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It’s unusual when independent consumer advocates and hospitals are on the same page. In a strongly worded letter, the CT Hospital Association laid out serious problems with OHS’s proposed plan to share data in their controversial Health Information Exchange (HIE). Only some hospitals were given the opportunity to comment on OHS’s plans.

Under law, all hospitals and doctors in the state will be required to connect their patient records to OHS’s HIE.

“Hospitals (and labs) have no choice but to engage with the State-wide Health Information Exchange, but that should not mean that they are required to agree to whatever contract is presented by the Health Information Alliance (HIA) or OHS. If that is the case, it defeats the purpose of a contract; it also relegates the contract to a sovereign fiat, to be imposed without due process protections, adherence to administrative procedures, or the implied condition of good faith and fair dealing that should underlie every contract in Connecticut.”

— CHA letter April 24, 2020

The 13-page list of concerns includes missing Connecticut context, a lack of transparency and how patient consent will be obtained, lack of clarity on requirements, misunderstanding of federal law, and the sale of patient health data, among many others.

Just one example of the lack of Connecticut context missing from OHS’s plan :

“The Definition of “Applicable Laws and Standards” includes a specific reference to the Connecticut Health Information Technology Commission. No such body exists in Connecticut. There is, however, a Michigan Health Information Commission, in Michigan.”  

“The materials should align with Connecticut’s HIE planning process, Connecticut laws, Connecticut IT assets, and Connecticut’s consumers. Using the pre-made Michigan framework does not achieve this.”

— CHA letter April 24, 2020

Note: The consultants hired by OHS for the project are from Michigan and previously worked on creating that state’s HIE.

The letter echoes advocates’ concerns about selling access to sensitive personal medical records to insurers and large health systems. When a federal grant runs out, the state intends to fund the HIE by selling access to patient records to insurers and unregulated large health systems (ACOs). Advocates are concerned about the lack of privacy and about financial incentives to deny people necessary care and dump expensive patients, as has happened in the past.

Given the unprecedented challenges facing all departments at Connecticut’s hospitals, CHA also sent a separate letter to OHS asking for a reasonable delay in designing the HIE. Meaningful engagement by every stakeholder group is critical to building a successful and trusted HIE for Connecticut. OHS’s answer was No – without addressing CHA’s concerns. Chasing a federal grant deadline is not sufficient reason for ignoring critical groups or for sloppy work.