HLS 18RS-278 ORIGINAL
2018 Regular Session
HOUSE BILL NO. 657
BY REPRESENTATIVE SIMON
HEALTH CARE/RECORDS: Requires interoperability of electronic health records
1 AN ACT
2To enact Subpart D of Part III of Subchapter A of Chapter 5-D of Title 40 of the Louisiana
3 Revised Statutes of 1950, to be comprised of R.S. 40:1168.1 through 1168.7, relative
4 to electronic health records technology; to provide for the interoperability of
5 electronic health records; to provide for the duties of the secretary of the Louisiana
6 Department of Health; to provide for the duties of the Health Care Information
7 Technology and Infrastructure Collaborative; to provide for implementation; to
8 provide for electronic medical records system standards; to provide definitions; and
9 to provide for related matters.
10Be it enacted by the Legislature of Louisiana:
11 Section 1. Subpart D of Part III of Subchapter A of Chapter 5-D of Title 40 of the
12Louisiana Revised Statutes of 1950, comprised of R.S. 40:1168.1 through 1168.7, is hereby
13enacted to read as follows:
14 SUBPART D. ELECTRONIC HEALTH RECORDS TECHNOL OGY
15 §1168.1 Definitions
16 (1) "Certified electronic health record technology" means an electronic
17 health record that is certified pursuant to Section 3001(c)(5) of the HITECH Act to
18 meet the standards and implementation specifications adopted under Section 3004
19 as applicable.
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1 (2) "Health Care Information Technology and Infrastructure Collaborative"
2 is composed of the Louisiana Rural Health Information Exchange and the Health
3 Information Technology Committee.
4 (3)"HITECH Act" means the Health Information Technology for Economic
5 and Clinical Health Act in Division A, Title XIII and Division B, Title IV of the
6 American Recovery and Reinvestment Act of 2009, including federal regulations
7 adopted under that Act.
8 (4) "Interoperable electronic health record" means an electronic health record
9 that securely exchanges health information with another electronic health record
10 system that meets requirements specified in R.S. 40:1168.4, and national
11 requirements for certification under the HITECH Act.
12 (5) "Qualified electronic health record" means an electronic record of
13 health-related information on an individual that includes patient demographic and
14 clinical health information and has the capacity to:
15 (a) Provide clinical decision support.
16 (b) Support physician order entry.
17 (c) Capture and query information relevant to health care quality.
18 (d) Exchange electronic health information with, and integrate information
19 from, other sources.
20 (6) "Secretary" means the secretary of the Louisiana Department of Health.
21 §1168.2 Interoperable; implementation
22 A. All hospitals and healthcare providers shall have in place an interoperable
23 electronic health records system within their hospital system or clinical practice
24 setting. The secretary, in consultation with the Health Care Information Technology
25 and Infrastructure Collaborative created pursuant to R.S. 40:1165.2, shall develop
26 a statewide plan to meet this goal, including uniform standards to be used for the
27 interoperable system for sharing and synchronizing patient data across systems. The
28 standards shall be compatible with federal efforts. The uniform standards shall be
29 developed by January 1, 2020, and updated on an ongoing basis.
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1 B. The secretary shall include an update on standards development as part
2 of an annual report to the legislature. Individual healthcare providers in private
3 practice with no other providers and healthcare providers that do not accept
4 reimbursement from a group purchaser, are excluded from the requirements of this
5 Section.
6 §1168.3. Health Care Information Technology and Infrastructure Collaborative
7 The Health Care Information Technology and Infrastructure Collaborative
8 shall advise the secretary on the following:
9 (1) Assessment of the adoption and effective use of health information
10 technology within the state, licensed healthcare providers and facilities, and local
11 public health agencies.
12 (2) Recommendations for implementing a statewide interoperable health
13 information infrastructure, to include estimates of necessary resources, and for
14 determining standards for clinical data exchange, clinical support programs, patient
15 privacy requirements, and maintenance of the security and confidentiality of
16 individual patient data.
17 (3) Recommendations for encouraging use of innovative healthcare
18 applications using information technology and systems to improve patient care and
19 reduce the cost of care, including applications relating to disease management and
20 personal health management that enable remote monitoring of patients' conditions,
21 especially those with chronic conditions and other related issues as requested by the
22 secretary.
23 §1168.4. Interoperable electronic health record requirements
24 Hospitals and healthcare providers shall meet the following criteria when
25 implementing an interoperable electronic health records system within their hospital
26 system or clinical practice setting:
27 (1) The electronic health record shall be a qualified electronic health record.
28 (2) The electronic health record shall be certified by the Office of the
29 National Coordinator pursuant to the HITECH Act. This criterion only applies to
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1 hospitals and healthcare providers if a certified electronic health record product for
2 the provider's particular practice setting is available. This criterion shall be
3 considered met if a hospital or healthcare provider is using an electronic health
4 records system that has been certified within the last three years, even if a more
5 current version of the system has been certified within the three-year period.
6 (3) The electronic health record shall meet the standards established
7 according to Section 3004 of the HITECH Act as applicable.
8 (4) The electronic health record shall have the ability to generate information
9 on clinical quality measures and other measures reported under Sections 4101, 4102,
10 and 4201 of the HITECH Act.
11 (5) The electronic health record system shall be connected to a state-certified
12 health information organization either directly or through a connection facilitated by
13 a state-certified health data intermediary.
14 §1168.5. Coordination with national health information technology activities
15 (1) The secretary, in consultation with the Health Care Information
16 Technology and Infrastructure Collaborative, shall update the statewide
17 implementation plan required by the Federal Health Information Technology
18 Strategic Plan released by the Office of the National Coordinator in accordance with
19 Section 3001 of the HITECH Act. The statewide plan shall meet the requirements
20 for a plan required under Section 3013 of the HITECH Act.
21 (2) The secretary, in consultation with the Health Care Information
22 Technology and Infrastructure Collaborative, shall work to ensure coordination
23 efforts to support and accelerate efforts to effectively use health information
24 technology to improve the quality and coordination of health care and the continuity
25 of patient care among healthcare providers, to reduce medical errors, to improve
26 population health, to reduce health disparities, and to reduce chronic disease.
27 (3) The secretary's coordination efforts shall include but not be limited to:
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1 (a) Assisting in the development and support of health information
2 technology regional extension centers established pursuant to Section 3012(c) of the
3 HITECH Act to provide technical assistance and disseminate best practices.
4 (b) Providing supplemental information to the best practices gathered by
5 regional centers to ensure that the information is relayed in a meaningful way to the
6 Minnesota health care community.
7 (c) Providing financial and technical support to Louisiana healthcare
8 providers to encourage implementation of admission, discharge and transfer alerts,
9 and care summary document exchange transactions and to evaluate the impact of
10 health information technology on cost and quality of care.
11 (d) Providing communications about available financial and technical
12 support which shall include clear information about the interoperable health record
13 requirements and exceptions to those requirements.
14 (e) Providing educational resources and technical assistance to healthcare
15 providers and patients related to state and national privacy, security, and consent
16 laws governing clinical health information.
17 (4) The secretary shall apply for funding necessary to administer the
18 incentive payments to providers authorized pursuant to Title IV of the American
19 Recovery and Reinvestment Act.
20 §1168.6 Health information blocking
21 (1) "Health information blocking" means knowingly interfering with or
22 knowingly engaging in business practices or other conduct that is reasonably likely
23 to interfere with the ability of patients, healthcare providers, or other authorized
24 persons to access, exchange, or use electronic health records, or knowingly using an
25 electronic health record system to both steer patient referrals to affiliated providers
26 and prevent or unreasonably interfere with patient referrals to healthcare providers
27 who are not affiliated providers, but shall not include legitimate referrals between
28 providers participating in an accountable care organization or similar value-based
29 collaborative care models.
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1 (2) Health information blocking is a violation of this Subpart. Provisions of
2 this Section shall be enforced by the secretary.
3 §1168.7 Rulemaking
4 The department shall promulgate rules and regulations, in accordance with
5 the Administrative Procedure Act, and take all other actions necessary to implement
6 the provisions of this Subpart.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 657 Original 2018 Regular Session Simon
Abstract: Establishes the implementation of an interoperable electronic health records
system for all hospitals and healthcare providers.
Proposed law requires all hospitals and healthcare providers to implement an interoperable
electronic health records system.
Proposed law provides for the secretary of the La. Dept. of Health (LDH) and the Health
Care Information Technology and Infrastructure Collaborative to develop a plan to
implement the interoperable system.
Proposed law provides for the duties of the Health Care Information Technology and
Infrastructure Collaborative in advising the secretary of LDH.
Proposed law provides as interoperable electronic health records requirements:
(1) The electronic health record must be a qualified electronic health record.
(2) The electronic health record must be certified by the Office of the National Coordinator
pursuant to the Health Information Technology for Economic and Clinical Health Act
(HITECH Act).
(3) The electronic health record must meet the standards established according to the
HITECH Act as applicable.
(4) The electronic health record must have the ability to generate information on clinical
quality measures and other measures reported under the HITECH Act.
(5) The electronic health record system must be connected to a state-certified health
information organization either directly or through a connection facilitated by a
state-certified health data intermediary.
Proposed law defines "certified electronic health record technology", "Health Care
Information Technology and Infrastructure Collaborative""HITECH Act", interoperable
electronic health record", "qualified electronic health record", and "information blocking".
(Adds R.S. 40:1168.1-1168.7)
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