Concerns regarding both the sharing and privacy of patient health information affect every facet of the health care system — from health care providers and their patients to pharmacies and insurance companies alike. According to the Oklahoma Health Care Authority, 70% of Oklahomans currently have health care records in multiple delivery systems, hindering Oklahoma’s goal of having both a comprehensive and efficient state health care system. In 2022, the Oklahoma Legislature created the Oklahoma State Health Information Network Exchange (OKSHINE), initiating a statewide effort to consolidate patient health care records. OKSHINE requires providers to access and transmit patient health information via MyHealth Access Network, Oklahoma’s state designated health information exchange, or HIE, entity. OKSHINE aims to enhance Oklahoma’s health care system by providing timely access to a secure HIE while protecting patient privacy under the Health Insurance Portability and Accountability Act.
Beginning July 1, all providers licensed and located in Oklahoma must meet OKSHINE’s two primary requirements: utilization and transmission. Utilization requires providers to access patient records from the MyHealth portal and pay an annual subscription fee based on provider type and size. Transmission requires providers to pay MyHealth’s one-time connection fee and send all “priority health information” (i.e., information necessary to effectively coordinate patient care) to MyHealth.
With the July 1 deadline looming, many providers have questions regarding MyHealth’s implementation process and potential costs associated with OKSHINE compliance. MyHealth is already compatible and sharing data with many electronic medical record, or EMR, systems. Unless providers already utilize a MyHealth-compatible EMR or qualify for an OKSHINE exemption, they must pay a one-time connection fee of $5,000 to transmit patient data and an annual subscription fee for MyHealth access. While these costs may minimally impact large providers, they may be debilitating for smaller providers, such as individual practitioners. The OHCA, however, may grant exemptions from OKSHINE requirements based on a variety of factors, including provider type or size and technological or financial hardship.
Certain providers, such as those working in an administrative, educational, or other non-patient treatment role, may qualify for a total, broad-based exemption from both the cost and requirements of transmission and utilization under OKSHINE. Additionally, licensed, nonprescribing providers — when working outside of a hospital, laboratory, home health, hospice, or nursing facility — will also qualify for a broadbased exemption. Many OKSHINE exemptions, however, will be partial, exempting the qualifying provider from transmission requirements, but not MyHealth utilization and subscription fees. To obtain a partial exemption, providers must complete OHCA’s online OKSHINE Exemption Request Form. After OHCA review, providers will receive notification of their exemption status and existing obligations.
Oklahoma providers should ensure they are actively engaged in implementing MyHealth or a MyHealth-compatible EMR system by July 1. Providers who believe they qualify for an OKSHINE exemption do not need to complete an Exemption Request Form, but should ensure that any information and/or records supporting OKSHINE exemption status are readily accessible. However, providers seeking partial exemption should submit an Exemption Request Form as soon as possible. OHCA will evaluate OKSHINE exemption criteria annually, indicating that providers — even if initially exempt — should continue to document any information pertaining to their exemption qualification. For additional information, providers should visit the OKSHINE webpage, which the OHCA periodically updates with new information regarding provider compliance and exemption criteria.
