TULSA, Okla. — On Wednesday, the Oklahoma Health Care Authority Board voted to accept the rules, but made changes to NOT require mental health providers to break their client's privacy.
This comes after mental health care providers expressed concerns about a new statewide health information exchange. They wanted to be excluded from the program that they say violates their client’s privacy.
“I have a lot of clients who ask is this going to stay confidential,” said Tiara Delonia. “Who’s going to find out about this?”
Tiara Delonia is the clinical director at Therapeutic Life Choices. It’s an outpatient mental health facility. She says privacy is the top concern for many of her clients.
“These are people’s personal life stories,” said Delonia. “Things that they are needing support with or struggling with whether it’s addiction or severe mental health.”
She’s worried about a statewide health information exchange run by the Oklahoma Health Care Authority that would provide patient information to all healthcare providers.
“For every medical professional to have access to it whether it’s a chiropractor or just your primary care or just a dentist or something like that,” said Delonia. “I just don’t see it as necessary.”
Delonia has several concerns. She says with the exchange too many people will have access to private and sensitive information that they don’t need to see. She says she’s also worried her clients will no longer seek the help they need.
“The biggest thing I can really think of is people not wanting to even engage in receiving the support that they need because they’re concerned about sensitive information,” said Delonia.
Chris Taylor is the executive director at Therapeutic Life Choices. He’s also concerned about the cost, an estimated average of $5,000 per provider to implement the system.
“There’s not an agency in Tulsa that has that kind of money set back for that kind of thing,” said Chris Taylor.
The Oklahoma Health Care Authority says the point of the exchange is to deliver patient health information seamlessly across different health systems. They say the rules would allow temporary exemptions based on size, technological capabilities or financial hardships. Clients would also be able to opt-out.
Some mental health care providers say they want to be left out of the exchange all together.
“Even the fact that the state is finding out specific information about a client that’s a violation in and of itself,” said Taylor.
In a statement the Oklahoma Health Care Authority said,
SB1369, passed in the 2022 legislative session, requires OHCA to set up a separate office, the Office of the State Coordinator for Health Information Exchange, with responsibility to oversee a statewide health information exchange with patient data from all healthcare providers. The proposed rules for the program were first introduced in September and have gone through two rounds of public comments, resulting in more than 300 comments. These comments, along with input from the public and dozens of stakeholder engagement meetings, are guiding and informing the implementation process. OHCA is grateful for the feedback of Oklahoma patients and providers.
The opportunity to utilize the HIE is significant, with potential to reduce adverse drug events, redundant testing, and promote a culture of improved collaboration among different healthcare providers, resulting in a more streamlined, holistic health care approach for Oklahomans. The agency understands the importance of privacy considerations in this effort and is working to ensure best practices and appropriate privacy safeguards, including all legal and licensure requirements under HIPAA and other applicable state and federal laws.
The proposed rules allow temporary exemptions based on size, technological capability or financial hardship. OHCA is actively engaging with providers to discuss exemption criteria for specific provider types regarding transmission of data restrictions, with a particular focus on behavioral health, and are expecting to revise the proposed rules to apply exemptions based on provider type.
After the passage of SB 1369, the rule proposal is the first step in a thorough process to develop regulations that will achieve the desired benefits for Oklahoma’s citizens, serving the needs of providers and patients alike. To ensure your concerns are addressed, OHCA invites you to be a part of the conversation. Please send your feedback through the new comments feature on oklahoma.gov/ohca/okshine [oklahoma.gov]. This page will be updated with new information as it becomes available.
Other changes from Wednesday's board meeting include:
Patients must approve to put their information on the HIE with written consent
Behavioral and mental health clients will have to opt-in to the program
The rules will allow the OHCA to grant several exemptions for financial hardship, size, technological capabilities.
Several mental health care providers spoke during the public comment asking them to vote no – and left audibily upset after the vote.
The rules will now be submitted to the legislature before heading to the Governor’s desk.
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