NC HealthConnex System: Fact vs. Fiction
Tammy has been seeing her family practice physician for 22 years. He was the doctor who detected symptoms which led to her cancer diagnosis many years ago. “I can’t imagine seeing anyone else after all these years.” Unfortunately, Tammy has to find a new physician by next year. Tammy’s doctor posted a notice in his office telling patients he would no longer accept insurance provided by the State Health Care Plan as of June 2020 because of a mandatory requirement that he participate in the North Carolina Health Information Exchange. This requirement isn’t new, but it’s recently caused some confusion for patients like Tammy who first heard about the Health Information Exchange via notices in their doctors’ waiting rooms. Since the deadline for compliance with the mandatory reporting requirement has been extended another year by our General Assembly, it’s time to clear up a few things.
The Statewide Health Information Exchange system, created in 2011 and expanded in 2015, requires data reporting from healthcare providers that receive state funds (e.g., Medicaid, Medicare, NC Health Choice, State Health plan). The exchange system policy is designed to help doctors communicate about patients’ medical histories so they can provide well-informed medical care to patients within these systems. All providers must connect to the NC HealthConnex system to continue to receive payments for services provided. The General Assembly passed a law this session (House Bill 70) that was signed by the Governor on June 6 which extended the deadline for mandatory participation requirement by one year, until 2020, to allow all providers to comply with the law, as some rural providers were having difficulty obtaining the computer equipment needed for participation. Providers who do not receive state funding may also connect to the NC HIEA on a voluntary basis.
Participating providers can receive information about their patients, including laboratory results, diagnostic studies and clinical documents. Healthcare providers currently house this information on site, but NC HealthConnex allows providers to access information about a patient’s allergies, immunizations, medications, procedures and test results across the entire network of participating healthcare providers in North Carolina. According to the NC Health Information Exchange Authority’s website, NC HealthConnex’s notification services can also alert providers if their patient’s health status changes, including when their patients receive acute and ambulatory health interventions. The goal of this service is to help doctors form an evolving and holistic view of their patients’ charts and medical histories before providing new services.
Tammy’s physician expressed concern that he was being forced to disclose a patient’s health care information and violate his oath as a physician, but this fear is really unfounded. Permitted uses of HealthConnex data include only those allowable under HIPAA and applicable law, and no data related to psychotherapy, substance abuse and/or alcoholism can be submitted to the exchange. Additionally, patients may even choose to opt out of the NC HealthConnex system if they prefer not to participate in the information exchange. The main goal of the information sharing system is to support and enrich care coordination between care providers, not to put patients and providers in the binds of an ethical dilemma.
Health Information Exchanges exist in all fifty states and in six U.S. territories. I believe the NC HealthConnex system will improve patient care by allowing physicians and other care providers to share information and create a holistic approach to health care. Both the General Assembly and Governor Cooper have allowed healthcare providers more time to comply with the system requirements by passing SL 2019–23. With the implementation of NC HealthConnex, we have the opportunity to provide better, more informed healthcare for our State employees and retirees. I hope that Tammy’s physician will soon change his opinion on the system and continue to provide care to all of his patients, including those within the State Health Care Plan.
