology. The ISG staff has 28 years of experience with over 50 highly certified systems engineers and consultants, and an award-winning Professional Services practice. ISG Technology offers a variety of technology solutions to commercial, public sector and education customers of all sizes. Core ISG solution areas include Datacenter, Networking, Collaboration, Physical Security, and Managed Services. In 2011, ISG Technology became an approved vendor partner by the Kansas and Missouri HITRECs (Health Information Technology Regional Extension Centers).
The ISG Support Center will be responsible for the initial troubleshooting of reported problems from KHIN Participants. Additionally, the ISG Support Center team will be tasked with performing the initial triage of support related issues. If the ISG Support Center team is unable to provide a resolution then the problem will be escalated to KHIN's technology vendor, ICA.
In August 2011 eligible providers all across Kansas began sharing personal health information utilizing the KHIN secure clinical messaging functionality. Secure messaging takes conversations, phone calls and paper messages between physicians, nurses, and other eligible providers and makes them electronic, thus expediting the message and response. It is particularly convenient when referring a patient to another provider or messaging the provider regarding requested procedures. Secure messaging also eliminates misinterpretation, and users can respond quickly to the electronic communications, which helps move information more efficiently than the older, traditional modes of communication. It is used for everything from referrals and consults to answering patient questions and filling prescriptions.
The KHINex site went live in early August and the first pilot group of 30 providers was trained. The roll-out of the product and the training went smoothly and during late August and early September an additional 84 providers were trained and are now participating. Training for new participants occurs several times each week through a webinar and conference call. Typical training times are 10-20 minutes. Passwords are assigned at the completion of the training.
Secure clinical messaging works very much like an encrypted email system where providers can communicate information regarding shared patients in a virtual private network (VPN). It can be rapidly implemented through a web browser and additional software is not required. Secure clinical messaging also provides the method in which eligible providers can meet a key core measure required to meet meaningful use and access Medicare incentive payments. For those physicians and hospitals who are insured by KaMMCO, KHIN will waive the first year's subscription cost for secure clinical messaging.
The biggest advantage is that nothing is lost. Reminders, audit trails, and reporting within the system ensure that every message is received and responded to appropriately. For more information or to access necessary paperwork regarding Secure Clinical Messaging go to the KHIN website or contact Michelle McGuire.
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