Tamela Griffin from the Department of Assistive and Rehabilitative Services and Dr. Ron Luke from the Health and Human Services Council watch as members of the committee discuss electronic data transfer in rural communities.
Texas hospitals and doctors’ offices may be switching the way they handle patients’ information because of a new grant program that encourages electronic transferring.
The Medicaid Health Information Exchange Advisory Committee met Oct. 20 to discuss the implementation of the grant program and concerns with the limitations it places on rural Texans.
Executive Director of the Texas Health Services Authority, Tony Gilman, reported to the committee about the progress of Texas Health Information Exchange (HIE) programs. An HIE is a way that healthcare information can be exchanged electronically across organizations in order to provide safer and more efficient care.
According to Gilman, two HIE’s have already submitted business and operational plans. Integrated Care Collaboration, which covers Central Texas, and Healthcare Access San Antonio are on an accelerated plan and are already fully operational.
Six HIE providers were selected to represent rural areas. “I think these organizations will offer a lot of choice to our providers in our white space counties,” Gilman said. These options would offer low-cost and secure basic services. Only one of the providers, Sandlot, would offer the more advanced features available in urban areas.
"The boots on the ground are really supported by these six organizations,” Gilman said. According to Gilman, the committee will be revealing a soft communications-plan to help inform citizens on their options of HIE's, although the responsibility lies with the six organizations to market themselves.
Dr. Joe Schneider, the committee chair, raised concerns about rural HIE’s only providing basic services rather than advanced capabilities. “The patients think that they are going to be able to go to an ER and have their data there. The answer is it depends on what the doctor and hospital have chosen as to whether that will be true or not,” Schneider said.
He was also critical of basic services. “The purpose of government is to set a floor, and we are setting out floor of health information exchange at a level that is being described as sort of electronically doing what we already do today,” Schneider said.
Schneider called for more advanced HIE features to be available for rural Texans. "What if we set our floor higher and say to be a qualified health-information exchange in the state of Texas you have to not only be direct, but you have to provide more classic exchange if the patient were to be in need of it," Schneider said.
Ann Kitchen, a member of the committee, said that the market would have to drive demands and you could not dictate to doctors the type of services they choose to use. “It is going to have to be a situation where a patient says, ‘I am not going to this doctor because they are in the dark ages basically and they have not taken advantage in sharing information in a way that I prefer’," Kitchen said.
Disinterest in these services is one reason that some may not be available in all rural areas. “The reason we have supported this strategy is because what we have seen is in some areas the interest, the technical and the financial capacities to support an HIE is not there," Gilman said.
Joe Schneider believes that the government has pushed doctors and hospitals towards basic services. “We have driven the doctors and hospital towards that sort of service,” Schneider said. “Our standards should be higher than that.”
The next meeting for the committee will be on Jan. 12 when most HIEs will be fully operational and offering basic services to most Texans.
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