The board of the nonprofit organization set up to govern health information exchange in Kansas voted unanimously Sept. 12 to turn its responsibilities over to the state government once federal grant funding runs out next September.

Healthcare Informatics has been following the financial struggles of groups established to oversee state-level health date exchange. Health information service providers, hospitals and insurers in some states are unwilling to pay any kind of fee to fund an oversight board. For example, in June the board of the nonprofit Health Information Partnership for Tennessee (HIP TN) announced plans to wind down its operations once federal grant money runs out. The group was created three years ago to help Tennessee create a statewide clinical health information exchange. Officials at HIP TN said the state decided to pursue a simpler strategy that relies on secure e-mail transmission of health information among providers.

The Kansas Health Institute (KHI) News Service reports that the goal of transferring the governing authority to the Kansas Department of Health and Environment (KDHE) is to save approximately $350,000 per year in operating costs, mostly in staff salaries.

(http://www.khi.org/news/2012/sep/12/khie-board-turns-over-regulatory-duties-state/)

The 17-member KHIE board would become an advisory committee to KDHE. Initially KHIE was going to provide technology services statewide but changed course to focus on regulatory and policy issues such as the privacy of patient health records. Now, following amendment of a state law by the Legislature, those responsibilities will transfer to KDHE by October 2013.

The KHI story quoted a few board meeting attendees who questioned the wisdom of the decision. Some noted that the quasi-public entity was set up to avoid political influence and to represent the interests of patients and providers. Others wondered whether KDHE had the resources to pay enough attention to health information exchange given all the other responsibilities it has. "The future is the ability to take this data and really start improving the science of medicine and identifying the most effective interventions,” said Martie Ross, a consultant who has worked for KHIE's legal contractors, Spencer Fane Britt & Browne. “That data is enormously valuable...You've got to see what lies ahead. It's all opportunity out there, and to flush that away (to save) what staffing costs I think is short-sighted."

The decision came at the same time that health information exchange is beginning in Kansas.

"This is a way to get the state to have some skin in the game. Right now the only people who have skin in the game are (medical) providers," said board member Jerry Slaughter, who also is executive director of the Kansas Medical Society.

Leading up to the decision, some board members and others had expressed concern that a state agency wouldn't represent the interestsof patients or health care providers as well as an independent board would do so.

Chair Dr. Joe Davison raised that concern with a question to KDHE's representative to the board, Aaron Dunkel:

"Short of your first-born child, can you give any assurances that the stakeholder group can have their say in this new advisory committee?" Davison asked.

"I think there's an opportunity to sit down and write up what the rules of engagement will be, a bylaws for the advisory committee," Dunkel said.

Two hours of comments preceded the vote, including some from among the dozen members in the audience.

"I am hard pressed to believe that KDHE — with its innumerable responsibilities and its focus on so many different aspects of public policy — can truly devote the effort and represent the provider community and (patients) in a way this organization can," said Martie Ross, a consultant who has worked for KHIE's legal contractors, Spencer Fane Britt & Browne.

"Don't think about just today," Ross said. "The future is the ability to take this data and really start improving the science of medicine and identifying the most effective interventions. That data is enormously valuable...You've got to see what lies ahead. It's all opportunity out there, and to flush that away (to save) what staffing costs I think is short-sighted."

 KHIE was formed in 2010 to ensure the security and privacy of patient health records as they are transferred via privately owned networks. It was set up as a quasi-public entity with board members appointed to represent the interests of patients, health care providers, employers and insurers in an open process intended to be independent of political influence.

Since then, its operations have been funded by a federal grant that runs out in September 2013. KHIE had planned to fund operations beyond the grant by assessing a fee on the networks it regulates.

Five board members voted on the proposal today:

• Davison, who represents West Wichita Family Physicians,

• Michael Atwood, who represents Blue Cross Blue Shield of Kansas,

• Jackie John, who represents the Great Plains Health Alliance,

• Jonalan Smith, who represents pharmacists and Genoa Healthcare, and

• Karen Braman, who represents pharmacists and Express Scripts.

Two non-voting board members also were present and Slaughter recused himself citing conflict of interest as he is the chair of the Kansas Health Information Network, one of the networks KHIE regulates. Eight of the 17 board seats are vacant, including those that represent patients as well as one resigned today by Janet Stanek who represented Stormont-Vail hospital.