Counterpoint: Oklahoma Health Care Authority was never created to make mandates for all providers

The Oklahoma Health Care Authority recently published a fact sheet about the Oklahoma State Health Information Network Exchange (OKSHINE) that shows health information exchanges (HIEs) have been in the works for nearly a decade, making it seem like people are making a fuss about something they should have spoken up about long ago.

But because the Health Care Authority has never had any authority over ALL mental health care providers before, no one was watching the rules they were trying to implement. If you are a provider in private practice, and do not have a contract with the Oklahoma Health Care Authority, you never report anything to them, you don’t deal with them at all. You would have no reason to even wonder what they are up to, or to go look.

This is why providers felt blindsided when a public meeting alerted everyone that the Health Care Authority is mandating participation from ALL mental health providers to participate in the health information exchange, OKSHINE, through the state designated entity, MyHealth.

According to OKSHINE, “In choosing MyHealth … existing legal agreements and policies remain in place.”

This is not true, private practice mental health providers do not currently upload their information into a statewide database and are not required to participate in any Oklahoma Health Care Authority contracts or programs. The state has never mandated what electronic health record (EHR) platforms we must use. This changes quite a bit for those in a private practice setting, many of whom are single providers working from a small office.

Another take: Point: Health information exchange delivers greater patient safety, more efficient care

Truly, the state Health Care Authority has not thought through all aspects of this program. At a recent Q&A session, officials were unable to answer questions about basic fees or what exemptions might look like.

Additionally, participants were told MyHealth retains records indefinitely, instead of destroying them after seven years, an industry standard.

Concerned clients are told they have no need to worry, because they can “opt out” of the process. This is deceptive. In their own fact sheet, the Oklahoma Health Care Authority notes that “providers will continue to use and maintain information in their own systems, but opting out will remove the ability for that information to be shared with other providers." Elsewhere, they state that such information may be accessible in “emergency” situations, which are currently defined as an emergency room visit with an emergency provider.

Additionally, the state Health Care Authority and OKSHINE keep updating their website information, rewording and rephrasing what they said previously. They then seem to be pointing out what others say as “misinformation,” and this feels dismissive. This feels like the Oklahoma Health Care Authority is not being open and honest, and they do not have all the details fully lined out.

Mental health information is incredibly private in nature, and people seek out care from private cash-only providers to keep that information out of their overall medical record. It is a privilege to be able to pay cash for services, but it is still an option that may soon disappear.

MyHealth CEO David Kendrick said, “The currency HIEs run on is trust …” But we already know that medical information isn’t safe in these HIE systems. Medical data breaches have become common news.

The “currency” that HIEs operate from depends on other providers always accessing this information correctly, the system not being hacked or stolen, and on opt-out forms that require a person to break their own confidentiality to “opt out.”

At its heart, privacy is about consent — knowing and giving permission when a person is accessing your information and for what purpose. If the Oklahoma Health Care Authority wants to introduce more integrated care, they can start by being more collaborative with the people they serve.

The bottom line is this: Mental health records do not belong in the HIE system at all and should be excluded, except perhaps as an “opt-in” rather than an “opt-out.” Private providers should not be subjected to this mandate at all. And the Oklahoma Health Care Authority should not be given carte blanche to determine what providers they have authority over.

Sabrina DeQuasie, MS LPC-S, is a concerned mental health provider.

This article originally appeared on Oklahoman: Guest: Mental health records do not belong in HIE system