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Department of Health Adopts Regulations Governing the SHIN-NY Health Information Exchange Network

The Department of Health (DOH) has adopted regulations governing the State Health Information Network for New York (SHIN-NY) and the regional health information organizations (RHIOs) that provide the infrastructure for secure sharing of health information among providers and health plans. The regulations set forth standards and requirements for RHIOs (described as "qualified entities" in the regulations), for the governance of the SHIN-NY, and for patient/resident authorization to share information through the SHIN-NY.

The regulations require hospitals, clinics, nursing homes, home care agencies, hospice programs, and health maintenance organizations which use certified electronic health record technology under the federal Health Information Technology for Economic and Clinical Health Act (HITECH), to connect to the SHIN-NY through a qualified entity or RHIO. Hospitals must connect by March 9, 2017, while other facilities and agencies (including nursing homes, home care agencies, hospice programs and health maintenance organizations) must connect by March 9, 2018. These connections must allow private and secure bi-directional access to patient information by providers and plans authorized by law to access that patient information. DOH is authorized to waive these requirements for health care facilities and agencies that demonstrate:

  • economic hardship;
  • technological limitations or practical limitations to the full use of certified electronic health record technology that are not reasonably within control of the health care provider; or
  • other exceptional circumstances.

The regulations allow providers to contribute health information to RHIOs without patient/resident authorization. However, the regulations prohibit RHIOs from sharing health information with other providers without written authorization from the patient/resident, except in certain circumstances. Information may be shared by a qualified entity without the patient's authorization when it is:

  • necessary for public health or health care oversight activities;
  • required or authorized by law;
  • provided to a federally-designated organ procurement organization to facilitate organ, eye or tissue donation and transplantation; or
  • needed for treatment in the case of a medical emergency.

The regulations also authorize providers to withhold information  from the qualified entity, including information about services that minors have consented to (such as reproductive health and mental health services). They prohibit qualified entities from sharing minor consent service information with a patient's parent. 

The regulations require DOH to establish, through recommendations of a policy committee and the work of a statewide collaboration process, SHIN-NY policy guidance that sets standards for:

  • privacy and security;
  • monitoring and enforcement;
  • minimum service requirements;
  • organizational characteristics of qualified entities; and
  • qualified entity certification.

LeadingAge New York is continuing to seek funding from DOH to support electronic health record adoption and health information exchange among long-term/post-acute care providers and plans. LeadingAge NY's comments on the proposed regulations are available here and here.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383 ext. 124.