Bill Summary – FastDemocracy

House Study Bill 623 - Introduced
                                  HOUSE FILE _____
                                  BY (PROPOSED COMMITTEE ON
                                      HEALTH AND HUMAN SERVICES
                                      BILL BY CHAIRPERSON MEYER)
                            A BILL FOR
An Act relating to the Iowa health information network and a
  state-designated health data utility.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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    Section 1. Section 135D.1, Code 2024, is amended to read as
 follows:
    135D.1 Short title.
    This chapter shall be known and may be cited as the “Iowa
 Health Information Network and Health Data Utility Act”.
    Sec. 2. Section 135D.2, Code 2024, is amended to read as
 follows:
    135D.2 Definitions.
    As used in this chapter, unless the context otherwise
 requires:
    1. “Board of directors” or “board” means the entity that
 governs and administers the Iowa health information network.
    2. 1. “Care coordination” means the management of all
 aspects of a patient’s care to improve health care quality.
    2. “Community information exchange” means an ecosystem
 comprised of multidisciplinary network participants that
 use standardized technical language, a resource database,
 and an integrated technology platform to deliver enhanced
 community care planning using care planning tools that enable
 participants to integrate data from multiple sources and make
 bidirectional referrals to create a shared longitudinal record.
    3. “Department” means the department of health and human
 services.
    4. “Designated entity” means the nonprofit corporation
 designated by the department through a competitive process as
 the entity responsible for administering and governing the Iowa
 health information network and the state-designated health data
 utility.
    5. “Exchange” means the authorized electronic sharing of
 health information and data between health care professionals,
 payors, consumers, public health agencies, the designated
 entity, the department, and other authorized participants
 utilizing the Iowa health information network, and Iowa health
 information network services, and the state-designated HDU.
    6. “Federally qualified health center” means a health care
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 entity that receives grant funding under section 330 of the
 federal Public Health Service Act, Pub. L. No. 78-410.
    7. “Governing board” means the board of directors that
 governs and administers the designated entity.
    6. 8. “Health care professional” means a person who is
 licensed, certified, or otherwise authorized or permitted by
 the law of this state to administer health care in the ordinary
 course of business or in the practice of a profession.
    9. “Health data utility” means a locally governed,
 statewide, multifaceted resource that provides services for the
 interchange of health data within the health care and public
 health ecosystems for the purpose of advancing health care
 and improving public health outcomes. A “health data utility”
 combines, enhances, and exchanges electronic health data across
 care and service settings for treatment, care coordination,
 quality improvement, and public and community health purposes,
 in accordance with applicable state and federal laws protecting
 patient privacy.
    7. 10. “Health information” means health information as
 defined in 45 C.F.R. §160.103 that is created or received by an
 authorized a participant.
    11. “Health information exchange” means participants
 contributing to the sharing and movement of health information
 electronically across participants within a state, region,
 community, or health care delivery system.
    12. “Health information network” means participants in the
 health information exchange in the aggregate.
    8. 13. “Health information technology” means the
 application of information processing, involving both computer
 hardware and software, that deals with the storage, retrieval,
 sharing, and use of health care information, data, and
 knowledge for communication, decision making, quality, safety,
 and efficiency of clinical practice, and may include but is not
 limited to:
    a. An electronic health record that electronically compiles
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 and maintains health information that may be derived from
 multiple sources about the health status of an individual, and
 may include a core subset of each care delivery organization’s
 electronic medical record such as a continuity of care record
 or a continuity of care document, computerized physician order
 entry, electronic prescribing, or clinical decision support.
    b. A personal health record through which an individual and
 any other person authorized by the individual can maintain and
 manage the individual’s health information.
    c. An electronic medical record that is used by health care
 professionals to electronically document, monitor, and manage
 health care delivery within a care delivery organization, is
 the legal record of the patient’s encounter with the care
 delivery organization, and is owned by the care delivery
 organization.
    d. A computerized provider health care professional
 order entry function that permits the electronic ordering of
 diagnostic and treatment services, including prescription
 drugs.
    e. A decision support function to assist physicians and
 other health care providers professionals in making clinical
 decisions by providing electronic alerts and reminders to
 improve compliance with best practices, promote regular
 screenings and other preventive practices, and facilitate
 diagnosis and treatments treatment.
    f. Tools to allow for the collection, analysis, and
 reporting of information or data on adverse events, the quality
 and efficiency of care, patient satisfaction, and other health
 care-related performance measures.
    9. 14. “Health Insurance Portability and Accountability
 Act” or “HIPAA” means the federal Health Insurance Portability
 and Accountability Act of 1996, Pub. L. No. 104-191, including
 amendments thereto and regulations promulgated thereunder.
    10. 15. “Hospital” means a licensed hospital as defined in
 section 135B.1.
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    11. 16. “Interoperability” means the ability of two or more
 systems or components to exchange information or data in an
 accurate, effective, secure, and consistent manner and to use
 the information or data that has been exchanged and includes
 but is not limited to:
    a. The capacity to connect to a network for the purpose of
 exchanging information or data with other users.
    b. The ability of a connected, authenticated user
 participant to demonstrate appropriate permissions to
 participate in the instant transaction over the network or the
 state-designated HDU.
    c. The capacity of a connected, authenticated user
 participant to access, transmit, receive, and exchange usable
 information with other users participants.
    12. 17. “Iowa health information network” or “network” means
 the statewide health information technology network that is
 the state-designated exchange and the sole statewide health
 information network for Iowa pursuant to this chapter.
    13. 18. “Medicaid program” means the medical assistance
 program as defined in section 249A.2.
    19. “Nursing facility” means a licensed nursing facility as
 defined in section 135C.1.
    14. 20. “Participant” means an authorized health care
 professional, payor, patient, health care organization, public
 health agency, or the department entity described in section
 135D.4 that has agreed entered into an agreement to authorize,
 submit, access, or disclose health information and data through
 the Iowa health information network or the state-designated HDU
 in accordance with this chapter and all applicable laws, rules,
 agreements, policies, and standards.
    15. 21. “Patient” means a person who has received or is
 receiving health services from a health care professional.
    16. 22. “Payor” means a person who makes payments for
 health services, including but not limited to an insurance
 company, self-insured employer, government program, individual,
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 or other purchaser that makes such payments.
    23. “Payor information exchange” means a large-scale
 database that systematically collects health care claims data
 from a variety of payor sources, including claims from health
 care professionals.
    24. “Pharmacy” means a pharmacy as defined in section
 155A.3.
    25. “Pharmacy information exchange” means the participants
 contributing to the sharing and movement of dispensed pharmacy
 information electronically across participants within a state,
 region, community, or health care delivery system.
    17. 26. “Protected health information” means protected
 health information as defined in 45 C.F.R. §160.103 that is
 created or received by an authorized a participant.
    18. 27. “Public health activities” means actions taken by
 a participant in its the participant’s capacity as a public
 health authority under the Health Insurance Portability and
 Accountability Act or as required or permitted by other federal
 or state law.
    19. 28. “Public health agency” means an entity that is
 governed by or contractually responsible to a local board of
 health or the department to provide services focused on the
 health status of population groups and their the population
 groups’ environments.
    20. 29. “Record locator service” means the functionality of
 the Iowa health information network that queries data sources
 to locate and identify potential patient records.
    30. “Rehabilitative services” means the same as defined in
 section 135C.1.
    31. “Social care” means any care, service, good, or supply
 related to an individual’s social needs. “Social care”
 includes but is not limited to support and assistance for an
 individual’s food stability and nutritional needs, housing,
 transportation, economic stability, employment, education
 access and quality, childcare and family relationship needs,
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 and environmental and physical safety.
    32. “Social care referral system” means a system that shares
 an individual’s social care information for the purpose of
 referrals among health care entities, public health agencies,
 and community-based organizations. “Social care referral
 system” includes but is not limited to a network, software, or
 technology platform.
    33. “State-designated health data utility” or
 “state-designated HDU” means the health data utility designated
 by the state under this chapter.
    34. “State-designated health information exchange” or
 “state-designated exchange” means the Iowa health information
 network.
    Sec. 3. Section 135D.3, subsection 1, paragraph c, Code
 2024, is amended to read as follows:
    c. A health information network involves the secure
 electronic sharing of health information across the boundaries
 of individual practice and institutional health settings and
 with consumers. The broad use of health information technology
 and a health information network should improve improves health
 care quality and the overall health of the population, increase
 increases efficiencies in administrative health care, reduce
 reduces unnecessary health care costs, and help helps prevent
 medical errors.
    Sec. 4. Section 135D.4, subsection 2, paragraph b, Code
 2024, is amended to read as follows:
    b. The network provides a variety of services from which to
 choose in order to best fit the needs of the user participant.
    Sec. 5. Section 135D.4, subsection 3, paragraph b, Code
 2024, is amended to read as follows:
    b. Participants The opportunity for participants without an
 electronic health records system to access health information
 from the Iowa health information network.
    Sec. 6. NEW SECTION. 135D.4A State-designated health data
 utility —— principles —— intent —— technical infrastructure
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 requirements.
    1. a. A state-designated health data utility facilitates
 the secure electronic sharing of health information and data
 across a variety of settings including health care delivery
 settings, payors, social care entities, and consumers.
    b. A state-designated HDU is designed to achieve better
 health care outcomes, improve the overall health and well-being
 of the people of the state, and reduce the cost of health
 care by creating a more seamless, transparent, and modernized
 approach to the sharing of health information and data.
    c. Utilization of health information and data requires
 appropriate governance and policy leadership. The
 state-designated HDU provides clear data governance, privacy,
 and security policies to facilitate the sharing of health
 information and data, ensuring that the health information and
 data follow the patient and improve the health of all citizens
 of the state.
    d. Health care professionals and entities have been subject
 to HIPAA since 1996, and HIPAA has driven initial efforts to
 develop a culture and infrastructure of health information
 governance. As holders of personal information, state agencies
 have a responsibility to demonstrate to the public the state’s
 commitment to respecting personal privacy.
    e. Health care entities have a duty to share health
 information and data, in accordance with applicable law, with
 other health care entities to ensure that optimal patient
 and population health is achieved. To further demonstrate
 the commitment to privacy, the state-designated HDU provides
 opt-out policies and procedures to allow patients to opt out of
 health information and data sharing.
    2. The purposes of the state-designated HDU include all of
 the following:
    a. The transmittal, collection, aggregation, and analysis
 of clinical information, public health data, and health
 administrative and operations data to assist the department,
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 local health departments, health care professionals, patients,
 policymakers, and the governing board in understanding the
 population health of Iowa.
    b. The enhancement and acceleration of the interoperability
 of health information and data throughout the state, ensuring
 compliance with all applicable privacy and security laws and
 regulations.
    c. The empowerment of patients in accessing and directing
 their health information and data, health care costs, and
 overall health to improve quality of life in the state.
    3. It is the intent of the general assembly that the
 state-designated HDU shall not constitute a health benefit
 network or a health insurance network.
    4. A state-designated HDU is created and shall operate
 as a public-private partnership. The state-designated HDU
 shall provide health information and data, in accordance with
 applicable law, to patients and organizations involved in the
 treatment and care coordination of patients, and shall support
 the health goals of the community and the state.
    5. The designated entity shall administer and govern
 the state-designated HDU. The state-designated HDU shall be
 comprised of all of the following data sources:
    a. A health information exchange. The governing board
 shall adopt health care information interoperability standards
 for the health information exchange. The minimum standard of
 sharing shall be the most recently approved version of the
 United States core data of interoperability. The minimum
 standard of sharing may be enhanced by the governing board.
    b. A pharmacy information exchange.
    (1) Unless otherwise prohibited by state or federal law,
 each licensed pharmacy that dispenses prescription drugs to
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