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TBCE flags compliance work after executive director outlines data, AI and parental-access mandates in SB 1188
Summary
TBCE Executive Director Dr. Bush told the board the new Senate Bill 1188 tightens requirements on electronic health records — including U.S. data residency, stricter access controls, mandated disclosure of AI-assisted diagnosis, parental access to minors’ EHRs, and prohibited data fields — and said staff will publish guidance and pursue monitoring approaches.
Executive Director Dr. Bush told the Texas Board of Chiropractic Examiners on May 28 that Senate Bill 1188 imposes a suite of requirements the agency must help licensees implement, including where patient data may be stored and how access is controlled.
"Only U.S. data storage," Dr. Bush said, summarizing a key provision, and added that the agency will need to work with the Department of Information Resources and others to determine how to verify compliance. He described several additional takeaways: stricter access control to EHRs; a requirement that any use of AI tools to assist diagnosis or treatment be disclosed to patients; mandated parental access to minors’ EHRs unless restricted by specific court order or federal law; and prohibited data fields such as credit score or voter-registration status.
Dr. Bush said the agency will publish an overview in the TBCE newsletter and that staff will convene stakeholder meetings and board discussions to determine how best to monitor compliance. He emphasized that some details "are still being worked out" and that the board will need to develop procedures for enforcement and guidance for licensees.
Why it matters: The changes affect routine practice operations for Texas chiropractors — from recordkeeping and vendor selection to patient consent and communications — and could require practice-level technical and policy changes. The board signaled that it expects to issue guidance and adapt its oversight as the implementation details become clearer.
What was said: In addition to the U.S.-data-storage point, Dr. Bush highlighted parental access rights: "Your system must allow a minor's parents, managing conservator, or legal guardian complete and unrestricted access to the minor's EHR immediately upon request, unless restricted by a specific court order or federal law." He also noted that some fields" — including biological sex at birth — are mandated with narrow amendment paths, and that metabolic-health fields and data-exchange options are required for chronic-disease management.
Next steps: Dr. Bush said staff will include a detailed bulletin and solicit stakeholder input; the board will consider how to monitor compliance and may include rulemaking or guidance in future agendas. The executive director said the legislature and DIR will play roles in verification and enforcement processes.
No formal board action on specific EHR implementation steps was taken at this meeting; Dr. Bush asked the board for feedback and indicated staff would return with guidance options.
