Idaho health department plans to stop paying health data contractor

The Idaho Department of Health and Welfare plans to stop paying to access the Idaho Health Data Exchange, a bankrupt government-created health data sharing service.

Interim health department director Dean Cameron told the Idaho Health Data Exchange director that the state would end its contract with the exchange, according to an April 17 letter obtained by the Idaho Capital Sun. 

But the health department could delay or stop the contract’s termination, Cameron said. That’s if, within the next month, the exchange shares a health data security audit, almost a decade of financial audits, employee contact information, and time-keeping policies, Cameron wrote. 

Idaho’s health data exchange is among several health information systems across the country meant to help health care providers, insurers and others share patient’s medical data more effectively.

The Idaho Health Data Exchange is a nonprofit organization propped up by almost $94 million in mostly federal tax funds. A watchdog report by the Office of Performance Evaluations in November found the exchange had few state-built accountability measures more than a decade after state officials created it.

What happened to the Idaho Health Data Exchange, and can other states learn from it?

“The Department takes these concerns seriously and is requesting that (the Idaho Health Data Exchange) take some action to ameliorate what (the watchdog report) had identified as (the Idaho Health Data Exchange’s) general ‘reluctance to adopt transparency measures’ before the Department may consider continuing its relationship,” Cameron wrote.

Idaho Health Data Exchange Executive Director Jesse Meldru told the Sun the exchange hopes its services will still be available to the health department. 

The Idaho Health Data Exchange “will continue to work hard with our partners at the Idaho Department of Health and Welfare to make sure” the exchange’s “services continue to remain available to the Idaho Department of Health and Welfare,” Meldru said in a statement.

The exchange is in the process of responding to the health department, Meldru said. 

The Idaho Health Data Exchange exited bankruptcy last year, with a plan to pay 25% of its debts.

It wasn’t immediately clear how much the Idaho Department of Health and Welfare contributes to the Idaho Health Data Exchange. 

The health department pays “relatively small” fees for accessing data on the exchange, Meldru previously told the Sun. He said Idaho withdrawing support for the exchange would not “materially impact” the exchange’s ability to operate.

The exchange has operated without state or federal grants since late 2020, Meldru previously told the Sun.

What this means for Idaho medical providers

Medical providers can continue to participate in the exchange, said health department spokesperson AJ McWhorter. Without the requested health data security audit, “providers participating do so at their own risk,” McWhorter said.

The watchdog report didn’t find evidence that the exchange’s data is vulnerable, but identified a potential conflict of interest in a third party that attested to its security in 2021. Meldru previously said the exchange’s data security is “top notch,” citing external reviews. 

If Idaho ended its contract with the exchange, the Idaho health department would stop paying the exchange, or receiving or sharing data through it, McWhorter told the Sun in a statement. The health department used the data for medical record reviews and epidemiology case work, he said. The agency would use other means for that work if the contract ended, McWhorter said.

But if Idaho withdrew, Idaho’s vaccine database called the Immunization Reminder Information System would not be accessible through the exchange, McWhorter said. 

“Providers would depend on other participating providers’ immunization data in (the exchange), and approved providers can still access immunization records directly from” the vaccine system, McWhorter said.

Idaho Health Data Exchange operations not impacted if state contract ends

Meldru said losing revenue from Idaho Department of Health and Welfare “would be immaterial” to the Idaho Health Data Exchange, which he said “has many important clients” throughout Idaho. 

But Meldru suggested it could strain the health department and medical providers.

When “a patient medical record is not retrieved prior to delivery of care, procedures are unnecessarily duplicated at a rate of more than 20%,” Meldru told the Sun. “To my mind, these suggest the Idaho Department of Health and Welfare and Idahoans would be considerably worse off by not having IHDE available to them as a resource to make their processes of care delivery more efficient and to help improve the potential for better health outcomes among their attributed population.”

Medical providers wouldn’t be impacted directly, Meldru said. But indirectly, he said, medical staff would have to spend more time responding manually to the health department’s health record requests.

“We remain hopeful that (the Idaho Health Data Exchange) can continue to support as much of the health care community in Idaho as possible, and that most certainly includes the Idaho Department of Health and Welfare,” Meldru told the Sun.

Meldru said the contract, already set to end June 30, had been renewed annually for five years.