New SHIN-NY Rules Proposed

September 12, 2014 | Health Services

In an effort to advance health information technology (IT) adoption and interoperability across the state, the New York State Department of Health (the “DOH”) has issued draft rules for the Statewide Health Information Network for New York (“SHIN-NY”).  The purpose of the rules is aimed at formalizing and updating the current governance structure and process for the operation of SHIN-NY.  Through implementation, the DOH intends to facilitate broad adoption of health information exchange (“HIE”),  increasing patient record availability statewide, reducing barriers for electronic health record (“EHR”) integration, and establishing a core set of HIE clinical and administrative services which are available to all providers and patients in New York State. 

Development of SHIN-NY Policy 

The rule would require the DOH to enter into contract with a State Designated Entity (“SDE”), such as the New York eHealth Collaborative, Inc. (“NYeHC”), which would operate SHIN-NY.  In addition to operations, the SDE would be responsible for implementing a strategy to increase adoption of the SHIN-NY by hospitals, physician practices, clinics and long-term care facilities, engage health plans to connect to the SHIN-NY, and increase utilization of the SHIN-NY in the public health context. The DOH and SDE will develop policy standards for SHIN-NY including privacy and security, patient rights, and the creation of a uniform certification process for Qualified health IT entities (“QEs”). The SDE will also be responsible for auditing and contract enforcement of such QEs.  Through participation agreements and compliance with federal requirements, QEs and QE participants will be able to access patient information without written patient authorization. 

Statewide Collaboration Process and Key Players

A statewide collaboration process is imperative for implementation of this rule and will require contribution from SHIN-NY stakeholders to develop SHIN-NY policy standards.  Such stakeholders include the DOH, the SDE, QEs, and QE participants which are any health care provider, health plan, State of local health department, or other entity that is qualified by the SHIN-NY policy standards and has executed a participation agreement with a QE.  The SDE will likely establish workgroups, forums and committees to solicit recommendations for policy, services and products as it will be required to submit proposed SHIN-NY policy standards annually to the DOH. 

Compliance Schedule and Cost 

One year from the effective date of the regulation, Regional Health Information Organizations (“RHIOs”) and QEs will be required to meet the certification requirements and provide baseline services to providers.  Health care facilities utilizing certified EHR technology must connect to the SHIN-NY through a QE, 2 years from the effective date of the regulation.  Physician practices that utilize certified EHR technology to qualify for meaningful use incentives, but are not regulated by the DOH, are encouraged but not required to connect.  The DOH estimates that the interface costs will average $75,000 for hospitals and $5000-$10,000 for physician practices.  The costs for other types of facilities, including nursing homes and home health agencies, will fall between physician practices and hospitals.  It is estimated that SHIN-NY will cost approximately $70 million annually for operations, development, member services and statewide policy work.  As the rule is touted as a “public good” model, certain baseline technical and administrative services will be made available to providers, at no charge.  

Conclusion 

With the inevitable shift towards adoption of EHR technology, providing such baseline services and developing policy will set a statewide standard to promote efficient access to patient information. Organizations such as HANYS and GNYHA have already expressed their support for the new rule which is open for public comment until October 20th.

End Notes

Proposed Addition of Part 300 to Title 10 NYCRR: http://w3.health.state.ny.us/dbspace/propregs.nsf/4ac9558781006774852569bd00512fda/e00f1f2cd3b9582285257d43006a8427?OpenDocument

  1. Current SHIN-NY policy standards: https://www.health.ny.gov/technology/regulations/shin-ny/ 
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