House File 2312 - Introduced
HOUSE FILE
BY CARROLL
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to electronic health records.
2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
3 TLSB 5174YH 81
4 pf/cf/24
PAG LIN
1 1 Section 1. NEW SECTION. 135N.1 DEFINITIONS.
1 2 1. "Council" means the electronic health records system
1 3 council created in section 135N.3.
1 4 2. "Electronic health record" or "EHR" means a secure,
1 5 interoperable, electronic collection of a person's episodic
1 6 and longitudinal health information based upon interactions
1 7 across multiple health care delivery organizations, that is
1 8 web=based, allows for real=time transaction processing, and is
1 9 accessed via a portal with appropriate authorization and in a
1 10 manner that complies with all state and federal health record
1 11 requirements.
1 12 3. "Interoperability" means the ability of disparate
1 13 information systems to operate in conjunction with each other
1 14 through shared or translated protocols and standards.
1 15 Sec. 2. NEW SECTION. 135N.2 PURPOSE.
1 16 The purpose of this chapter is to provide for the
1 17 utilization of electronic health records to improve health
1 18 care quality and advance the delivery of coordinated,
1 19 appropriate, patient=centered medical care; to reduce health
1 20 care costs by ensuring the timely availability of relevant
1 21 health information to assist medical decision making at the
1 22 location of health care delivery; and to provide an effective
1 23 electronic health information infrastructure that ensures the
1 24 confidentiality, security, and privacy of the authorized
1 25 exchange of patients' health care information.
1 26 Sec. 3. NEW SECTION. 135N.3 ELECTRONIC HEALTH RECORDS
1 27 SYSTEM COUNCIL.
1 28 1. An electronic health records system council is created
1 29 to oversee the development, implementation, and administration
1 30 of an electronic health records system.
1 31 2. The council shall consist of all of the following
1 32 voting members:
1 33 a. The following public members, appointed by the governor
1 34 as follows:
1 35 (1) An administrator of a large hospital or health system
2 1 with experience in the implementation of electronic health
2 2 records.
2 3 (2) An administrator of a small hospital or health system
2 4 with experience in the implementation of electronic health
2 5 records.
2 6 (3) A representative of multiphysician practices or
2 7 clinics.
2 8 (4) A representative of single or small physician
2 9 practices.
2 10 (5) A representative of long=term care facilities.
2 11 (6) A representative of community health providers.
2 12 (7) A representative of pharmacies.
2 13 (8) A representative of health care provider
2 14 organizations.
2 15 (9) A representative of health care consumers.
2 16 (10) A representative of employers.
2 17 (11) A representative of state government health care
2 18 purchasers.
2 19 (12) A representative of group health plans or other
2 20 health insurers.
2 21 (13) A representative of entities with expertise in health
2 22 care quality and patient safety, including those with
2 23 experience in utilizing health information technology to
2 24 improve health care quality and patient safety.
2 25 (14) A representative of a health research or academic
2 26 institution.
2 27 (15) A representative of health care technology interests.
2 28 (16) A representative of vendors of health care
2 29 information technology.
2 30 (17) A representative of a telecommunications carrier.
2 31 (18) A representative of entities with experience in
2 32 developing health information technology standards and new
2 33 health information technology.
2 34 (19) A representative of entities with expertise in health
2 35 information security.
3 1 (20) A representative of entities with expertise in health
3 2 information privacy.
3 3 b. The following representatives of state agencies or
3 4 institutions:
3 5 (1) The commissioner of insurance.
3 6 (2) The dean of the college of public health of the
3 7 university of Iowa.
3 8 (3) The director of the department of administrative
3 9 services.
3 10 (4) The director of public health.
3 11 (5) The director of human services.
3 12 (6) The director of the department of corrections.
3 13 3. One member of the senate from each of the two major
3 14 political parties, one appointed by the president of the
3 15 senate after consultation with the majority leader of the
3 16 senate, and one appointed by the minority leader of the
3 17 senate, and two members of the house of representatives from
3 18 their respective parties, one appointed by the speaker of the
3 19 house of representatives and one appointed by the minority
3 20 leader of the house of representatives. The legislative
3 21 members shall serve as ex officio, nonvoting members of the
3 22 council.
3 23 4. Nonlegislative members shall serve staggered terms of
3 24 three years and appointments shall comply with sections 69.16
3 25 and 69.16A. Legislative members shall serve two=year terms
3 26 coinciding with the legislative biennium. A member shall not
3 27 have a conflict of interest with the entity selected to
3 28 create, implement, and administer the electronic health
3 29 records system. Vacancies shall be filled by the original
3 30 appointing authority and in the manner of the original
3 31 appointments. Nonlegislative members shall receive actual
3 32 expenses incurred while serving in their official capacity and
3 33 may also be eligible to receive compensation as provided in
3 34 section 7E.6. Legislative members shall receive compensation
3 35 pursuant to section 2.12.
4 1 5. The commissioner of insurance shall act as the
4 2 chairperson of the council. A majority of the voting members
4 3 of the council shall constitute a quorum. The insurance
4 4 division of the department of commerce shall provide staff
4 5 support to the council.
4 6 6. The council shall do all of the following:
4 7 a. Be informed by research into and identification of the
4 8 best practices in electronic health records systems, including
4 9 system design, implementation, operation, and evaluation.
4 10 b. Identify obstacles to the implementation of an
4 11 electronic health records system and provide policy
4 12 recommendations to remove or minimize these obstacles.
4 13 c. Serve as the advisory body to the general assembly and
4 14 governor in the development, implementation, and oversight of
4 15 the electronic health records system.
4 16 d. Ensure the adoption and implementation of system design
4 17 components including uniform data standards for the exchange
4 18 of patient information and images, certification of
4 19 applications and interfaces, interoperability, user
4 20 identification, and privacy and confidentiality.
4 21 e. Ensure that the electronic health records system is
4 22 consistent with emerging national standards, coordinates with
4 23 other public and private efforts, and promotes
4 24 interoperability.
4 25 f. Develop criteria to be included in a request for
4 26 proposals for the selection of any electronic health records
4 27 system contractor.
4 28 g. Approve the contract with an entity selected to create,
4 29 implement, and administer an electronic health records system
4 30 among the populations specified and in accordance with the
4 31 time frames prescribed in section 135N.4.
4 32 h. Receive and accept grants, loans, or advances of funds
4 33 from any person and receive and accept from any source
4 34 contributions of money, property, labor, or any other thing of
4 35 value, to be held, used, and applied for the purposes of this
5 1 chapter.
5 2 Sec. 4. NEW SECTION. 135N.4 ELECTRONIC HEALTH RECORDS ==
5 3 IMPLEMENTATION SCHEDULE.
5 4 1. The department of administrative services with the
5 5 approval of the electronic health records council shall
5 6 contract with an entity selected through a request for
5 7 proposals process to create, implement, and administer an
5 8 electronic health records system for the health care providers
5 9 in this state, as prescribed in subsection 2. The entity
5 10 selected shall, at a minimum, be dedicated to health care
5 11 quality improvement, health care data management and research,
5 12 and information technology systems development.
5 13 2. Health care providers that provide services to the
5 14 following shall utilize the electronic health records system
5 15 created, implemented, and administered under this chapter by
5 16 the dates specified as follows:
5 17 a. For the expansion population as defined in section
5 18 249J.3, by December 31, 2006.
5 19 b. For state employees as described in chapter 70A, and
5 20 including an employee covered under a collective bargaining
5 21 agreement, unless the agreement provides otherwise, but not
5 22 including an employee of the state board of regents or an
5 23 elected official, by December 31, 2007.
5 24 c. For residents, patients, or inmates of state
5 25 institutions, by June 30, 2007.
5 26 d. For medical assistance program recipients pursuant to
5 27 chapter 249A, by June 30, 2008.
5 28 e. For hawk=i program recipients pursuant to chapter 514I,
5 29 by December 31, 2008.
5 30 Sec. 5. NEW SECTION. 135N.5 STANDARDS AND LIMITATIONS.
5 31 All of the following shall apply to the electronic health
5 32 records system created, implemented, and administered under
5 33 this chapter:
5 34 1. The identity of the subject of an electronic health
5 35 record and anyone accessing the record shall be strictly
6 1 confirmed to prevent unauthorized access or any cases of
6 2 mistaken identity.
6 3 2. Information contained in an electronic health record
6 4 shall only be available to those authorized by the subject of
6 5 the record to have access.
6 6 3. Information provided to a third=party payor shall be
6 7 limited to only the selected records and information necessary
6 8 for claims review and the subject of the electronic health
6 9 record shall not be subject to financial penalties or to
6 10 denial of eligibility for coverage based upon restricted
6 11 access or information disclosed in an unauthorized manner.
6 12 4. The complete electronic health record shall be
6 13 accessible to the subject of the record through a web=based,
6 14 secure account.
6 15 5. The system shall be compatible with electronic health
6 16 record software approved by the centers for Medicare and
6 17 Medicaid services of the United States department of health
6 18 and human services for use by Medicare providers, and to the
6 19 greatest extent possible with available information
6 20 technology.
6 21 6. The subject of the electronic health record is the
6 22 owner of the record.
6 23 EXPLANATION
6 24 This bill provides for the incremental implementation of an
6 25 electronic health records system by various populations in the
6 26 state. The bill defines "electronic health record" as a
6 27 secure, interoperable, electronic collection of a person's
6 28 episodic and longitudinal health information based upon
6 29 interactions across multiple health care delivery
6 30 organizations, that is web=based, allows for real=time
6 31 transaction processing, and is accessed via a portal with
6 32 appropriate authorization and in a manner that complies with
6 33 all state and federal health record requirements.
6 34 The bill provides the purposes of the chapter, establishes
6 35 an electronic health records system council consisting of
7 1 public members, representatives of state agencies and
7 2 institutions, and members of the general assembly and
7 3 specifies the duties of the council.
7 4 The bill establishes a schedule for implementing the use of
7 5 electronic health records as follows: for IowaCare expansion
7 6 population members, by December 31, 2006; for state employees,
7 7 by December 31, 2007; for residents, patients, or inmates of
7 8 state institutions, by June 30, 2007; for medical assistance
7 9 program recipients, by June 30, 2008; and for hawk=i program
7 10 recipients, by December 31, 2008.
7 11 The bill also prescribes standards and limitations
7 12 applicable to any electronic health records system created,
7 13 implemented, or administered under the new Code chapter.
7 14 LSB 5174YH 81
7 15 pf:rj/cf/24