Library: Policy

317:30-3-35. Oklahoma Statewide Health Information Exchange

Revised 11-4-22

(a) Authority. This rule is promulgated under the authority granted in Title 63 of the Oklahoma Statutes Section 1-133 (63 O.S. ' 1-133). This Section is intended to be read in conjunction with applicable Oklahoma statutes and federal law.

(b) Applicability and purpose.

(1) Applicability. This section shall apply to and govern the establishment and operation of the statewide health information exchange (HIE).

(2) Purpose. The Office of the State Coordinator for HIE is the office within the Oklahoma Health Care Authority (OHCA) that holds the power and duty to oversee the state-designated entity for health information exchange, as described under 63 O.S. ' 1-133.

(c) Definitions. The following words and terms, when used in this Section, shall have the following meaning, unless the context clearly indicates otherwise:

(1) "Health care provider" means the following individuals and organizations who are licensed pursuant to the laws of the State of Oklahoma and includes organizations who employ or contract with such licensed individuals for the purpose of providing services associated with their licenses to residents of Oklahoma:

(A) A hospital or related institution licensed pursuant to 63 O.S. ' 1-702;

(B) Nursing facilities licensed pursuant to 63 O.S. ' 1-1903;

(D) Physical therapists as specified in 59 O.S. ' 887.2, paragraph 3;

(E) Physician assistants as specified in 59 O.S. ' 519.2, paragraph 5;

(F) Pharmacists as specified in 59 O.S. ' 353.1, paragraph 15;

(G) Nurses as specified in 59 O.S. ' 567.3a, paragraphs 3 through 10;

(H) Licensed Mental Health Professionals as specified in 43a O.S. ' 1-103; and

(I) Home Health Care Agencies and/or providers licensed pursuant to 63 O.S. ' 1-1965.

(2) "Health care provider organization" means the legal entity that offers the services of health care providers to patients in Oklahoma.

(3) "Report data to" means that health care providers shall establish a direct, secure connection to the state designated entity for HIE and submit data in the form and format as defined on the Office of the State Coordinator for HIE website.

(4) "State designated entity (SDE)" means the health information exchange organization designated by the State of Oklahoma under 63 O.S. ' 1-133. The name and contact information for the state designated entity for HIE is found on the Office of the State Coordinator for HIE website.

(5) "Utilize" means to actively use the HIE services to securely access records during and/or in support of patient treatment or health care operations.

(d) Required participation.

(1) By July 1, 2023, all health care providers as defined above and who are licensed by and located in the state of Oklahoma shall report data to and utilize the SDE.

(2) The state acknowledges that establishing the connection to the HIE can take substantial time to complete. A health care provider will be considered to have met the requirement to report data to the SDE as long as the provider is actively engaged with the HIE in the onboarding process of connecting to the HIE, and as reported by the SDE.

(3) In order to meet the requirement to utilize the SDE, each health care provider or their health care provider organization shall secure access to HIE services by the following:

(A) Completing and maintaining an active participation agreement with the SDE for HIE;

(B) Executing annually an order form electing at a minimum the set of core services relevant to the provider practice or organization; and

(C) Maintaining good standing as a participating organization in the SDE for HIE by remaining compliant with the terms and conditions, network policies and procedures, and paying all fees associated with the services elected on the order form.

(4) Each health care provider or health care provider organization will provide a utilization report from the SDE to the Office of the State Coordinator for HIE on an annual basis. Utilization metrics and benchmarks will be determined annually by the Office of the State Coordinator for HIE in consultation with the board of directors of the SDE and will be published three (3) months prior to the commencement of each State Fiscal Year.

(e) Hardship exemption.

(1) The Office of the State Coordinator for HIE may allow exemptions from the requirement to report data to and utilize the SDE beginning July 1, 2023, on the basis of financial hardship, size, or technological capability of a health care provider or organization or such other bases as may be provided by rules promulgated by OHCA.

(2) Any health care provider or health care provider organization as defined above that believes they will fall under hardship in order to meet the requirements to report data to and utilize the SDE must submit a request for exemption providing detailed justification as to the hardship they will sustain as specified on the Office of the State Coordinator for HIE website.

(3) The authorization of a hardship exemption does not exclude the provider from having to meet the requirements to report data to and utilize the SDE but will provide additional time for the provider to mitigate their hardship in doing so.