Wyoming health information organization-pilot.

WORKING DRAFT
2007
STATE OF WYOMING
07LSO-0656.E1

HOUSE BILL
NO.
HB0320

Wyoming health information organization-pilot.

Sponsored by:
Representative(s) Simpson and Lubnau and Senator(s) Von Flatern

A BILL

for

AN ACT relating to public health and safety; providing for an electronic health records pilot program; providing for the designation of a regional health information organization; providing for contracting with the regional health information organization for development of a system of electronic health records; providing priorities in system development; providing protections for patient privacy; establishing a crime for misuse of electronic health records as specified; providing an appropriation; authorizing a position; and providing for an effective date.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1.
W.S. 35
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29
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101 through 35
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29
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106 are created to read:

CHAPTER 29
REGIONAL HEALTH INFORMATION ORGANIZATION–PILOT PROGRAM

35
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29
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101.

Definitions.

(a)

As used in this act:

(i)

"Continuity of care record" means an electronic record which provides access by healthcare providers to relevant patient medical history. A continuity of care record contains the electronic health record or the portion of the electronic health record most likely to be useful to a new healthcare provider treating a patient and shall contain identifying information needed to associate an individual with the record and other pertinent information;

(ii)

"Department" means the department of health;

(iii)

"Electronic health record" means a record stored electronically containing medical and other health related information about an individual and containing identifying information needed to associate an individual with the record and any other pertinent information;

(iv)

"Hub" means a centralized computer software function that receives, translates and transmits information among various electronic health record systems. A hub may also facilitate data management including but not limited to all or portions of electronic health records and may develop reports and perform other functions needed for a functioning statewide electronic health records system;

(v)

"Personal health record" means that part of an electronic record that an individual may access and make available to others, and includes a record of the sources of information and those persons to whom it has been transferred;

(vi)

"RHIO" means a regional health information organization for Wyoming;

(vii)

"This act" means W.S. 35
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29
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101 through 35
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29
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106.

35
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29
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102.

Regional health information organization designation; contracting with the regional health information organization.

(a)

The department shall designate an organization as the RHIO for purposes of a pilot electronic health records program for the state of Wyoming.

(b)

The department shall contract with the RHIO for the development and operation of systems to enable and facilitate the operation of electronic health records capable of interchanging information within the state and to the extent feasible outside the state.

(c)

The contract pursuant to subsection (b) of this section shall provide for the:

(i)

Design and operation of the hub, using existing technologies to the extent practicable;

(ii)

Accommodating and integrating information from electronic health record and medical record systems used by up to one hundred (100) Wyoming healthcare providers, state agencies and, if possible, federal government providers including but not limited to the veterans administration and the Indian health service;

(iii)

Safeguards and requirements set forth in W.S. 35
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29
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106;

(iv)

A right for the department to terminate the contract for unsatisfactory performance.

35
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29
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103.

Regional health information organization; addition of hospitals and other healthcare providers.

(a)

The RHIO in consultation with the department shall develop and publish criteria relevant to cost effective and timely connection of healthcare providers to the hub.

(b)

The RHIO may provide technical and consultative services to any Wyoming healthcare provider seeking to interface with the statewide electronic healthcare records system via the hub. Subject to the restrictions of W.S. 35
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29
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106(f), the RHIO in consultation with the department may develop a pilot program of financial assistance and incentives for healthcare providers in Wyoming including providers in private practice to install electronic health records or electronic medical records. In developing the pilot program the RHIO shall consider using incentives for providers such as personal digital assistants or other devices to access relevant drug formularies and the Wyoming Medicaid preferred drug list and capable of transmitting electronic prescriptions entered by the provider. The pilot program shall be implemented only with the approval of the department.

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29
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104.

Electronic healthcare record systems; applications; interfacing with the hub.

(a)

The RHIO shall develop the following capabilities and applications for the electronic healthcare record system interfacing via the hub:

(i)

Electronic prescribing enabling prescribers to write electronic prescriptions and have them sent electronically to pharmacies;

(ii)

Continuity of care records that would be available to providers treating the patient in any setting interfacing with the hub, without interfering with the provider-patient relationship;

(iii)

Local provider access to hospital information systems either directly or via the hub;

(iv)

Administrative transaction processing to provide administrative functions such as a claims processing and eligibility checking service for providers to process insurance transactions electronically with their payers provided that development of this function may be discontinued if information from providers indicates existing systems are adequate and cost effective for this function without the state effort;

(v)

A registry of individual advance directives;

(vi)

Integrated evidence based practice guidelines, compatible with pay for performance incentives;

(vii)

Automated patient chart generation;

(viii)

Record information and entry through the Internet, World Wide Web or a similar proprietary or common carrier electronic system;

(ix)

Appropriate provisions, consistent with industry standards, to encrypt and secure its data against unauthorized access and to maintain a record of all information requests;

(x)

Provision for entry of nonelectronic data and documents into the system;

(xi)

Ongoing de-identified performance data collection and analysis to improve the operation of the system and the quality of the healthcare delivery system in the state; and

(xii)

Regular review and quality improvement input from participating providers, public entities and third party payors.

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29
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105.

Operating costs.

Subject to legislative appropriation, the department shall plan to meet all operating costs of the RHIO not funded through grants from other sources for the fiscal biennium ending June 30, 2008. The RHIO shall develop a plan to cover all operating costs via earnings and provider fees once the system is fully implemented on a statewide basis. The plan shall include a schedule of the professional staff needed to operate and maintain the hub and provide technical assistance to providers and other authorized users.

35
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29
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106.

Conditions and precautions; misuse of healthcare information.

(a)

The statewide electronic healthcare records and the hub shall be compliant with the patient privacy requirements of article 6 of chapter 2 of title 35 of the Wyoming statutes and the federal Health Insurance Portability and Accountability Act of 1996 and subsequent similar enactments.

(b)

The hub shall be constructed so that it cannot be used by employers in their capacity as employers and insurance companies to access individual continuity of care records or inappropriate parts of individual health or medical records. Information needed to pay claims and information useful for providing care where an insurer is a health maintenance organization or similar organization that provides care is appropriate access.

(c)

The chief state information officer in his standard budget shall request funds for third party security audits of the RHIO, the hub and related systems to ensure compliance with privacy provisions and identify security weaknesses in need of improvement.

(d)

Individuals are entitled to access and copy information in their individual continuity of care record and vaccination records. The RHIO shall develop appropriate procedures to make this access practical, secure and inexpensive.

(e)

Except when the patient has opted not to make his information available, the RHIO may make information in electronic health or medical records accessed via the hub available in a de-identified form for legitimate medical, health related or public policy research. Where the research is valuable for commercial purposes, the RHIO may charge a fee which shall be used to support the operation of the RHIO. Where research finds information of value to a patient whose de-identified data is being used, the RHIO may disclose the information to the patient either directly or via his healthcare provider. Where identified information is sought for research, it may be disclosed only with the consent of the person whose information is sought or his appropriate legal guardian, representative or surrogate.

(f)

The RHIO shall give priority in selecting participating healthcare providers to primary care healthcare providers.

(g)

Any person who, without proper authorization or for an unauthorized purpose, knowingly accesses, receives or distributes information from electronic health records is guilty of a misdemeanor and upon conviction shall be punished by a fine for each offense of not less than five hundred dollars ($500.00) nor more than one thousand dollars ($1,000.00).

Section 2.

If the federal government, with respect to electronic prescribing of drugs for Medicare or another federal program, preempts state pharmacy law or regulations relating to prescribing of drugs, the state board of pharmacy shall promulgate regulations allowing all electronic prescribing in Wyoming to conform to the federal requirements. The state board of pharmacy shall report to the joint labor, health and social services interim committee regarding any conforming changes needed in state law.

Section 3.

(a)

There is appropriated from the general fund to the department of health four million dollars ($4,000,000.00) for purposes of the pilot project authorized by this act. The appropriation shall
not revert as provided in W.S. 9
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4
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207
but shall remain available until expended.

(b)

There is appropriated from the general fund to the department of administration and information for the biennium ending June 30, 2008, forty thousand dollars ($40,000.00) for security audits by the state chief information officer, including pre-audits during the development of the hub.

(c)

There is appropriated from the general fund to the department of health for the biennium ending June 30, 2008, eighty thousand dollars ($80,000.00) and one (1) at will employee contract position is authorized to implement the purposes of this act.

Section 4.

This act is effective immediately upon co
m
pletion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constit
u
tion.

(END)

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HB0320