Boise News

state politics: idaho

Questions Linger: Idaho’s Health Data Exchange

By Sharon Fisher, 1-22-08

Lawmakers heard more today about the Health Data Exchange proposed by Governor Butch Otter in his State of the State speech earlier this month.

The budget for Medicaid Administration and Medical Management includes two line items for the Health Data Exchange—$350,000 in a supplemental for this year and $150,000 for next year. Otter said the state would be working with Blue Cross, Regence Blue Shield, St. Luke’s and Saint Alphonsus of Boise, Kootenai Medical Center of Coeur d’Alene, Health West in Pocatello to develop the system.

But lest citizens think this is a bright idea of Otter’s, or something in which Idaho is taking the lead, Idaho is behind many other states in developing such a system – which was mandated by the federal government back in 2004 for completion in 2014.

Health & Welfare Director Dick Armstrong told the Joint Finance-Appropriations Committee this morning that the system will be phased in over five years and give different health providers – starting with three hospitals and 100 doctors – access to patient records. Advantages of the system include a complete record of a patient’s history regardless of location, with the potential of saving money by preventing Medicaid and pharmaceutical fraud.

The system does not create a central health database. Rather, it creates a data interchange method that enables two existing databases to exchange data.

President George W. Bush called for a national system, to be created from a number of state and regional systems, back in 2004, to be completed in 2014. The national effort is called the National Health Information Network, while regional efforts are known as Regional Health Information Organizations. The effort altogether is known as Health Data Exchange or Health Information Exchange.

But regions of states such as Indiana offered such services as long ago as 1994, and the state of Delaware said it was the first to offer such a service statewide, in March, 2007.  More than 150 regional efforts are underway, including the Inland Northwest RHIO in Washington and the Quality Health Network in western Colorado.

What exactly the Health Data Exchange initiative will get for its half-million dollars isn’t specified, nor is it clear where the expertise will come from. The ITRMC does not appear to have any health IT committee, and while the Idaho Health Quality Planning Council was established in 2006 ostensibly to help plan such activities, it is difficult to find any information about it. The Governor’s Science and Technology Advisory Council might have been well-suited to examine such a project – if Otter hadn’t disbanded it for taking on too much of an advocacy role.

The Governor’s Health Care Summit made such a recommendation back in August 2007, noting that barriers included difficulty in setting up such systems in physicians’ offices due to the cost; beefing up state infrastructure; and the question of who will administer the data. The state might offer incentives and information technology support to the physicians, and “innovative funding sources” such as a tax on rental cars or increased “sin taxes” might help pay for it, the recommendation continued.

There are also a number of issues that would need to be determined, each of which will be covered in future articles:

- How will Idaho pay for it, and how do other states pay for it?
- What other states and regions are doing – and how a number of them have dropped their RHIO efforts
- What sort of infrastructure is required? Specifically, how will rural Idaho regions that don’t even have broadband Internet be able to participate? What sort of security systems will be in place?

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