SSB 5501 -
By Committee on Health Care & Wellness
NOT CONSIDERED 04/14/2009
Strike everything after the enacting clause and insert the following:
"NEW SECTION. Sec. 1 The legislature finds that:
(1) The inability to securely share critical health information
between practitioners inhibits the delivery of safe, efficient care, as
evidenced by:
(a) Adverse drug events that result in an average of seven hundred
seventy thousand injuries and deaths each year; and
(b) Duplicative services that add to costs and jeopardize patient
well-being;
(2) Consumers are unable to act as fully informed participants in
their care unless they have ready access to their own health
information;
(3) The blue ribbon commission on health care costs and access
found that the development of a system to provide electronic access to
patient information anywhere in the state was a key to improving health
care; and
(4) In 2005, the legislature established a health information
infrastructure advisory board to develop a strategy for the adoption
and use of health information technologies that are consistent with
emerging national standards and promote interoperability of health
information systems.
NEW SECTION. Sec. 2 A new section is added to chapter 41.05 RCW
to read as follows:
The definitions in this section apply throughout sections 3 through
6 of this act unless the context clearly requires otherwise.
(1) "Administrator" means the administrator of the state health
care authority under this chapter.
(2) "Exchange" means the methods or medium by which health care
information may be electronically and securely exchanged among
authorized providers, payors, and patients within Washington state.
(3) "Health care provider" or "provider" has the same meaning as in
RCW 48.43.005.
(4) "Health data provider" means an organization that is a primary
source for health-related data for Washington residents, including but
not limited to:
(a) The children's health immunizations linkages and development
profile immunization registry provided by the department of health
pursuant to chapter 43.70 RCW;
(b) Commercial laboratories providing medical laboratory testing
results;
(c) Prescription drugs clearinghouses, such as the national patient
health information network; and
(d) Diagnostic imaging centers.
(5) "Lead organization" means a private sector organization or
organizations designated by the administrator to lead development of
processes, guidelines, and standards under this act.
(6) "Payor" means public purchasers, as defined in this section,
carriers licensed under chapters 48.20, 48.21, 48.44, 48.46, and 48.62
RCW, and the Washington state health insurance pool established in
chapter 48.41 RCW.
(7) "Public purchaser" means the department of social and health
services, the department of labor and industries, and the health care
authority.
(8) "Secretary" means the secretary of the department of health.
NEW SECTION. Sec. 3 A new section is added to chapter 41.05 RCW
to read as follows:
(1) By August 1, 2009, the administrator shall designate one or
more lead organizations to coordinate development of processes,
guidelines, and standards to:
(a) Improve patient access to and control of their own health care
information and thereby enable their active participation in their own
care; and
(b) Implement methods for the secure exchange of clinical data as
a means to promote:
(i) Continuity of care;
(ii) Quality of care;
(iii) Patient safety; and
(iv) Efficiency in medical practices.
(2) The lead organization designated by the administrator under
this section shall:
(a) Be representative of health care privacy advocates, providers,
and payors across the state;
(b) Have expertise and knowledge in the major disciplines related
to the secure exchange of health data;
(c) Be able to support the costs of its work without recourse to
state funding. The administrator and the lead organization are
authorized and encouraged to seek federal funds, including funds from
the federal American recovery and reinvestment act, as well as solicit,
receive, contract for, collect, and hold grants, donations, and gifts
to support the implementation of this section and section 4 of this
act;
(d) In collaboration with the administrator, identify and convene
work groups, as needed, to accomplish the goals of this section and
section 4 of this act;
(e) Conduct outreach and communication efforts to maximize the
adoption of the guidelines, standards, and processes developed by the
lead organization;
(f) Submit regular updates to the administrator on the progress
implementing the requirements of this section and section 4 of this
act; and
(g) With the administrator, report to the legislature December 1,
2009, and on December 1st of each year through December 1, 2012, on
progress made, the time necessary for completing tasks, and
identification of future tasks that should be prioritized for the next
improvement cycle.
(3) Within available funds as specified in subsection (2)(c) of
this section, the administrator shall:
(a) Participate in and review the work and progress of the lead
organization, including the establishment and operation of work groups
for this section and section 4 of this act; and
(b) Consult with the office of the attorney general to determine
whether:
(i) An antitrust safe harbor is necessary to enable licensed
carriers and providers to develop common rules and standards; and, if
necessary, take steps, such as implementing rules or requesting
legislation, to establish a safe harbor; and
(ii) Legislation is needed to limit provider liability if their
health records are missing health information despite their
participation in the exchange of health information.
(4) The lead organization or organizations shall take steps to
minimize the costs that implementation of the processes, guidelines,
and standards may have on participating entities, including providers.
NEW SECTION. Sec. 4 A new section is added to chapter 41.05 RCW
to read as follows:
By December 1, 2011, the lead organization shall, consistent with
the federal health insurance portability and accountability act,
develop processes, guidelines, and standards that address:
(1) Identification and prioritization of high value health data
from health data providers. High value health data include:
(a) Prescriptions;
(b) Immunization records;
(c) Laboratory results;
(d) Allergies; and
(e) Diagnostic imaging;
(2) Processes to request, submit, and receive data;
(3) Data security, including:
(a) Storage, access, encryption, and password protection;
(b) Secure methods for accepting and responding to requests for
data;
(c) Handling unauthorized access to or disclosure of individually
identifiable patient health information, including penalties for
unauthorized disclosure; and
(d) Authentication of individuals, including patients and
providers, when requesting access to health information, and
maintenance of a permanent audit trail of such requests, including:
(i) Identification of the party making the request;
(ii) The data elements reported; and
(iii) Transaction dates;
(4) Materials written in plain language that explain the exchange
of health information and how patients can effectively manage such
information, including the use of online tools for that purpose;
(5) Materials for health care providers that explain the exchange
of health information and the secure management of such information.
NEW SECTION. Sec. 5 A new section is added to chapter 41.05 RCW
to read as follows:
If any provision in sections 2 through 4 of this act conflicts with
existing or new federal requirements, the administrator shall recommend
modifications, as needed, to assure compliance with the aims of
sections 2 through 4 of this act and federal requirements.
NEW SECTION. Sec. 6 A new section is added to chapter 41.05 RCW
to read as follows:
Within available funds as specified in section 3(2)(c) of this act,
by December 1, 2009, and annually thereafter, the administrator shall
report to the legislature on the implementation of the requirements of
sections 2 through 4 of this act, including:
(1) An assessment of the benefits and any drawbacks resulting from
the implementation of the exchanges; and
(2) Recommendations for legislation to help further the goals of
sections 2 through 4 of this act.
NEW SECTION. Sec. 7 Within available funds as specified in
section 3(2)(c) of this act, by July 1, 2011, the office of financial
management shall contract with an independent research organization to
evaluate implementation of sections 3 and 4 of this act. The
evaluation must include recommendations for program changes to better
meet the goals of this act."
Correct the title.
EFFECT: Requires the lead organization to consider the cost of
implementing the processes, guidelines, and standards and focus on the
most cost-effective ones that can be implemented by the majority of
providers.
Directs the lead organization to attempt to minimize the
implementation costs for participating entities.
Strikes the language authorizing the administrator of the health
care authority to adopt by rule or submit legislation implementing the
guidelines, standards, and processes if the lead organization fails to
complete its work in a timely fashion.