“It is a five-year plan,” Ms. Kauff-
man said. “The approach would be to build this in small stages.” In the first year, HHSC would study
whether the existing gateway can sup- port a massive expansion. If the state has to chuck the current gateway and start anew, it would use the second year to build a more expansive sys- tem from scratch, she says. HHSC also would connect to a master list of health care professionals and organi- zations as well as a master index of patient records in year two, she adds. By year three, Ms. Kauffman says,
HHSC hopes to set up a helpdesk and make the system operational. HHSC would use subsequent years to make new connections and expand services, she says. Dr. Schneider says the HIE Adviso-
ry Committee recommends connect- ing the enterprise gateway to HIEs in Texas. Contributing data to the local HIE allows the broader health care community to benefit from additional patient information, he says. “HIEs serve a very important func-
tion, particularly when it comes to things like lab and radiology results,” Dr. Schneider said. “We can prevent repetitive testing on patients, and we can speed their care if we know the results from another place.” The existing gateway is not yet connected to any HIEs. Dr. Schneider says the committee recognizes that some hospitals and larger health care systems might opt to connect direct- ly to the state instead of connecting through an HIE.
HIE OVERSIGHT Texas currently has 10 HIEs. (See “HIEs in Texas,” opposite page.) “We started with a larger number
of HIEs than we have now, and we’ve whittled down to a smaller number,” Dr. Schneider said. “It is conceivable that there might be further consolida- tion, but the important thing is that if there is further consolidation, we’re all working together to make sure ac- cess is not eliminated and communi-
ties and physicians are supported in any upcoming changes that take place.” In other words, he says, consolida-
tion should not disrupt physician ac- cess to patient information. The Texas Legislature created the
nonprofit Texas Health Services Au- thority (THSA) in 2007 to provide governance, infrastructure, policy development, and oversight of HIEs in Texas. In 2013, THSA created HIE- Texas — a project designed to connect all regional HIEs in the state. Last year, two of the largest HIEs —
SECURETexas certification remain in place beyond THSA’s Sept. 1, 2021, sunset date. SECURETexas is the first state program in the country to offer privacy and security certification for compliance with state and federal laws. SECURETexas is managed by THSA and the Health Information Trust Alliance.
The commis- “It saves you
from errors of omission.”
Greater Houston HealthConnect and Integrated Care Collaboration of Aus- tin — connected through HIETexas, allowing thousands of doctors and hospitals in the two regions to quickly and securely share patient health data. According to THSA’s 2014 report,
Supporting HIE Growth While Build- ing Trust and Confidence in HIE, avail- able at tma.tips/THSA2014report, “Healthcare Access San Antonio has completed testing and is preparing to conduct final live testing with HIE- Texas. Leveraging shared services through HIETexas reduces costs be- cause it reduces the number of inter- faces and legal agreements necessary for exchange.” THSA is undergoing sunset review
in the 2015 legislative session. The Texas Sunset Advisory Commission reviews state agencies to determine whether they are effective and should continue to receive state funding. The Sunset Advisory Commission
voted in December to recommend that THSA operate without government oversight or funding beginning Sept. 1, 2021. Until then, the commission says THSA should add to its board of directors two members representing state health agencies to act as state data sources and one new member to represent HIEs. The Sunset Advisory Commis- sion also recommended that THSA’s
sion presented its recommendations to state legislators to consider in the 2015 session. To read the sunset re- port, visit tma.tips
/SunsetRecommendations. Another bill before the legislature
would limit the liability of physicians who participate in HIEs. According to the bill, unless a health care profes- sional acts with gross negligence, he or she would not be liable for dam- ages for failure to obtain or disclose information from or to an HIE. The bill would also protect physicians who rely on inaccurate patient data obtained through an HIE as well as physicians who submit patient data to an HIE, which is then used by some other entity in a manner that violates state or federal laws. The same bill would protect HIEs
in similar instances. The Texas Medi- cal Association supports the bill; Rep. John Zerwas, MD (R-Richmond), is a sponsor. n
Kara Nuzback is a reporter for Texas Medicine. You can reach her by phone at (800) 880-1300, ext. 1393, or (512) 370-1393; by fax at (512) 370- 1629; or by email at
kara.nuzback@
texmed.org.
All articles in Texas Medicine that mention Texas Medical Association’s stance on state legislation are defined as “legislative advertising,” according to Texas Govt. Code Ann. §305.027. That law requires disclosure of the name and address of the person who contracts with the printer to publish the legislative advertising in Texas Medicine : Louis J. Goodman, PhD, Executive Vice President, TMA, 401 W. 15th St., Austin, TX 78701.
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