Medical providers raise questions about health database

OKLAHOMA CITY — State officials are finalizing plans to launch a massive statewide database that will contain specific details about every Oklahoman’s health information.

Supporters say the creation of the database overwhelmingly received bipartisan support in the state Legislature last year and will modernize the state’s health care record-keeping system to help improve continuity of care between providers.

Local therapists argue against health database

❝This will be devastating to mental health providers and those who seek private mental health care.❞ — Justin Loughman, a mental health professional in Enid

But, critics are concerned with why the government wants to maintain a massive centralized database containing records of things like Oklahomans’ mental health visits and referrals, prescription medications, broken bones, hospitalizations, allergies, teeth cavities, immunization records, laboratory testing results and information about women’s visits to OB-GYNs.

They argue that such records, if misused, could impact people’s employment or their ability to access needed health care or bar them from owning guns.

And, they said Oklahoma Health Care Authority’s plan to put the onus on health care providers to pay for the system will worsen medical access, particularly in rural areas that already are grappling with shortages.

Sean Byrne, a licensed independent professional counselor in Enid, said OHCA’s average $5,000 startup fee will force him to close his business, which treats about 25 clients a week. Providers also said they’ve been told to expect recurring monthly fees of $400 to $600 to maintain the system.

“For a small provider like myself, it would put us all out of business,” Byrne said.

Byrne said the idea for the Health Information Exchange initially was pitched as a voluntary information sharing system, but at some point it “morphed” into a mandatory one that no provider can now opt out of.

“I think we need to ask why and how that happened, and again for what purpose,” he said. “Why would we ever need to store information on our citizens unless we want to, at some point in the future, have that information and use it for something other than transferring to another provider?”

Byrne said his clients don’t want their health information and diagnoses stored in a centralized government database.

“It also takes the power away from the client,” he said. “That’s their right and their responsibility. (It’s) not to create a nanny-type state where we are collecting information on individuals for whatever reason.”

An OHCA spokeswoman did not respond to questions emailed by CNHI Oklahoma on Wednesday.

However, OHCA said in an email Thursday morning that Senate Bill 1369 requires all health care providers to participate.

“While participation in the HIE is regulated by state law, patients still maintain the right to protect their health information,” spokeswoman Laura Wilcox wrote in an email. “Patient privacy is a top priority, and the HIE system will comply with all licensure and state and federal legal requirements, including HIPAA protections.”

Carly Atchison, a spokeswoman for Gov. Kevin Stitt, said the database empowers providers and doctors to treat patients in a more timely, efficient and effective manner because they’ll have instant access to a patient’s full medical history. The data will be guarded closely, and Atchison said she believes patients will be able to opt in or out. Information in the database cannot be used civilly or criminally.

“The ultimate goal here is to make sure Oklahoma is a top 10 state for health outcomes,” Atchison said. “We’re certainly not interested in spying on anybody. It’s about providing the best possible care for patients in Oklahoma.”

She said every state has a similar database or is in the process of implementing one.

Atchison confirmed $5,000 is the average estimated startup cost for providers, but there are plans to exempt some providers facing financial hardships from paying. OHCA officials, though, later said there would only be “temporary exemptions.”

State Rep. Randy Randleman, R-Eufaula, who voted for the measure, said the law has not done what he thought it would, nor has the implementation gone as expected.

Randleman, a licensed psychologist, said he didn’t expect mental health patients to be included in the database. He said providers are federally required to protect patient health information and questioned who ultimately will be able to access the database.

He also does not like OHCA’s proposed provider fees.

“We don’t need to be making laws that’s shutting down our small businesses,” he said. “You need the small entities out here scattered all over the state, helping to provide (care). The more things they pass like this that you have to pay these kind of fees … it’s just going to shut more of them down. That’s not where Oklahoma needs to go, and I will fight that.”

Rebecca Kroeker, who owns Associated Therapeutic Services in Enid, one of the largest privately owned mental health clinics in Northwest Oklahoma, said she’s concerned with maintaining patient confidentiality. She said her businesses’ clientele include military personnel, law enforcement, judges, attorneys and a lot of people who don’t want government to know they’re receiving certain care. Some even pay out of pocket, she said.

Kroeker said ethically she can’t even confirm whether someone is a patient. Under the new state law, she may be able to withhold diagnoses, but she’s going to have to tell OHCA the name of every patient who visits her office, even if the patient opts out.

“We don’t need the state of Oklahoma collecting our data,” Kroeker said.

Don Spencer, president of the Oklahoma Second Amendment Association, said his organization is “not comfortable” with the concept at all. He’s concerned health information collected in a centralized database could impact the right of Oklahomans to own guns.

“It’s just too much information in one area with no appeals process for clearing up a problem or fixing a problem,” Spencer said. “And the information can be misused. We just have a problem with it across the board.”

Oklahoma State Medical Association, which represents doctors, said in a statement that having information is vital in medicine, especially in an emergency. A statewide database can bridge “critical information gaps.”

But the group said it “must be implemented thoughtfully and in a way that does not financially burden physicians, hospitals and other care providers,” and Oklahomans must be assured that their private health information is secured.

The group said it is concerned OHCA may not be able to accomplish those goals by July 1.

It urged OHCA, which is scheduled to meet next week to promulgate rules, and the Legislature to postpone the rollout.