The state’s controversial HIE signed up its first participating provider network. Thursday the Office of Health Strategy (OHS) announced that CT Health Link, run by the CT State Medical Society (CSMS), will “immediately begin the technical connections necessary” to allow access into their system. Advocates have been concerned about OHS’s plans to sell access to sensitive medical records and the lack of privacy policies or protections in their HIE (Health Information Exchange). Advocates are concerned that it could allow insurers and ACOs, with financial incentives to lower the costs of care, to inappropriately limit care and to cherry-pick more lucrative patients. So far, insurers and ACOs have been identified as customers. There are serious questions about whether Connecticut needs yet another HIE. Over 70% of Connecticut hospitals and 57% of doctors are now getting clinical information from other health systems, well above national averages.
In a strongly worded letter, the CT Hospital Association laid out extensive and serious problems with the proposed HIE including plans to sell access to private medical records, concerns about how patient consent will be obtained, a lack of clarity on requirements, and missing or inaccurate Connecticut information critical to implementation.
In discussions, CSMS leaders claimed that insurers already have access to our medical records through companies that collect a sample of records for quality and fraud monitoring. Beyond DSS, we have been unable to confirm access by insurers despite calls to those companies, medical record staff at hospitals, and HIT experts. Advocates are less concerned about DSS’s direct access as Medicaid is an entitlement program that must accept all qualified applicants and, in Connecticut, without any competing managed care organizations to reward cherry picking. Medicaid utilization information is far more publicly available than for any other coverage in Connecticut. CSMS’s claim is also contradicted by insurer statements that they need the HIE data and the fact that they are willing to pay for access. Requests to CSMS for information to confirm their claims were not answered.
“What we can tell from the claims data is what a physician or a provider did, but not whether the patient got better,” Jill Hummel, president of Anthem, said recently during a forum sponsored by the Office of Health Strategy. “And it is not easy today to get that data. One of the things we need is a sustainable HIE.”Health Information Exchange Picks Up The Pace, CT News Junkie, January 30, 2020
Insurers have expressed great interest in gaining access to medical records and are represented on the Board of the nonprofit ostensibly running the HIE, but with public funding and many public members on the Board. Under current state law, all hospitals and physicians will be required to sign onto the state’s HIE, with access given to whoever OHS chooses.
CT Health Link’s website indicates that 63 sites in Connecticut are participating in their system including physician practices, dialysis centers, urgent care centers, specialists, and DSS. Consumers concerned about privacy and inappropriate use of their records should talk to their provider and find out if they are in CT Health Link. Consumers can opt-out of CT Health Link here.