The Minnesota
e-Health Initiative
Smart Health for Rural communities
July 19, 2005
Mark Schoenbaum, Office of Rural Health &
Primary Care
www.Health.state.mn.us/e-health/
Health & Health Care
System Challenges
•
•
•
•
Error rates are too high
Quality is inconsistent
Costs are escalating
Research results are not
rapidly used
• Demographics of baby
boomers increasing
demand
• Capacity for early
detection & response to
threats is minimal
www.Health.state.mn.us/e-health/
Health Information Technology:
What is it?
• Electronic Health Records (EHR), but also:
• Computerized provider order entry (CPOE), Including
applications like:
– E-Pharmacy (Formulary, History and Prescribing)
– Diagnostic applications for Laboratory, Radiology
• Secure e-mail communication
• Telehealth & Imaging Technology
• Public Health monitoring and disease surveillance, and
prevention
– Communicable Disease Reporting
– Immunization Registries
• Computerized decision support systems
• Personal health records
www.Health.state.mn.us/e-health/
Minnesota e-Health
Initiative
What is it?
•
Based on:
• National Framework for Strategic
Action 2004
• State legislation 2004, 2005
www.Health.state.mn.us/e-health/
Minnesota e-Health Initiative
What is it?
•
Public - Private collaboration
•
•
•
2004,2005 Advisory Committees
Designed to accelerate the use of Health
Information Technology in all areas of the
state
Purpose is to:
-
Improve health and health care quality,
Increase patient safety,
Reduce health care costs, and
Improve public health
www.Health.state.mn.us/e-health/
Minnesota Roadmap
Minnesota e-Health Roadmap for Strategic Action
The Minnesota e-Health Initiative will accelerate the adoption and use of Health Information
Technology (HIT) to improve healthcare quality, increase patient safety, reduce healthcare
costs and enable individuals and communities to make the best possible health decisions.
Vision
1
Inform
Clinical
Practice
Goal-Specific
1) Assess current use &
adoption-readiness
for HIT (such as EHR
and e-prescribing)
1) Ensure secure
methods to
uniquely identify an
individual
2) Promote HIT
adoption by
identifying/addressing
true barriers &
analyzing Value of
Investment
2) Define data and
information for
electronic
interoperability
3) Define targeted
incentives that get
buy-in and promote
interoperability
Cross Cutting
Recommendations for Action
to Achieve in One Year
Goals
2
Interconnect
Clinicians
a.
b.
c.
d.
e.
f.
3) Interconnect with
sources of health
and healthcare data
(such as pharmacy,
immunizations, etc.)
3
Personalize
Care
1) Develop principles
for consumer rights
2) Address privacy and
security concerns
3) Educate and inform
consumers about
opportunities and
benefits of health
information
technology
4
Improve
Population /
Public
Health
1) Adopt standards for
data and technical
structure
2) Expand use of local
population data to
support good policy
development,
decision making, and
planning
3) Establish a
governance structure
for public and private
data exchange
Analyze Value of Investment and develop principles for financing
Establish governance structure for sharing data
Establish a statewide process for adopting and promoting national standards for data and interoperability
Implement ongoing communication/education programs
Establish policies and practices to ensure protection of confidentiality and security
Endorse MDH’s continued leadership role in guiding e-Health development
Draft Preliminary Recommendations for Discussion Only December 14, 2004
Minnesota
Challenges and Gaps*
Type of Facility/
Provider
Number
Estimated
use of HIT
Gap/
Comment
Clinics / Primary Care
~ 700
Est. 5%-15%
Small & rural clinics
Long Term care-Nursing
Homes
~ 402
~ 2% - 4%
Clinical support, Interconnectivity
Hospital Emergency
Departments
~ 129
~ 10% - 12%
Rural & smaller, Connect
across systems
Local Public Health
Departments
~ 91
Varies
Limited access to
community data
No Interoperability
* Preliminary data – Based limited surveys
www.Health.state.mn.us/e-health/
Vision: A Minnesota Health
Information Exchange
MN-HIE will
interconnect
clinicians and be
the connection
point for:
• National Health
Information Network
(NHIN)
• Community-Based
Initiatives
www.Health.state.mn.us/e-health/
Framework for HIT Financing in
Minnesota
MN &
National
Goals
Goal 1
Inform Clinical
Practice
Goal 2
Interconnect
Physicians
Goal 3
Personalize
Care
Goal 4
Improve
Population
and Public
Health
System
Technology
(Initial Focus)
Electronic Health
Record
RHIO
Infrastructure/Hub
Personal Health
Record (PHR)
Disease
Surveillance
MN-PHIN
Startup Phase
Ongoing
Operations
Phase
www.Health.state.mn.us/e-health/
Nat’l Critical Access Hospital HIT
Survey (May 05, n = 361)
• Conducted by Rural Health Resource Center, Duluth
• Biggest Barriers to Initiating HIT:
– Capital Needs – 81% of respondents noted
– Staff Time - 50%
• Biggest Barriers to Continuing HIT:
– Acquiring hardware/software – 50%
– Staff time – 50%
• Most Helpful Resources?
– Grants/loans – 92%
– Access to best practices – 46%
www.Health.state.mn.us/e-health/
Financing Needs & Sources
Finance Needs - Who,What, Where:
• Locations and Institutions: Clinics, Clinic Systems, Nursing
Homes, Hospitals, Pharmacies, Home Health Care Systems,
Local Health Departments, etc.
• Persons: Physicians, Nurses, other providers
• What: Infrastructure, hardware, software, education,
conversion initiatives
Potential Funding Sources:
• Employers, Purchasers/Insurers, Private Financing, Selffunded, State Loans/Grants, Federal Grants, Non-profit
Grants
www.Health.state.mn.us/e-health/
Financing Principles
• Financially “able” entities are expected to
make investments as part of their regular
budget and IT planning
• State financing will complement, not
displace, private or federal investments
• Public financing will:
– Support small, rural, or underserved communities
– Require resource commitments from recipients
– Require interoperable system investment
www.Health.state.mn.us/e-health/
Financing Principles
• Investments need to:
– Advance interoperability
– Improve quality
– Be consistent with national standards &
certifications
• Align the cost of HIT investment with
benefits received
www.Health.state.mn.us/e-health/
Doctor’s Office Quality Information Technology
(DOQ-IT)
• Stratis - Medicare QIO
• Will help small/med clinics implement
EHR systems
– readiness assessment
– vendor selection
– practice redesign
– implementation and change management
www.Health.state.mn.us/e-health/
Grants/Loans for HIT
• MN Rural Hospital Capital Improvement
Grant Program
• MN Rural Hospital Planning/Transition Grants
• MN Community Clinics Grant Program
• Healthier MN Community Clinic Fund
• USDA RUS Telemedicine Grant Program
• US Office for Advancement of Telehealth
• US Agency for Healthcare Research &
Quality
• Loans – various sources
• Iron Range Resources
www.Health.state.mn.us/e-health/
Opportunities for
Action/Support
• Conduct readiness assessment for HIT
• Participate in community/regional
collaboration
• Increase health informatics knowledge &
education
• Educate your elected representatives on
your needs on this issues
• Help shape Minnesota directions
www.Health.state.mn.us/e-health/
Summary
• Critical need & readiness
for change leadership &
innovation
• Rural issues on the radar,
we need to keep them there!
• Call us!
– Mark Schoenbaum
– 651.282.3859
– mark.schoenbaum@state.mn.
us
• Thanks!
“…Doctors deserve to
focus on the quality of
their care, not the quantity
of their paperwork. And
both patients and doctors
deserve systems that will
prevent medical errors
before they become
medical and legal
problems.”
Secretary Thompson – July
2004
www.Health.state.mn.us/e-health/
For More Information
• www.health.state.mn.us/e-health
www.Health.state.mn.us/e-health/