Bankruptcy Idaho Medical Records Organization Replaces Leader


A consultant in the Washington, DC area has resigned as director of the Idaho Health Data Exchange, Idaho’s central medical records repository.

Hans Kastensmith, managing partner of Capitol Health Associates, a Washington, DC-based consulting group, was appointed executive director of the Idaho Health Data Exchange in October 2019. Jesse Meldl, who was head of finance at the company, replaced Kasten-Smith. , according to court records filed this month.

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The exchange filed for Chapter 11 bankruptcy protection last August, as first reported by the Idaho Capital Sun. The group said at the time it owed $4 million to creditors.

The bankruptcy raises questions from lawmakers about how the exchange, which has received more than a decade of government support and millions of patient records, will fare.

It is currently the subject of a Performance Evaluation Office investigation ordered by the Idaho legislature during its 2023 session.

In response to questions from The Sun, Meldl said April 30 was the last day Kasten-Smith worked for the organization.

“Hans came[to the Idaho Health Data Exchange]at a time when the exchange’s underlying technology was being rapidly innovated, and that was his particular area of ​​expertise and the main focus of his consulting business. is,” Meldl wrote in an email to The Sun. . “Now that IHDE is moving towards more focus on the day-to-day operations of the exchange, Hans has decided to move on to other projects through consulting work in line with his own passion and expertise. “

Meldl said he intends to continue in his role as the exchange’s chief financial officer in addition to executive director.

Idaho’s Health Information Exchange Road to Financial Crisis

The exchange is a private, non-profit organization that launched a medical records portal in 2009, using federal grants and millions of dollars of seed money from ongoing federal funds to operate and improve. .

But federal revenue streams didn’t last forever. The exchange will move toward relying on user fees, or memberships of healthcare providers large and small, who pay to use its infrastructure to share patient medical records in a streamlined portal. I had a need.

The HITECH Act, a law enacted in 2009, expires in 2021, depriving exchanges of a major source of revenue.

The image shows one page of the bankruptcy filing
Idaho Health Data Exchange filed a Chapter 11 bankruptcy petition granting debt consolidation on August 12, 2022. Tap or click the image for the full 68-page bankruptcy filing. (Courtesy of the Idaho Bankruptcy Court)

Kastensmith told The Sun in August that the exchange’s management was working to identify new revenue streams to keep the repository alive.

“We’ve been working to increase revenue while reducing costs,” he said.

At the time, the exchange had three employees and 10 to 12 external contractors, he said.

“We’ve put a lot of effort into right-sizing the company and keeping it running to deliver the expected service,” Kasten-Smith told The Sun.

What is the Idaho Medical Data Exchange?

Although the exchange has roots in state and federal government, it is not a state-owned institution. The Idaho Legislature passed a bill in 2006 codifying Idaho’s intention to improve healthcare through the use of technology.

Current medical records may be cumbersome or impossible to transfer immediately if a patient needs a specialist visit, a change of doctor, or urgent care in another part of the state. had.

The goal of the Idaho Health Data Exchange, like similar medical record repositories in other states and regions, is to provide all Idaho health care providers with access to all patient health records at all times.

The exchange’s medical director told the publication Healthcare Innovation in 2021 that the exchange accepts about 100,000 medical records per day.

According to Healthcare Innovation, the health data exchange housed medical records for more than 3 million people as of September 2021.

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