Joint Public Health
August 6, 2025
Representative Jeff Wardlaw If members would grab your seats, we’ll go ahead and get started. I need a motion to accept the minutes from last meeting. I need a second. All those in favor say aye. Opposed? Ayes have it. We’ll move right along to item C, discussion of State Health Alliance for Records Exchange. Looks like we’re going to have a couple of people to the table. Health Department. If you guys would, introduce yourselves for the record and y’all are recognized to present your items.
Austin Porter Chief Science Officer, State Epidemiologist, Department of Health.
Don Adams Don Adams, Chief of Staff for the Health Department.
SHARE health data tool
Anne Santifer Hi everyone, I’m Anne Santifer. I’m the director of the Office of Health Information Technology that’s now housed under the Arkansas Department of Health. And I’m just here today to tell you a little bit about our office and what we do. We are the health information exchange for the state. And what that means is we connect directly to providers, hospitals’ and clinics’ electronic medical records, and we aggregate the data at the health department.
The data comes in real time, and it’s available to the patient’s care team. You have to have a treatment or a provider that’s taking care of a patient, a payment, a health plan that’s paying that claim, or operational need, so somebody that’s helping coordinate the care of that patient who’s allowed to use our tool traditionally.
The SHARE tool is meant to be used at a point of care. So as a provider is taking care of you, if they have access to your previous medical records, your allergies, your medications, diagnosis, any procedures you have done, that is all aggregated into a single central record, regardless of where you’ve been.
So most EMRs traditionally don’t talk to each other. So you may have heard of Care Everywhere, which is an Epic branded platform. So Care Everywhere is just for Epic providers. There’s like an Athena Hub that’s just for Athena users. But these systems traditionally don’t communicate with one another. And that’s why health information exchanges have been established in just about– I think all 48 states have health information exchanges except for Illinois and Pennsylvania maybe.Some states like Texas and California have multiple HIEs, which kind of defeats the purpose of having a central place to house all the medical records.
When providers have access to this information, they are able to make faster decisions regarding your care. They’re able to hopefully reduce any duplicate tests because they already have access to the previous information. And then just better safety for us because if they see that you have an allergy to a specific drug or are on a medication that might not work with what they’re trying to prescribe, they’re able to make better informed decisions related to your health care. So that’s SHARE.
We are also I should point out Arkansas is an opt out state which means if you’re wondering, is my data in there? Most likely, when you completed all those documents, when you checked into your provider, there’s a section on there that allows those records to be shared with SHARE.
You are always welcome to opt out if you don’t want your record shared electronically. But that just means your record can’t be shared electronically. Your health insurance plan still has the right to request those records. Your providers that are working on your care still have the right to access that information. So opting out just means your record is not shared electronically and instead is used either by fax or paper records.
Representative Jeff Wardlaw Representative Wooldridge.
AI in healthcare
Representative Jeremy Wooldridge Thank you, Mr. Chair. And thank you for being here. Right in front of you. I wanted to know and maybe just start a conversation or get your thoughts, the AI component of EHRs and medical health records, what is that current component or what does that look like?
I know that several states are talking about legislation and things that limit that component to make sure that there is still the human factor when it comes to medical decision making. Is that something you guys are working on talking about, something we need to be looking at as we move towards the next session?
Anne Santifer I had a feeling you were going to ask about AI. So, yeah, so AI is on its way to healthcare. It’s here. I think, whether we like it or not, I think we have to cautiously embrace it. Some providers are using AI. I don’t think they’re using it for clinical decision-making.
They’re using more– I had one provider tell me he wanted to create a treatment plan for a diabetic woman. So he put her information onto ChatGPT or whatever, and it created just a guide for this woman who is diabetic, who had very specific conditions. So I think providers are using to help them with that more than to actually make clinical decisions using AI.
Representative Jeremy Wooldridge Follow-up, Mr. Chair. Who, I guess, for lack of a better word, polices or monitors that to make sure that there are safeguards around that component in medical records?
Anne Santifer So the electronic medical record vendor would be the one that houses that AI component. I have heard, like at Mercy, for example, one way AI is being used in a positive way is doctor’s notes. So you may have heard providers complain. And it’s very burdensome for them to do what they call pajama notes. So after hours, record note taking and things like that.
AI, there’s a tool that Mercy uses where it’s a note taking AI bot. So the provider has a microphone. When he enters the room, he introduces himself. He introduces the people there in the room. And then AI is able to take those notes for him. And then at the end of the day, rather than having to type up all the notes or be less engaged during the visit, he can focus more on the patient and let the AI bot take the notes. But those are usually monitored, like the provider would enter into a contract directly with that company, and the company would police it.
Austin Porter I was just going to add, a lot of clinics and hospitals, they may have policies in place that regulate the usage of artificial intelligence for their clinical practices. So I mean, a lot of it may be independently managed by those independent hospitals and clinics.
Representative Jeremy Wooldridge I appreciate that. And I appreciate the note-taking aspect of it. I understand the value there. I just wonder, from an organization standpoint, when we look at health care across the state, we would probably want some uniformity there. Who would be the agency or who would look at regulating or at least overseeing that to make sure that it’s being utilized the same across the state?
Anne Santifer There’s been some conversations at the federal level to use AI for fraud, waste and abuse with the new administration. And I think there’s a place for that. If we were to engage with them, we would probably present it to the Board of Health and bring that up. Because that would be what we call a new use case. It’s not something that our data has traditionally been used for. So we would present it to the Board of Health and let them make that determination.
Representative Jeremy Wooldridge Okay, thank you, Mr. Chair.
Representative Jeff Wardlaw Senator Love.
Senator Fredrick Love Thank you, Mr. Chair. And I’m going to stay with the same line of questioning. I just want to know about the informed consent. Because it was good that you touched on the hospitals having their different, I guess, protocols. But is there any informed consent given to the patients that you know of in regards to AI treatment?
Austin Porter Not that I’m aware of, senator. In terms of patients having to provide some type of consent to whether or not their provider can use AI, I’m not familiar with that. We can look into it though.
SHARE vs MyChart
Senator Fredrick Love All right. And then I want to go back just to the overall SHARE system now. All right. I’m trying to make sense of this. I am familiar with the MyChart. Are you all the back end of MyChart? Is that what you’re saying? You’re connecting providers? Like I use MyCharts, somebody else could use whatever.
Anne Santifer So if you go to different providers, you probably have different MyCharts that you have to access, right? So at UAMS, they have Epic MyChart, but if I go to Ortho Arkansas and they use Athena, that’s a different, what they call a patient portal. What SHARE is is like a neutral aggregator.
So when these electronic medical records were created, there was a lot of meaningful use money behind it. And they were created in a way where they don’t talk to each other. So that was built in that sense, the systems don’t talk to each other.
So we need a neutral party, a mediator, such as an HIE like SHARE, to consume those records from different brands of EMRs into a central location and make that available. Because otherwise our provider is not going to have a full picture of their patient.
Selling of health data from SHARE?
Senator Fredrick Love Okay, gotcha. All right, so yeah. All right. I’ll put it into my terms, the backend of those systems. Secondly, let me ask about the information that is collected. None of this information is sold or?
Anne Santifer Correct.
Senator Fredrick Love Can you talk, can you talk?
Anne Santifer Yeah, so our data is allowed to be used for TPO– so treatment, payment or operational need. We require an existing relationship with that patient in order to view their records. So we, I don’t want to say sell, but we do work with health plans and we do provide them data back on their own members and they do pay a fee to participate in SHARE.
So SHARE, the way we’re funded is we get a portion of our funds from the federal government through Medicaid funding, we get a portion of it from providers who pay to participate in the exchange, and then we get a portion of our funds from payers who pay to be able to access their own member records. So, for example, like a bundled payment, right? When Medicaid pays a bundle payment, you don’t see the individual visits under that patient in a claim or you might not see lab results in a claim. But that’s important information, say, for Blue Cross.
One example we do with Blue Cross is we send them all their members’ A1C results. We have a lot of diabetics in Arkansas and a lot pre-diabetics. So we send them all those A1c results on their members, and if they identify someone that’s pre-diabetic, they go ahead and enroll them in a pre-dietetic prevention program.
So there’s things that come across our clinical data that’s not available in a traditional claim that’s very attractive to health plans, to private payers, so they do engage with us. We have most payers in Arkansas participating in SHARE.
Senator Fredrick Love Okay, so is it just health plans that have access to this information or is it?
Anne Santifer Yeah, so we do health plans. Or you may have heard of accountable care organizations or clinically integrated network. They are like a group of providers that get together and assume risk. And if there are savings, they share the savings. If there’s no savings, then they share the downfall.
But so providers get together and they say, we want to create this group. We’re going to manage these patients. We’re going to reduce their costs. And then we’re going to share the savings. So we do work with those organizations, too. They’re risk-based organizations that the provider entered into a contract with, and we’re sharing the data back with that organization on the behalf of the provider.
Senator Fredrick Love All right, thank you.
Senator Missy Irvin Thank you. Senator Payton, you’re recognized.
SHARE not reducing patient paperwork
Senator John Payton Thank you, Madam Chair. It’s very fortuitous that this has come up. I’ve had a little personal experience here in the last six weeks or two months that I had never dreamed that I’d have somebody right on topic sitting in front of me in committee.
But so before the databases and the computers, we’d go to the doctor or provider and they’d have us fill out a questionnaire on paper. And obviously they need to know all of those answers in order to treat you safely and effectively. From what you described in your opening, the database is supposed to make that available to providers for the same purpose. So why are we required to fill out the stupid form every time?
And I know it’s funny, but it’s very aggravating. So here’s the thing, I had to have surgery on my hand. And so I fill out all the questionnaire and everything for Baptist Health. And they do the nerve induction test and then schedule the appointment with a surgeon, which was Ortho Arkansas. So I had to fill out another big questionnaire for Ortho Arkansas
. They did the surgery and I go back for the follow up to get the stitches out, they want to force me to fill out that questionnaire again. And I refused and went to my personal provider and got the stitches out. But I mean, it is ridiculous that you’d return within two or three weeks on a follow-up for a procedure that’s been done.
And I can’t fathom why they would force you to fill it out a second, a third, a fourth time, unless it’s because they’re getting paid 2 cents for every survey they turn into your group. So are we incentivizing them to force this on the patients? Is there any medical reason to have somebody refill that out every two weeks or whatever when they’re in a treatment series?
Anne Santifer No, I think sometimes the policy hasn’t caught up with the technology. But Ortho Arkansas and Baptist are both connected to SHARE. So they’re able to access each other’s medical records using us. So they could. I think, sometimes, there’s just hospital workflows or clinic workflows that require, somebody made this policy a while back that says, you’re going to come in, you’re going to answer these questions, and then we’re going to take you back to this room, we’re going to take your blood.
Senator John Payton So they’re not compensated by the number of surveys they turn in?
Anne Santifer I don’t think so. I used to work on Medicaid. And I know like to do a depression screening sometimes you could get compensated by health plans, but that was like once a year or once every six months type of thing.
Senator John Payton All right, thank you. Thank you, Madam Chair.
Senator Missy Irvin Thank you. Are there any other questions from members of the committee? All right. Sorry, Representative Long. Yes, you’re recognized.
Covid vaccine information requirement
Representative Wayne Long It’s a little bit off the topic, but y’all look like the right people to ask this question. Right after the governor took office, she did an executive order requiring the Health Department to explain or at least give the data to people that are considering taking COVID shots about the adverse reactions. And I checked with a couple of Health Department units, and they didn’t know what I was talking about. So I’m wondering if that never got implemented or if they just maybe were not trained to distribute that information.
Don Adams Representative Long, to my knowledge, we’re in compliance with all the executive orders. I would have to look specifically into this situation. And if we have a local health unit or two that are out there that aren’t doing what they’re supposed to do, we’d really like to look into it. Mr. Gilmore may know a little bit more about this.
Matt Gilmore Matt Gilmore, Department of Health. Representative Long, there was legislation, I’m familiar with it. I think the wording of the legislation spoke to posting it on our website. But we can make sure that our health units have all that information specifically. And I’ll have to get with you about these in particular. But I think the language of the law required it to be on our website, and so that’s what we’re trying to make sure we’re in compliance with. But we’re happy to visit about any specific.
Representative Wayne Long Yeah, because most people don’t go on websites before they visit. And even if they do, the Health Department’s website is sort of hard to navigate.
Matt Gilmore Yes, sir. It’s big. I agree.
Representative Wayne Long But if it was just a handout, just so people know that there’s some people that have had adverse reactions to these shots, and they might want to be able to make an informed consent whether or not they want to do it.
Matt Gilmore And I may, if you don’t mind, I do think there are some fact sheets we’re required to give them, I think. And also there’s an insert and that sort of thing that we’re required to make sure they’re aware of and that sort of thing. But, yeah, we will double check. I’ll get with you after this is over and make sure we’re on the same page as far as what health units this was.
Representative Wayne Long Thank you very much. I appreciate it.
Senator Missy Irvin And seeing any other further questions? All right, thank you so much for your testimony. Let’s see, is there any other business to come before the committee? All right. Seeing none, I’ll turn it back over to you.
Representative Jeff Wardlaw Seeing none, we stand adjourned. Thank you.
