Oklahoma Proposes Opt-Out Provision in Updated Statewide HIE Rules

Oklahoma's attempt to implement a statewide health information exchange (HIE) has been met with resistance. Responding to concerns, the Oklahoma Health Care Authority Board (OHCA) has approved emergency rules, providing healthcare providers with an opt-out choice.

Prior to this, the state board had unanimously agreed on passing Senate Bill 1369, mandating that all licensed healthcare providers participate in the HIE by July 1, 2023.

OHCA has been dedicated to establishing an HIE allowing Oklahomans' digital medical records to be accessible by any state healthcare provider. Supporters believe this exchange will facilitate doctor collaboration on patient care and reduce unnecessary duplicate medical testing.

“With the HIE, we can vastly improve public health, care coordination, records exchange, and address care fragmentation for providers,” Stephen Miller, CHCIO, state coordinator for Health Information Exchange, said in a public statement. “Utilizing our partnership with MiHealth, the State Designed Entity for HIE operations, we are on the road to making this vision a reality.”

Despite these benefits, the initiative has been met with resistance from both patients and providers. Critics highlight concerns about patient privacy, implementation of the system, and communication regarding the rollout.

Additionally, on June 23, 2023, the Governor vetoed the proposed HIE rules. The newly proposed emergency revisions were written in order to align policy with feedback received from members, providers, and the Governor.

Notably, these revisions allow providers to request exemptions from the HIE Coordinator.

“OHCA is thankful for the feedback of Oklahoma patients and providers in creating these emergency rules which encourages improved collaboration among different healthcare providers while protecting a patient’s right to privacy,” the agency stated in a public statement. “OHCA remains committed to creating a streamlined, holistic health care approach and improving health outcomes for Oklahomans through the HIE.”

The revised rules also shed light on the availability of grants aimed at mitigating the costs that providers often incur when establishing secure digital connections and maintaining data standards for HIE. Even though HIE connection and subscription carry costs for providers, these rules introduce no new fees. Any costs incurred are expected to be counterbalanced by the benefits of enhanced data sharing and potential improvements in patient care. As a result, these rule changes are seen as budget-neutral for the agency.

The agency maintains that the proposed rules won't adversely impact small businesses or public health, safety, or the environment. Furthermore, the agency doesn't foresee any detrimental effects on public health and safety if the rule changes are not implemented.