Rhode Island to create HIE; gives patients control over PHRs

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Rhode Island will build a statewide health information exchange (HIE) as a result of Gov. Don Carcieri Monday signing into law the Rhode Island Health Information Act of 2008.

The state has tasked the Rhode Island Quality Institute, a private agency, to run the voluntary HIE. The institute has received a $5 million federal grant to build the network but will seek additional funding from the state and health insurers, according to the Providence Journal.

When the HIE launches in March, it will include laboratory information from Lifespan, East Side Clinical and the Department of Health laboratories, as well as medication history information from retail pharmacies. Laura Adams, president and CEO of the Rhode Island Quality Institute, estimated that the entire state will be connected within five years, as other groups gradually participate.

With a $5 million federal grant to build the network, the institute said it will seek money from the state and from payors to bring it to fruition. Adams estimates it will cost $3 million to $4 million a year for five years to build it, and then about $1.5 million to $2 million a year to sustain it, reported the Journal.

The new law also gives residents the option of participating in the HIE and control over who can access their health records. With stronger patient privacy protections than the HIPAA medical privacy rule, residents can choose from three levels of privacy:

  • Making their health records available only in an emergency;
  • Specifying certain health care providers who can access their records; or
  • Giving anyone involved in their healthcare access to their health records.

Participants will be notified every time someone looks at their medical records and will have the ability to change their privacy level or withdraw from the system at any time.

Adams added that the law's $10,000 fine for each privacy violation is greater than federal privacy penalties, and physicians would not participate in the HIE if they did not have the assurance that patients' medical records are complete.

However, Steven Brown, executive director of the Rhode Island Affiliate of the American Civil Liberties Union, also noted that the law does not prevent physicians from refusing to treat patients who decide not to participate in the exchange, arguing that voluntary participation may prove "illusory,” reported the Journal.