Kansas' two largest health systems are now sharing data on a provider-based health information exchange. That's been achieved just as the state's quasi-governmental HIE board is considering dissolving itself, and some significant regulatory debates are waiting to be settled.

Wesley Medical Center and Via Christi Health announced earlier this week that the two systems have started sharing clinical data through the Wichita Health Information Exchange (WHIE), a project using Informatics Corporation of America’s CareAlign platform that links diffuse electronic medical records systems at clinics and hospitals throughout the two networks.

The WHIE is an affiliate of the Kansas Health Information Network (KHIN), a statewide HIE created through a partnership of the Kansas Medical Society and the Kansas Hospital Association. KHIN went live about a year ago, with about 1,900 eligible providers in the system, said KHIN executive director Laura McCrary.

WHIE, a sort-of child of KHIN, McCrary said, went live with query functionality two weeks ago, and a dozen or more providers are expected to join by the end of the year. KHIN and WHIE are funded through private grants and provider fees -- based on the number of hospital beds and doctors in a physcian group -- and not with any public dollars, McCrary said.

"We would like to have some of the stimulus funds," McCrary said, referring to the roughly $9 million grant from the Office of the National Coordinator for Health IT to the public-private state HIE board, the fate of which is currently contested.

"There’s about $5 million left, and we’re hopeful we’ll get a portion of that," McCrary said. "It’d be great to have a bridge fund" for exchange infrastructure in the works, until providers start paying fees.

Funding the HIEs still needs to be sorted out, as does how and to what extent they will be regulated. The state HIE board, the Kansas Health Information Exchange, Inc. (KHIE), is set to decide in the next month whether or not to disband itself and just have two employees on staff at the Kansas Department of Health and the Environment, which would then regulate state HIEs.

 [See also: Ryba’s 16 rules of effective HIE]

When KHIE was created in 2010 with ONC funds, it initially intended to build and manage state HIEs. Then, as KHIN beat them to it, the consensus was that KHIE would be a regulator -- funded by fees levied on providers. That concerned the provider community. "In part our worries are making sure that we’re sustainable," McCrary said.

The 17-member KHIE board meets in September to determine its fate. And either way, several significant regulatory questions have not been answered, such as who owns the data and whether it can be used for public health research. Kansas offers patients an opt-out option.

Whether the HIE data can be used for research -- including measuring the performance of providers and their services -- is especially important, said Robert St. Peter, MD, president and CEO of the Kansas Health Institute.

"Kansas has a history of sitting on mountains of data and not putting it to the most forward-looking use," St. Peter said, of other health data in the hands of state officials.

Meanwhile, KHIN is trying to figure out how to incorporate another HIE -- the Lewis and Clark Health Information Exchange (LACIE) -- into its network, McCrary said, as required by KHIN’s certificate of authority.

LACIE is used by providers in in western Missouri and is increasingly stretching into northeast Kansas and southern Nebraska. It also uses Cerner software, not ICA’s, and so a major financial and technical challenge will be creating interfaces that connect the two systems across providers.