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Publicly insured employees would automatically be plugged into Utah's health information exchange with or without their consent under legislation endorsed by a committee on Wednesday.
Low-income Utahns on Medicaid and the Children's Health Insurance Program (CHIP) would be added, too, until they take steps to opt out.
The bill sets up a double standard when it comes to patient privacy. Currently, privately-insured patients must specifically opt in before their medical records are placed on the state's data superhighway, or Clinical Health Information Exchange (cHIE).
But the idea met with little resistance. Advocates for the poor were silent Wednesday and lawmakers, most of whom get coverage through the state's Public Employee Health Plan (PEHP) and would have to share their records, were generally supportive.
Sen. Allen Christensen, R-North Ogden, opposed mandating participation by public employees since they pay a portion of their insurance premiums.
As for Medicaid, he said, "If the state's paying the bill, we get to tell you this is how it's going to be. If you don't want your records shared under Medicaid, that's fine, get out of Medicaid."
Others, however, argued against unequal treatment.
"I'm on PEHP. If we see this as good public practice, then we should be the first ones to join and make everyone on PEHP do it," said Sen. Luz Robles, D-Salt Lake City.
The committee was swayed.
For now, Medicaid patients will be given a chance to pull out only because a mandate for them would require the federal government's blessing, which the bill directs state health officials to seek.
Sponsoring Rep. Ronda Menlove, R-Garland, pitched the measure as necessary to the success of Utah's cHIE. "We've built the information highway. Now we need to put people on the highway."
The cHIE promises to save lives, time and money by reducing misdiagnoses and medical errors caused by doctors having incomplete access to patient information. The system will allow a family practitioner in Moab to push patient data to an emergency room doctor in Salt Lake City.
To date, only about 16,000 of the state's 2.7 million residents have signed up, said Teresa Rivera, COO of the nonprofit Utah Health Information Network (UHIN), tasked with overseeing the cHIE. Enrolling PEHP, Medicaid and CHIP recipients would bring that number to about 375,000.
The state's major hospital systems are connected. Some have pushed data. But until patients consent to share it, doctors can't access it, said Menlove.
UHIN spent the summer urging consumers to "make a choice" at health fairs, 5K races, farmers markets and other events. Given the opportunity most people, about 95 percent, agree to participate and opt in, Rivera said.