OKSHINE HIE and Data Transmitting Exemption How To

Senate Bill 574 (2021) and Senate Bill 1369 (2022) created OKSHINE which changed Oklahoma laws surrounding HIE. The deadline for healthcare providers to participate was July 1st, 2023. However, penalties have not yet been imposed for providers that did not meet the deadline.

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What Is OKSHINE

OKSHINE stands for the Oklahoma State Health Information Network and Exchange. It is an alleged secure system that allows healthcare providers across Oklahoma to electronically share a patient's medical records. This supposedly improves coordination of care, reduces medical errors, and improves patient outcomes.

All 50 states have initiatives related to Health Information Exchanges (HIEs). While some states may have a single, centralized HIE, others might have multiple regional ones.

Here is a breakdown of what you need to know:

• Every state has an HIE: This means all states have some form of a system for healthcare providers to share patient information electronically.
• The number of HIEs per state varies: Some states, like California with 15 HIEs, have a more fragmented system with regional HIEs. Others might have a single, statewide HIE.

While all states are working toward improved health information exchange, there are currently three states that do not have an active statewide HIE:

• Iowa
• New Hampshire
• Wyoming

Pros and Cons of OKSHINE

Pros of OKSHINE:

• Improved care coordination: With OKSHINE, healthcare providers across Oklahoma can easily access a patient's complete medical history. This allows them to see medications, allergies, past procedures, and other important information. This comprehensive view helps them provide more coordinated care, avoid unnecessary tests or procedures, and potentially reduce medication errors.
• Enhanced patient safety: By enabling a more complete picture of a patient's medical history, OKSHINE can help reduce medical errors. For example, if a patient has a drug allergy documented in OKSHINE, healthcare providers are alerted and can avoid prescribing that medication.
• Improved patient outcomes: By facilitating better care coordination and reducing medical errors, OKSHINE can lead to improved patient outcomes. Patients may experience fewer complications, receive more targeted treatment plans, and potentially experience a quicker recovery.
• Streamlined communication: OKSHINE allows for easier communication between healthcare providers. This can expedite referrals, and consultations, and overall improve the efficiency of the healthcare system.

Cons of OKSHINE:

• Privacy concerns: Sharing medical information electronically raises privacy concerns. While OKSHINE has security measures in place, some patients might be apprehensive about their data being available across the healthcare network.
• Security risks: There is always a potential risk of data breaches with any electronic system.
• Implementation challenges: Integrating OKSHINE into existing healthcare workflows can be challenging for providers. Smaller practices might require additional resources or training to adapt to the new system.
• Limited connection fee assistance: A $30 million legislative appropriation was provided for one-time HIE connection fees through June 30th, 2024. Funding is not guaranteed beyond this date.
• On-going subscription fees: A subscription fee is also required to access the network and is based on organization/provider types and size.
• Limited participation: Some healthcare providers are required to participate in OKSHINE so the benefits of a complete medical picture might be limited.

The Oklahoma Health Care Authority (OHCA) has contracted with MyHealth Access Network as the State Designated Entity (SDE). OKSHINE requires Oklahoma healthcare providers to pay a one-time connection fee of around $5,000 to connect to the Oklahoma HIE through the SDE. The fee is variable and depends on the provider's system. Providers can submit one MyHealth HIE application for each of their clinics or hospitals with the fee covering all employees at each location.

OHCA has revised emergency rules for OKSHINE, approved on July 17th, 2023. Providers registering for exemption from transmission and utilization requirements will automatically receive it, without paying fees. You just need to fill out OHCA's OKSHINE exemption registration form which I will explain how to submit momentarily. Once reviewed by OHCA, exemption status will be granted, unless the provider opts into the HIE instead.

What Is Data Transmitting

OKSHINE transmits a variety of healthcare data electronically between authorized providers across Oklahoma. This data exchange aims to improve care coordination and patient outcomes.

Here's a breakdown of the typical data transmitted through OKSHINE HIE:

• Demographics: Basic patient information like name, date of birth, address, and contact details.
• Medical history: Past conditions, diagnoses, procedures, and hospitalizations.
• Medications: Current medications, allergies, and medication history.
• Immunizations: Vaccination records and immunization history.
• Laboratory results: Blood test results, imaging scans, and other diagnostic test results.

Psychotherapy notes are excluded from transmission to the HIE as well as any behavioral health data covered by 42 CFR part 2. Additionally, any patient may decide to prevent access to their medical records. Providers do not need to submit historical data. Only data moving forward will be included in the HIE.

How To Get An Exemption

Getting an exemption is fairly straightforward. First, click here to go to the OKSHINE website then click on Exemption Registration in the lower left of the page.

Once you are taken to the exemption page, click on Open Form to fill out the exemption registration form.

Six questions are required. Unless the question has an asterisk *, the information is optional at your discretion. It is recommended to select the option to opt out of transmitting data AND utilizing the HIE.

Exemptions are granted when requested. Exemptions never expire unless you indicate to OHCA that you want to participate in the HIE.

The email from OHCA arrived the next business day. Once the exemption is approved, there is nothing else you need to do.

Click here to visit the OKSHINE website for more information.

More Resources

If you are interested in learning more, click here. For more information on this topic, we recommend the following:

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About the Author

Jessica Taylor is a licensed therapist and board certified coach who contributes to the promotion of mental health and addiction awareness by providing educational resources and information.