Iowa 2023 2023-2024 Regular Session

Iowa House Bill HSB623 Introduced / Bill

Filed 01/29/2024

                    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 1   state-designated health data utility. 2   BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3   TLSB 5482YC (11) 90   pf/ko  

  H.F. _____   Section 1. Section 135D.1, Code 2024, is amended to read as 1   follows: 2   135D.1 Short title. 3   This chapter shall be known and may be cited as the Iowa 4   Health Information Network and Health Data Utility Act . 5   Sec. 2. Section 135D.2, Code 2024, is amended to read as 6   follows: 7   135D.2 Definitions. 8   As used in this chapter , unless the context otherwise 9   requires: 10   1.   Board of directors or board means the entity that 11   governs and administers the Iowa health information network. 12   2. 1. Care coordination means the management of all 13   aspects of a patients care to improve health care quality. 14   2.   Community information exchange means an ecosystem 15   comprised of multidisciplinary network participants that 16   use standardized technical language, a resource database, 17   and an integrated technology platform to deliver enhanced   18   community care planning using care planning tools that enable   19   participants to integrate data from multiple sources and make 20   bidirectional referrals to create a shared longitudinal record.   21   3. Department means the department of health and human 22   services. 23   4. Designated entity means the nonprofit corporation 24   designated by the department through a competitive process as 25   the entity responsible for administering and governing the Iowa 26   health information network and the state-designated health data   27   utility . 28   5. Exchange means the authorized electronic sharing of 29   health information and data   between health care professionals, 30   payors, consumers, public health agencies, the designated 31   entity, the department, and other authorized   participants 32   utilizing the Iowa health information network , and Iowa health 33   information network services , and the state-designated HDU   . 34   6. Federally qualified health center means a health care 35   -1-   LSB 5482YC (11) 90   pf/ko   1/ 17                                 

  H.F. _____   entity that receives grant funding under section 330 of the 1   federal Public Health Service Act, Pub. L. No. 78-410.   2   7. Governing board means the board of directors that 3   governs and administers the designated entity. 4   6.   8. Health care professional means a person who is 5   licensed, certified, or otherwise authorized or permitted by 6   the law of this state to administer health care in the ordinary 7   course of business or in the practice of a profession. 8   9.   Health data utility means a locally governed, 9   statewide, multifaceted resource that provides services for the 10   interchange of health data within the health care and public   11   health ecosystems for the purpose of advancing health care 12   and improving public health outcomes. A health data utility 13   combines, enhances, and exchanges electronic health data across   14   care and service settings for treatment, care coordination, 15   quality improvement, and public and community health purposes, 16   in accordance with applicable state and federal laws protecting 17   patient privacy.   18   7.   10. Health information means health information as 19   defined in 45 C.F.R. 160.103 that is created or received by an 20   authorized   a participant. 21   11. Health information exchange means participants 22   contributing to the sharing and movement of health information   23   electronically across participants within a state, region, 24   community, or health care delivery system. 25   12. Health information network means participants in the 26   health information exchange in the aggregate. 27   8.   13. Health information technology means the 28   application of information processing, involving both computer 29   hardware and software, that deals with the storage, retrieval, 30   sharing, and use of health care information, data, and 31   knowledge for communication, decision making, quality, safety, 32   and efficiency of clinical practice, and may include but is not 33   limited to: 34   a. An electronic health record that electronically compiles 35   -2-   LSB 5482YC (11) 90   pf/ko   2/ 17                                            

  H.F. _____   and maintains health information that may be derived from 1   multiple sources about the health status of an individual ,   and 2   may include a core subset of each care delivery organizations 3   electronic medical record such as a continuity of care record 4   or a continuity of care document, computerized physician order 5   entry, electronic prescribing, or clinical decision support. 6   b. A personal health record through which an individual and 7   any other person authorized by the individual can maintain and 8   manage the individuals health information. 9   c. An electronic medical record that is used by health care 10   professionals to electronically document, monitor, and manage 11   health care delivery within a care delivery organization, is 12   the legal record of the patients encounter with the care 13   delivery organization, and is owned by the care delivery 14   organization. 15   d. A computerized provider   health care professional 16   order entry function that permits the electronic ordering of 17   diagnostic and treatment services, including prescription 18   drugs. 19   e. A decision support function to assist physicians and 20   other health care providers   professionals in making clinical 21   decisions by providing electronic alerts and reminders to 22   improve compliance with best practices, promote regular 23   screenings and other preventive practices, and facilitate 24   diagnosis and treatments   treatment . 25   f. Tools to allow for the collection, analysis, and 26   reporting of information or data on adverse events, the quality 27   and efficiency of care, patient satisfaction, and other health 28   care-related performance measures. 29   9.   14. Health Insurance Portability and Accountability 30   Act or HIPAA means the federal Health Insurance Portability 31   and Accountability Act of 1996, Pub. L. No. 104-191, including 32   amendments thereto and regulations promulgated thereunder. 33   10.   15. Hospital means a licensed hospital as defined in 34   section 135B.1 .   35   -3-   LSB 5482YC (11) 90   pf/ko   3/ 17             

  H.F. _____   11. 16. Interoperability means the ability of two or more 1   systems or components to exchange information or data in an 2   accurate, effective, secure, and consistent manner and to use 3   the information or data that has been exchanged and includes 4   but is not limited to: 5   a. The capacity to connect to a network for the purpose of 6   exchanging information or data with other users. 7   b. The ability of a connected , authenticated user   8   participant   to demonstrate appropriate permissions to 9   participate in the instant transaction over the network or the 10   state-designated HDU   . 11   c. The capacity of a connected , authenticated user 12   participant to access, transmit, receive, and exchange usable 13   information with other users   participants . 14   12. 17. Iowa health information network or network means 15   the statewide health information technology network that is 16   the state-designated exchange and the sole statewide health 17   information   network for Iowa pursuant to this chapter . 18   13.   18. Medicaid program means the medical assistance 19   program as defined in section 249A.2 . 20   19.   Nursing facility means a licensed nursing facility as 21   defined in section 135C.1. 22   14.   20. Participant means an authorized health care 23   professional, payor, patient, health care organization, public 24   health agency, or the department entity described in section 25   135D.4 that has agreed entered into an agreement to authorize, 26   submit, access, or disclose health information and data through 27   the Iowa health information network or the state-designated HDU 28   in accordance with this chapter and all applicable laws, rules, 29   agreements, policies, and standards. 30   15.   21. Patient means a person who has received or is 31   receiving health services from a health care professional. 32   16.   22. Payor means a person who makes payments for 33   health services, including but not limited to an insurance 34   company, self-insured employer, government program, individual, 35   -4-   LSB 5482YC (11) 90   pf/ko   4/ 17                                         

  H.F. _____   or other purchaser that makes such payments. 1   23.   Payor information exchange means a large-scale 2   database that systematically collects health care claims data 3   from a variety of payor sources, including claims from health 4   care professionals.   5   24.   Pharmacy means a pharmacy as defined in section 6   155A.3. 7   25. Pharmacy information exchange means the participants 8   contributing to the sharing and movement of dispensed pharmacy   9   information electronically across participants within a state, 10   region, community, or health care delivery system.   11   17. 26. Protected health information means protected 12   health information as defined in 45 C.F.R. 160.103 that is 13   created or received by an authorized   a participant. 14   18. 27. Public health activities means actions taken by 15   a participant in its the participants capacity as a public 16   health authority under the Health Insurance Portability and 17   Accountability Act or as required or permitted by other federal 18   or state law. 19   19.   28. Public health agency means an entity that is 20   governed by or contractually responsible to a local board of 21   health or the department to provide services focused on the 22   health status of population groups and their   the population 23   groups environments. 24   20. 29. Record locator service means the functionality of 25   the Iowa health information network that queries data sources 26   to locate and identify potential patient records. 27   30.   Rehabilitative services means the same as defined in 28   section 135C.1. 29   31.   Social care means any care, service, good, or supply 30   related to an individuals social needs.   Social care 31   includes but is not limited to support and assistance for an   32   individuals food stability and nutritional needs, housing, 33   transportation, economic stability, employment, education   34   access and quality, childcare and family relationship needs, 35   -5-   LSB 5482YC (11) 90   pf/ko   5/ 17                                                   

  H.F. _____   and environmental and physical safety. 1   32.   Social care referral system means a system that shares 2   an individuals social care information for the purpose of 3   referrals among health care entities, public health agencies, 4   and community-based organizations.   Social care referral 5   system   includes but is not limited to a network, software, or 6   technology platform. 7   33. State-designated health data utility or 8   state-designated HDU   means the health data utility designated 9   by the state under this chapter. 10   34.   State-designated health information exchange or 11   state-designated exchange means the Iowa health information 12   network. 13   Sec. 3. Section 135D.3, subsection 1, paragraph c, Code 14   2024, is amended to read as follows: 15   c. A health information network involves the secure   16   electronic sharing of health information across the boundaries 17   of individual practice and institutional health settings and   18   with consumers.   The broad use of health information technology 19   and a health information network should improve improves health 20   care quality and the overall health of the population, increase   21   increases efficiencies in administrative health care, reduce 22   reduces   unnecessary health care costs, and help helps prevent 23   medical errors. 24   Sec. 4. Section 135D.4, subsection 2, paragraph b, Code 25   2024, is amended to read as follows: 26   b. The network provides a variety of services from which to 27   choose in order to best fit the needs of the user participant . 28   Sec. 5. Section 135D.4, subsection 3, paragraph b, Code 29   2024, is amended to read as follows:   30   b. Participants   The opportunity for participants without an 31   electronic health records system to access health information 32   from the Iowa health information network.   33   Sec. 6. NEW SECTION   . 135D.4A State-designated health data 34   utility  principles  intent  technical infrastructure 35   -6-   LSB 5482YC (11) 90   pf/ko   6/ 17                                             

  H.F. _____   requirements. 1   1. a. A state-designated health data utility facilitates 2   the secure electronic sharing of health information and data 3   across a variety of settings including health care delivery 4   settings, payors, social care entities, and consumers. 5   b. A state-designated HDU is designed to achieve better 6   health care outcomes, improve the overall health and well-being 7   of the people of the state, and reduce the cost of health 8   care by creating a more seamless, transparent, and modernized 9   approach to the sharing of health information and data. 10   c. Utilization of health information and data requires 11   appropriate governance and policy leadership. The 12   state-designated HDU provides clear data governance, privacy, 13   and security policies to facilitate the sharing of health 14   information and data, ensuring that the health information and 15   data follow the patient and improve the health of all citizens 16   of the state. 17   d. Health care professionals and entities have been subject 18   to HIPAA since 1996, and HIPAA has driven initial efforts to 19   develop a culture and infrastructure of health information 20   governance. As holders of personal information, state agencies 21   have a responsibility to demonstrate to the public the states 22   commitment to respecting personal privacy. 23   e. Health care entities have a duty to share health 24   information and data, in accordance with applicable law, with 25   other health care entities to ensure that optimal patient 26   and population health is achieved. To further demonstrate 27   the commitment to privacy, the state-designated HDU provides 28   opt-out policies and procedures to allow patients to opt out of 29   health information and data sharing. 30   2. The purposes of the state-designated HDU include all of 31   the following: 32   a. The transmittal, collection, aggregation, and analysis 33   of clinical information, public health data, and health 34   administrative and operations data to assist the department, 35   -7-   LSB 5482YC (11) 90   pf/ko   7/ 17  

  H.F. _____   local health departments, health care professionals, patients, 1   policymakers, and the governing board in understanding the 2   population health of Iowa. 3   b. The enhancement and acceleration of the interoperability 4   of health information and data throughout the state, ensuring 5   compliance with all applicable privacy and security laws and 6   regulations. 7   c. The empowerment of patients in accessing and directing 8   their health information and data, health care costs, and 9   overall health to improve quality of life in the state. 10   3. It is the intent of the general assembly that the 11   state-designated HDU shall not constitute a health benefit 12   network or a health insurance network. 13   4. A state-designated HDU is created and shall operate 14   as a public-private partnership. The state-designated HDU 15   shall provide health information and data, in accordance with 16   applicable law, to patients and organizations involved in the 17   treatment and care coordination of patients, and shall support 18   the health goals of the community and the state. 19   5. The designated entity shall administer and govern 20   the state-designated HDU. The state-designated HDU shall be 21   comprised of all of the following data sources: 22   a. A health information exchange. The governing board 23   shall adopt health care information interoperability standards 24   for the health information exchange. The minimum standard of 25   sharing shall be the most recently approved version of the 26   United States core data of interoperability. The minimum 27   standard of sharing may be enhanced by the governing board. 28   b. A pharmacy information exchange. 29   (1) Unless otherwise prohibited by state or federal law, 30   each licensed pharmacy that dispenses prescription drugs to 31   patients in the state shall provide all dispensed prescription 32   information to the state-designated HDU in compliance with all 33   applicable state and federal rules. 34   (2) The governing board shall adopt interoperability 35   -8-   LSB 5482YC (11) 90   pf/ko   8/ 17  

  H.F. _____   standards, data elements, and terminologies necessary to 1   provide data in as close to real time as possible to facilitate 2   data exchange. 3   c. A payor information exchange. The governing board shall 4   adopt the interoperability standards for claims data sharing by 5   all payors required to share data. 6   d. A community information exchange. The governing board 7   shall adopt the interoperability standards for data sharing by 8   social care entities specified by the governing board. 9   6. By December 31, 2024, all hospitals, critical access 10   hospitals, general acute care hospitals, rehabilitative 11   hospitals, provider clinics, ambulatory surgical centers, 12   mental health and substance use treatment centers, psychiatric 13   or mental hospitals, facilities providing rehabilitative 14   services, imaging centers, laboratories, federally qualified 15   health centers, and payors in the state shall be participants 16   with the state-designated HDU, and shall share all data in 17   accordance with standards, policies, and procedures adopted by 18   the governing board pursuant to this chapter. 19   7. By March 31, 2025, all entities utilizing digital 20   technology for the purposes of social care referral and 21   care coordination in the state, including but not limited to 22   community-based organizations, shall be participants with the 23   state-designated HDU, and shall share data in accordance with 24   federal interoperability guidance and policies adopted by the 25   governing board pursuant to this chapter. 26   8. By December 31, 2025, all health clinics, public health 27   clinics, urgent care facilities, nursing facilities, and 28   pharmacies shall be participants with the state-designated 29   HDU, and shall share all data in accordance with policies and 30   procedures adopted by the governing board pursuant to this 31   chapter. 32   Sec. 7. Section 135D.5, Code 2024, is amended to read as 33   follows:   34   135D.5 Designated entity  selection,   administration , and 35   -9-   LSB 5482YC (11) 90   pf/ko   9/ 17    

  H.F. _____   governance. 1   1. The Iowa health information network and the   2   state-designated HDU shall be administered and governed 3   by a designated entity selected by the department through 4   a competitive process. The designated entity shall be 5   established as a nonprofit corporation organized under 6   chapter 504 . Unless otherwise provided in this chapter , the 7   corporation is subject to the provisions of chapter 504 . 8   The designated entity shall be established for the purpose   9   of administering and governing the statewide Iowa health 10   information network.   11   2. The designated entity shall collaborate with the 12   department, but the designated entity shall not be considered, 13   in whole or in part, an agency, department, or administrative 14   unit of the state. 15   a. The designated entity shall not be required to comply 16   with any requirements that apply to a state agency, department, 17   or administrative unit and shall not exercise any sovereign 18   power of the state. 19   b. The designated entity does not have authority to pledge 20   the credit of the state. The assets and liabilities of 21   the designated entity shall be separate from the assets and 22   liabilities of the state and the state shall not be liable 23   for the debts or obligations of the designated entity. All 24   debts and obligations of the designated entity shall be payable 25   solely from the designated entitys funds. The state shall 26   not guarantee any obligation of or have any obligation to the 27   designated entity. 28   3. The articles of incorporation of the designated entity 29   shall provide for its   the designated entitys governance and 30   its efficient management. In providing for its the designated 31   entitys   governance, the articles of incorporation of the 32   designated entity shall address the following: 33   a. A governing   board of directors to govern the designated 34   entity. 35   -10-   LSB 5482YC (11) 90   pf/ko   10/ 17                

  H.F. _____   b. The appointment of a chief executive officer by the 1   governing   board to manage the designated entitys daily 2   operations. 3   c. The delegation of such powers and responsibilities to the 4   chief executive officer as may be necessary for the designated 5   entitys efficient operation. 6   d. The employment of personnel necessary for the efficient 7   performance of the duties assigned to the designated entity. 8   All such personnel shall be considered employees of a private,   9   nonprofit corporation and shall be exempt from the personnel 10   requirements imposed on state agencies, departments, and   11   administrative units. 12   e. The financial operations of the designated entity 13   including the authority to receive and expend funds from public 14   and private sources and to use its property, money, or other 15   resources for the purpose of the designated entity. 16   Sec. 8. Section 135D.6, Code 2024, is amended to read as 17   follows: 18   135D.6 Board of directors   Governing board  composition  19   duties. 20   1. The designated entity shall be administered by a 21   governing   board of directors . 22   2. A single industry shall not be disproportionately 23   represented as voting members of the governing   board. The 24   governing board shall include at least one member who is a 25   consumer of health services and a majority of the voting 26   members of the governing board shall be representative of 27   participants in the Iowa health information network and 28   the state-designated HDU . The director of health and human 29   services or the directors designee and the director of the 30   Medicaid program or the directors designee shall act as 31   voting members of the governing   board. The commissioner of 32   insurance shall act as an ex officio, nonvoting member of 33   the governing   board. Individuals serving in an ex officio, 34   nonvoting capacity shall not be included in the total number of 35   -11-   LSB 5482YC (11) 90   pf/ko   11/ 17                  

  H.F. _____   individuals authorized as members of the governing board. 1   3. The governing   board of directors shall do all of the 2   following: 3   a. Ensure that the designated entity enters into contracts 4   with each state agency necessary for state reporting 5   requirements. 6   b. Develop, implement, and enforce the following: 7   (1) A single patient identifier or alternative mechanism 8   to share secure patient health   information and data that is 9   utilized by all health care professionals. 10   (2) Standards, requirements, policies, and procedures 11   for access to, use, secondary use, privacy, and security of 12   health information and data, including clinical information,   13   exchanged through the Iowa health information network and the   14   state-designated HDU , consistent with applicable federal and 15   state standards and laws. 16   c. Direct a public and private collaborative effort to 17   promote the adoption and use of health information technology 18   in the state to improve health care quality, increase patient 19   safety, reduce health care costs, enhance public health, 20   and empower individuals and health care professionals with 21   comprehensive, real-time medical information to provide 22   continuity of care and make the best health care decisions. 23   d. Educate the public and the health care sector about 24   the value of health information technology in improving 25   patient care, and methods to promote increased support and 26   collaboration of state and local public health agencies, 27   health care professionals, and consumers in health information 28   technology initiatives. 29   e. Work to align interstate and intrastate interoperability 30   standards in accordance with national health information 31   exchange standards. 32   f. Provide an annual budget and fiscal report for the Iowa 33   health information network and the state-designated HDU   to the 34   governor, the department of health and human services , the 35   -12-   LSB 5482YC (11) 90   pf/ko   12/ 17            

  H.F. _____   department of management, the chairs and ranking members of the 1   legislative government oversight standing committees,   and the 2   legislative services agency. The report shall also include 3   information about the services provided through the network and 4   the state-designated HDU   and information on the participant 5   usage of the network and the state-designated HDU   . 6   g. Ensure any health information and data within the 7   state-designated HDU is shared and accessed according to all 8   applicable state and federal laws and standards, including   9   HIPAA, to uphold the privacy and security of a patients 10   protected health information.   11   Sec. 9. Section 135D.7, Code 2024, is amended to read as 12   follows: 13   135D.7 Legal and policy  liability  confidentiality. 14   1. The governing   board shall implement industry-accepted 15   security standards, policies, and procedures to protect the 16   transmission and receipt of protected health information and 17   data   exchanged through the Iowa health information network and 18   the state-designated HDU   , which shall, at a minimum, comply 19   with HIPAA and shall include all of the following: 20   a. A secure and traceable electronic audit system to 21   document and monitor the sender and recipient of health 22   information exchanged through the Iowa health information 23   network. 24   b. A required standard participation agreement which 25   defines the minimum privacy and security obligations of all 26   participants using the Iowa health information network or the   27   state-designated HDU, and services available through the Iowa 28   health information network and the state-designated HDU . 29   c. The opportunity for a patient to decline exchange of the 30   patients health information or data   through the record locator 31   service of the Iowa health information network or through the   32   state-designated HDU . 33   (1) A patient shall not be denied care or treatment for 34   declining to exchange the patients health information or   35   -13-   LSB 5482YC (11) 90   pf/ko   13/ 17                          

  H.F. _____   data , in whole or in part, through the network or through the 1   state-designated HDU   . 2   (2) The governing board shall provide the means and process 3   by which a patient may decline participation. The means and 4   process utilized shall minimize the burden on patients and 5   health care professionals. 6   (3) Unless otherwise authorized by law or rule, a patients 7   decision to decline participation means that none of the 8   patients health information or data   shall be accessible 9   through the record locator service function of the Iowa health 10   information network or through the state-designated HDU   . A 11   patients decision to decline having health information or 12   data shared through the record locator service function or 13   through the state-designated HDU   shall not limit a health 14   care professional with whom the patient has or is considering 15   a treatment relationship from sharing health information 16   concerning the patient through the secure messaging function of 17   the Iowa health information network. 18   (4) A patient who declines participation in the Iowa 19   health information network or the state-designated HDU   may 20   later decide to have the patients   health information or data 21   shared through the network or through the state-designated 22   HDU   . A patient who is participating in the network or the 23   state-designated HDU may later decline participation in the 24   network or the state-designated HDU . 25   2. A participant shall not be compelled by subpoena, court 26   order, or other process of law to access health information or 27   data through the Iowa health information network or through the 28   state-designated HDU in order to gather records or information 29   not created by the participant. 30   3. A participant exchanging health information and data 31   through the Iowa health information network or through the   32   state-designated HDU shall grant to other participants of the 33   network or the state-designated HDU   a nonexclusive license to 34   retrieve and use that health information or data in accordance 35   -14-   LSB 5482YC (11) 90   pf/ko   14/ 17                             

  H.F. _____   with applicable state and federal laws, and the policies and 1   standards established by the governing   board. 2   4. A health care professional who relies reasonably and 3   in good faith upon any health information or data provided 4   through the Iowa health information network or through the   5   state-designated HDU   in the treatment of a patient who is the 6   subject of the health information or data shall be immune 7   from criminal or civil liability arising from the damages 8   caused by such reasonable, good-faith reliance. Such immunity 9   shall not apply to acts or omissions constituting negligence, 10   recklessness, or intentional misconduct. 11   5. A participant who has disclosed health information or   12   data through the Iowa health information network or through the 13   state-designated HDU   in compliance with applicable law and the 14   standards, requirements, policies, procedures, and agreements 15   of the Iowa health information network or the state-designated 16   HDU shall not be subject to criminal or civil liability for the 17   use or disclosure of the health information or data   by another 18   participant. 19   6. The following records shall be confidential records 20   pursuant to chapter 22 , unless otherwise ordered by a court or 21   consented to by the patient or by a person duly authorized to 22   release such information: 23   a. The health information contained in, stored in, submitted 24   to, transferred or exchanged by, or released from the Iowa 25   health information network or the state-designated HDU   . 26   b. Any health information or data in the possession of the 27   governing board due to its administration and governance of the 28   Iowa health information network or the state-designated HDU . 29   7. Unless otherwise provided in this chapter , when sharing 30   health information or data   through the Iowa health information 31   network or   , through the state-designated HDU, or through a 32   private health information network maintained in this state 33   that complies with the privacy and security requirements of 34   this chapter for the purposes of patient treatment, payment ,   35   -15-   LSB 5482YC (11) 90   pf/ko   15/ 17                         

  H.F. _____   or health care operations, as such terms are defined in 1   HIPAA, or for the purposes of public health activities or care 2   coordination, a participant authorized by the designated entity 3   to use the record locator service or the state-designated HDU   4   is exempt from any other state law that is more restrictive 5   than HIPAA that would otherwise prevent or hinder the exchange 6   of patient information or data by the participant. 7   8. A patient aggrieved or adversely affected by the 8   designated entitys failure to comply with subsection 1, 9   paragraph c , may bring a civil action for equitable relief as 10   the court deems appropriate. 11   Sec. 10. NEW SECTION   . 135D.8 Funding. 12   The department may expend funds appropriated to or received 13   by the department for the purposes of this chapter to carry out 14   the requirements of this chapter. 15   EXPLANATION 16   The inclusion of this explanation does not constitute agreement with 17   the explanations substance by the members of the general assembly. 18   This bill relates to the Iowa health information network 19   (IHIN) under Code chapter 135D (Iowa health information 20   network) and a state-designated health data utility (HDU). 21   The bill includes definitions used in the bill. 22   The bill requires the designated entity to administer and 23   govern the state-designated HDU for the state. Health data 24   utility is defined under the bill as a locally governed, 25   multifaceted resource that provides services for the 26   interchange of health data within the health care and public 27   health ecosystems for the purpose of advancing health care and 28   improving public health outcomes. A health data utility 29   combines, enhances, and exchanges electronic health data across 30   care and service settings for treatment, care coordination, 31   quality improvement, and public and community health purposes, 32   in accordance with applicable state and federal laws protecting 33   patient privacy. 34   The bill provides the principles, intent, and technical 35   -16-   LSB 5482YC (11) 90   pf/ko   16/ 17     

  H.F. _____   infrastructure requirements for the state-designated HDU, 1   including that the state-designated HDU include data from a 2   health information exchange, a pharmacy information exchange, 3   a payor information exchange, and a community information 4   exchange. 5   The bill requires certain entities to participate in the 6   state-designated HDU by specified dates. 7   The bill provides that the department of health and human 8   services (HHS) may expend funds appropriated to or received by 9   HHS for the purposes of the bill to carry out the requirements 10   of the bill. 11   -17-   LSB 5482YC (11) 90   pf/ko   17/ 17