House File 2623 - Introduced
HOUSE FILE 2623
BY COMMITTEE ON HEALTH AND
HUMAN SERVICES
(SUCCESSOR TO HSB 623)
A BILL FOR
1 An Act relating to the Iowa health information network
2 including functioning as the state-designated health data
3 utility.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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1 Section 1. Section 135D.2, Code 2024, is amended to read as
2 follows:
3 135D.2 Definitions.
4 As used in this chapter, unless the context otherwise
5 requires:
6 1. “Board of directors” or “board” means the entity that
7 governs and administers the Iowa health information network.
8 2. 1. “Care coordination” means the management of all
9 aspects of a patient’s care to improve health care quality.
10 2. “Community information exchange” means an ecosystem
11 comprised of multidisciplinary network participants that
12 use standardized technical language, a resource database,
13 and an integrated technology platform to deliver enhanced
14 community care planning using care planning tools that enable
15 participants to integrate data from multiple sources and make
16 bidirectional referrals to create a shared longitudinal record.
17 3. “Department” means the department of health and human
18 services.
19 4. “Designated entity” means the nonprofit corporation
20 designated by the department through a competitive process as
21 the entity responsible for administering and governing the Iowa
22 health information network.
23 5. “Exchange” means the authorized electronic sharing of
24 health information and data between health care professionals,
25 payors, consumers, public health agencies, the designated
26 entity, the department, and other authorized participants
27 utilizing the Iowa health information network and Iowa health
28 information network services.
29 6. “Federally qualified health center” means a health care
30 entity that receives grant funding under section 330 of the
31 federal Public Health Service Act, Pub. L. No. 78-410.
32 7. “Governing board” means the board of directors that
33 governs and administers the designated entity.
34 6. 8. “Health care professional” means a person who is
35 licensed, certified, or otherwise authorized or permitted by
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1 the law of this state to administer health care in the ordinary
2 course of business or in the practice of a profession.
3 9. “Health data utility” means a locally governed,
4 statewide, multifaceted resource that provides services for the
5 interchange of health data within the health care and public
6 health ecosystems for the purpose of advancing health care
7 and improving public health outcomes. A “health data utility”
8 combines, enhances, and exchanges electronic health data across
9 care and service settings for treatment, care coordination,
10 quality improvement, and public and community health purposes,
11 in accordance with applicable state and federal laws protecting
12 patient privacy.
13 7. 10. “Health information” means health information as
14 defined in 45 C.F.R. §160.103 that is created or received by an
15 authorized a participant.
16 11. “Health information exchange” means participants
17 contributing to the sharing and movement of health information
18 electronically across participants within a state, region,
19 community, or health care delivery system.
20 12. “Health information network” means participants in the
21 health information exchange in the aggregate.
22 8. 13. “Health information technology” means the
23 application of information processing, involving both computer
24 hardware and software, that deals with the storage, retrieval,
25 sharing, and use of health care information, data, and
26 knowledge for communication, decision making, quality, safety,
27 and efficiency of clinical practice, and may include but is not
28 limited to:
29 a. An electronic health record that electronically compiles
30 and maintains health information that may be derived from
31 multiple sources about the health status of an individual and
32 may include a core subset of each care delivery organization’s
33 electronic medical record such as a continuity of care record
34 or a continuity of care document, computerized physician order
35 entry, electronic prescribing, or clinical decision support.
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1 b. A personal health record through which an individual and
2 any other person authorized by the individual can maintain and
3 manage the individual’s health information.
4 c. An electronic medical record that is used by health care
5 professionals to electronically document, monitor, and manage
6 health care delivery within a care delivery organization, is
7 the legal record of the patient’s encounter with the care
8 delivery organization, and is owned by the care delivery
9 organization.
10 d. A computerized provider health care professional
11 order entry function that permits the electronic ordering of
12 diagnostic and treatment services, including prescription
13 drugs.
14 e. A decision support function to assist physicians and
15 other health care providers professionals in making clinical
16 decisions by providing electronic alerts and reminders to
17 improve compliance with best practices, promote regular
18 screenings and other preventive practices, and facilitate
19 diagnosis and treatments treatment.
20 f. Tools to allow for the collection, analysis, and
21 reporting of information or data on adverse events, the quality
22 and efficiency of care, patient satisfaction, and other health
23 care-related performance measures.
24 9. 14. “Health Insurance Portability and Accountability
25 Act” or “HIPAA” means the federal Health Insurance Portability
26 and Accountability Act of 1996, Pub. L. No. 104-191, including
27 amendments thereto and regulations promulgated thereunder.
28 10. 15. “Hospital” means a licensed hospital as defined in
29 section 135B.1.
30 11. 16. “Interoperability” means the ability of two or more
31 systems or components to exchange information or data in an
32 accurate, effective, secure, and consistent manner and to use
33 the information or data that has been exchanged and includes
34 but is not limited to:
35 a. The capacity to connect to a network for the purpose of
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1 exchanging information or data with other users.
2 b. The ability of a connected, authenticated user
3 participant to demonstrate appropriate permissions to
4 participate in the instant transaction over the network.
5 c. The capacity of a connected, authenticated user
6 participant to access, transmit, receive, and exchange usable
7 information with other users participants.
8 12. 17. “Iowa health information network” or “network” means
9 the statewide health information technology network that is the
10 sole statewide health information network for Iowa pursuant to
11 this chapter.
12 13. 18. “Medicaid program” means the medical assistance
13 program as defined in section 249A.2.
14 19. “Nursing facility” means a licensed nursing facility as
15 defined in section 135C.1.
16 14. 20. “Participant” means an authorized health care
17 professional, payor, patient, health care organization, public
18 health agency, or the department entity described in section
19 135D.4, subsection 4, paragraph “d”, that has agreed entered
20 into an agreement to authorize, submit, access, or disclose
21 health information and data through the Iowa health information
22 network in accordance with this chapter and all applicable
23 laws, rules, agreements, policies, and standards.
24 15. 21. “Patient” means a person who has received or is
25 receiving health services from a health care professional.
26 16. 22. “Payor” means a person who makes payments for
27 health services, including but not limited to an insurance
28 company, self-insured employer, government program, individual,
29 or other purchaser that makes such payments.
30 23. “Payor information exchange” means a large-scale
31 database that systematically collects health care claims data
32 from a variety of payor sources, including claims from health
33 care professionals.
34 24. “Pharmacy” means a pharmacy as defined in section
35 155A.3.
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1 25. “Pharmacy information exchange” means the participants
2 contributing to the sharing and movement of dispensed pharmacy
3 information electronically across participants within a state,
4 region, community, or health care delivery system.
5 17. 26. “Protected health information” means protected
6 health information as defined in 45 C.F.R. §160.103 that is
7 created or received by an authorized a participant.
8 18. 27. “Public health activities” means actions taken by
9 a participant in its the participant’s capacity as a public
10 health authority under the Health Insurance Portability and
11 Accountability Act or as required or permitted by other federal
12 or state law.
13 19. 28. “Public health agency” means an entity that is
14 governed by or contractually responsible to a local board of
15 health or the department to provide services focused on the
16 health status of population groups and their the population
17 groups’ environments.
18 20. 29. “Record locator service” means the functionality of
19 the Iowa health information network that queries data sources
20 to locate and identify potential patient records.
21 30. “Rehabilitative services” means the same as defined in
22 section 135C.1.
23 31. “Social care” means any care, service, good, or supply
24 related to an individual’s social needs. “Social care”
25 includes but is not limited to support and assistance for an
26 individual’s food stability and nutritional needs, housing,
27 transportation, economic stability, employment, education
28 access and quality, child care and family relationship needs,
29 and environmental and physical safety.
30 32. “Social care referral system” means a system that shares
31 an individual’s social care information for the purpose of
32 referrals among health care entities, public health agencies,
33 and community-based organizations. “Social care referral
34 system” includes but is not limited to a network, software, or
35 technology platform.
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1 Sec. 2. Section 135D.3, subsection 1, paragraph c, Code
2 2024, is amended to read as follows:
3 c. A health information network involves the secure
4 electronic sharing of health information across the boundaries
5 of individual practice and institutional health settings and
6 with consumers. The broad use of health information technology
7 and a health information network should improve improves health
8 care quality and the overall health of the population, increase
9 increases efficiencies in administrative health care, reduce
10 reduces unnecessary health care costs, and help helps prevent
11 medical errors.
12 Sec. 3. Section 135D.4, Code 2024, is amended to read as
13 follows:
14 135D.4 Iowa health information network —— principles
15 —— technical infrastructure requirements —— function as
16 state-designated health data utility.
17 1. The Iowa health information network shall be
18 administered and governed by a designated entity using, at a
19 minimum, the following principles:
20 a. Be patient-centered and market-driven.
21 b. Comply with established national standards.
22 c. Protect the privacy of consumers and the security and
23 confidentiality of all health information.
24 d. Promote interoperability.
25 e. Increase the accuracy, completeness, and uniformity of
26 data.
27 f. Preserve the choice of the patient to have the patient’s
28 health information available through the record locator
29 service.
30 g. Provide education to the general public and provider
31 communities on the value and benefits of health information
32 technology.
33 2. Widespread adoption of health information technology is
34 critical to a successful Iowa health information network and is
35 best achieved when all of the following occur:
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1 a. The network, through the designated entity complying
2 with chapter 504 and reporting as required under this chapter,
3 operates in an entrepreneurial and businesslike manner in which
4 it is accountable to all participants utilizing the network’s
5 products and services.
6 b. The network provides a variety of services from which to
7 choose in order to best fit the needs of the user participant.
8 c. The network is financed by all who benefit from the
9 improved quality, efficiency, savings, and other benefits that
10 result from use of health information technology.
11 d. The network is operated with integrity and freedom from
12 political influence.
13 3. The Iowa health information network technical
14 infrastructure shall provide a mechanism for all of the
15 following:
16 a. The facilitation and support of the secure electronic
17 exchange of health information between participants.
18 b. Participants The opportunity for the participants
19 without an electronic health records system to access health
20 information from the Iowa health information network.
21 4. a. Beginning July 1, 2024, the Iowa health information
22 network shall function as the state-designated health data
23 utility or state-designated HDU, operated and governed by the
24 designated entity. The state-designated HDU shall operate as a
25 public-private partnership to facilitate the secure electronic
26 sharing of health information and data across a variety of
27 settings including health care delivery settings, payors,
28 social care entities, and consumers.
29 (1) The state-designated HDU is designed to achieve better
30 health care outcomes, improve the overall health and well-being
31 of the people of the state, and reduce the cost of health
32 care by creating a more seamless, transparent, and modernized
33 approach to the sharing of health information and data.
34 (2) Utilization of health information and data requires
35 appropriate governance and policy leadership. The
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1 state-designated HDU provides clear data governance, privacy,
2 and security policies to facilitate the sharing of health
3 information and data, ensuring that the health information and
4 data follow the patient and improve the health of all citizens
5 of the state.
6 (3) Health care professionals and entities have been
7 subject to HIPAA since 1996, and HIPAA has driven initial
8 efforts to develop a culture and infrastructure of health
9 information governance. As holders of personal information,
10 state agencies have a responsibility to demonstrate to the
11 public the state’s commitment to respecting personal privacy.
12 (4) Health care entities have a duty to share health
13 information and data, in accordance with applicable law, with
14 other health care entities to ensure that optimal patient
15 and population health is achieved. To further demonstrate
16 the commitment to privacy, the state-designated HDU provides
17 opt-out policies and procedures to allow patients to opt out of
18 health information and data sharing.
19 b. The purposes of the state-designated HDU include all of
20 the following:
21 (1) The transmittal, collection, aggregation, and analysis
22 of clinical information, public health data, and health
23 administrative and operations data to assist the department,
24 local health departments, health care professionals, patients,
25 policymakers, and the governing board in understanding the
26 population health of Iowa.
27 (2) The enhancement and acceleration of the
28 interoperability of health information and data throughout the
29 state, ensuring compliance with all applicable privacy and
30 security laws and regulations.
31 (3) The empowerment of patients in accessing and directing
32 their health information and data, health care costs, and
33 overall health to improve quality of life in the state.
34 c. The state-designated HDU