Oklahoma Bets Big on Health Data: Inside the State’s Mandated HIE

In 2022, Oklahoma took a bold step: it required nearly every licensed provider in the state to join its health information exchange. The program, known as OKSHINE, is operated by MyHealth Access Network, a Tulsa-based HIE with more than a decade of experience connecting hospitals, clinics, and community providers.

The mandate was controversial, but it has also given Oklahoma something most states still lack: a single network with broad participation. Now, with a new partnership that extends data sharing across state lines, Oklahoma is testing whether mandated exchange can deliver the continuity of care policymakers have been promising for years.

Why Oklahoma Went All In

Fragmented health records have long frustrated both providers and patients. A 2023 state report noted that more than 70 percent of Oklahomans have health records scattered across multiple systems. Without a shared platform, clinicians faced a daily guessing game.

Lawmakers addressed the problem with Senate Bill 1369, creating the Office of the State Coordinator for HIE and requiring participation by July 1, 2023. Exemptions were available, but the expectation was clear: interoperability would no longer be optional.

How It Works in Practice

By designating MyHealth as the state’s official exchange, Oklahoma avoided starting from scratch. MyHealth already connected a large share of hospitals and physician groups, and the state provided funding—about $21 million in grants—to offset onboarding costs for smaller providers.

Today, the network covers more than 1,400 locations and sees over 110,000 patient transactions daily. Providers report that when they query the system, patient records are available roughly 85 percent of the time. That consistency is what transforms data exchange from theory to practice.

MyHealth has also picked up unexpected accolades: it was named a finalist in the 2025 Oklahoma Nonprofit Excellence (ONE) Awards, a nod to its growing impact and deeper community coordination.

Innovations Beyond the Mandate

MyHealth has layered new services on top of the baseline exchange:

• ADT notifications that alert clinics when their patients are admitted or discharged, reducing avoidable readmissions.

• Social needs screening tools that allow patients to complete SDOH questionnaires by text in the waiting room, with referrals routed directly to community resources.

• A public-utility governance model that brings payers, providers, tribes, and community groups into the decision-making process.

These features show how a mandated network can evolve into more than a compliance exercise.

The Behavioral Health Gap

Not everyone has signed on. Roughly 500 behavioral health providers opted out during the first year, citing privacy concerns and workflow challenges. The result is a critical blind spot, especially given Oklahoma’s high rates of mental illness and substance use disorder.

Community behavioral health clinics that do participate say the exchange is valuable, especially for continuity after hospitalizations. But until more behavioral health providers engage, the system will struggle to deliver truly whole-person care. Filling that gap may require use cases designed specifically for crisis episodes and SUD treatment—areas where timely information can be the difference between stabilization and relapse.

Looking Beyond State Borders

The newest development is a partnership with Connxus, a Texas-based nonprofit HIE. The agreement will allow real-time admission and discharge alerts to flow across state lines.

For patients who live near the border, this matters. If an Oklahoman ends up in a Texas emergency department, their primary care team back home could be notified within hours. That kind of cross-border alerting is rare in the U.S., but it reflects a simple truth: patients do not stay within state lines, and their data should not either.

What to Watch Next

Oklahoma’s HIE has achieved something most states are still chasing: scale. Mandated participation created the density needed for meaningful alerts and shared records. But mandates alone cannot guarantee success.

The next tests will be:

• Whether behavioral health and SUD providers can be brought into the fold.

• How well cross-border alerting with Connxus works in practice.

• Whether frontline clinicians see measurable reductions in avoidable ED visits, duplicate tests, and gaps in follow-up care.

If those pieces come together, Oklahoma could demonstrate that statewide mandates paired with practical support can move interoperability from aspiration to everyday reality.