Minnesota e-Health Initiative Progress and Plans 2005

1
Minnesota e-Health InitiativeProgress and Plans
2005 2006 An Update

• Topics for Discussion
• Update on Progress
• Role of Stratis Health for advancing Goal 2
  recommendations for MN-HIE

• Presenters
• Marty LaVenture, Director, Center for Health
  Informatics, MDH
• Greg Linden, CIO
• Stratis Health

2
Motivation Preparedness, Response and Electronic
Health Records

• HHS Secretary Leavitt .
• "There may not have been an experience that
  demonstrates, for me or the country, more
  powerfully the need for electronic health records
  ... than Katrina." .
• (HHS - 9/13/2005).
• Hurricane Katrina
• Many paper health and health care records
• lost permanently
• Many digital records available in days

3
Motivation Storm of Problems

• Error rates are too high
• 20 deaths due to errors in MN Hospitals in 2004
• Quality is inconsistent
• 50 of adults dont get offered recommended care
• Costs are escalating
• 11 average yearly cost growth over past 5 years.
  
• Research results are not rapidly used
• 17 years until new innovations are widely used.
  
• Capacity for early detection response to
  threats and disasters is minimal
• Katrina response
• Limited Public Health Capacity

4
Motivation Un-Linked Systems Are Resource
Expensive

• we typically have to enter the same child's name
  again and again in 6 or more data systems and
  then try and keep the address and related
  information up to date. It can be a nightmare
  and it is expensive.
• Local Public Health Department Director

5
Motivation Information Technology Can Help Solve
Real Problems Today

• 40 of outpatient prescriptions unnecessary
• 20 of lab x-ray tests ordered because
  originals can not be found
• 18 medical errors from inadequate patient
  information.
• Patients get only 54.9 of recommended care
• 49 of notifiable diseases reported
• - Dr. Blackford Middleton, PHIN 2005 Meeting

6
Motivation Minnesota Gaps Preliminary data
Based on limited surveys
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, Inter-connectivity
Emergency Departments 129 10 - 12 Core data access, Connect across systems
Local Public Health Departments 91 Varies Limited access to community data No Interoperability
7
Opportunity National Framework for Strategic
Action

• 2004 Goals
• Inform Clinical Practice
• Interconnect Clinicians
• Personalize Care
• Improve Population Health

• 2005 Action
• American Health Information Community (AHIC)
  
• 4 - RFPs
• Pilots NHIN
• Harmonize Health IT Standards
• Assess Privacy Security
• Develop Certification Process for Health IT

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What is the Minnesota e-Health Initiative?

• Private-Public collaboration
• Guided by an advisory committee
• Born of need and legislation 2004/05
• Dedicated to accelerate the use of Health
  Information Technology (HIT) in all areas of the
  state
• For the purpose of
• Improving health and health care quality
• Increasing patient safety
• Reducing health care costs
• Improving public health

9
MN e-Health Steering Committee Progress
Proposed Actions 2004-2006

• Progress To date
• Delivered report to Legislature (vision, roadmap,
  recommendations)
• Developed principles for MN Health information
  exchange (MH-HIE) (Goal 2 Interconnect)
• Collaborated on response to NHIN-RFI
• Identified priorities for MN-HIE
• Held statewide summit

2004
2005
2006
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Vision for Minnesota e-Health

• accelerate the adoption and use of Health
  Information Technology to improve healthcare
  quality, increase patient safety, reduce
  healthcare costs and enable individuals and
  communities to make the best possible health
  decisions.

Source Committee Report to the Legislature,
January 2005
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Minnesota e-health InitiativeRoadmap for
Strategic Action
Source Committee Report to the Legislature,
January 2005
12
Strengths of Minnesota Approach

• Statewide approach
• Private-Public initiative
• Broad participation and strong collaboration
• Build on existing initiatives
• Comprehensive vision- e.g. includes many settings
  and disciplines
• Global vision, incremental sustainable
  implementations

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Minnesota e-Health Initiative A private-public
collaboration to accelerate use of Health
Information Technology in order to improve health
care quality, Increase patient safety, reducing
health care costs, and improve public health
Statewide Advisory Committee
Example Statewide Activities by Goal
Goal 2 Interconnect Clinicians
Goal 4 Improve Population /Public Health
Goal 1 Inform Clinical Practice
Goal 3 Personal Health Record

• Stratis Health MN Health Information Exchange
  (MN-HIE) Establish Board, Business case
• HIPAA Collaborative Medication history exchange
• CHIC NE MN planning for exchange
• AHRQ Shared Abstract Allina, Fairview, Health
  Partners, U of M

• Access for individuals and care givers

• MDH Rural Health Grants
• Stratis Health/QIO DOQ-IT program
• Assessment (Stratis Health, MDH/U of M)

• MDH/LPHA MN-PHIN Governance, Population
  Indicators
• RWJF Funding Application

Rev. 9-25-05
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Minnesota e-Health InitiativeMN Health
Information Exchange Update from Stratis
Health10/21/05

• Topics for Discussion
• MN-HIE Update from Stratis Health
• Greg Linden, CIO
• Stratis Health

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Recommendation Form a Minnesota Health
Information Exchange

• MN-HIE will interconnect clinicians and be the
  connection point for
• National Health Information Network (NHIN)
• Community-Based Initiatives

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Recommendation Form a Minnesota Health
Information Exchange
Phase I MN-HIE Initialization

• The MN-HIE governance structure will be developed
  utilizing a phased-in approach.

Phase II MN-HIE Implementation
Phase III MN-HIE Development Maintenance
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Minnesota Health Information ExchangeRole of
Stratis Health

• Build on Year 1 recommendations
• Gather stakeholder input for transition phase
• Update HIT Assessment framework
• Recommend Board of Directors
• Establish legal structure for MN-HIE
• Develop business plan for three identified
  business areas
• Develop framework for funding

18
Stakeholder Input to date

• We (MDH and Stratis Health) have started to meet
  with key stakeholder groups (e.g. Buyers, Health
  Plans, Hospitals)
• General consensus
• Keep communicating
• Move forward!
• More meetings to come!

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HIT Assessment Objectives

• Inventory the major assessments and related data
  collection tools for measuring the status of HIT
  adoption in Minnesota
• Identify gaps in current adoption of HIT
• Identify gaps in assessments of HIT
• Present the findings to the MN e-Health Advisory
  Committee
• Establish an ongoing assessment framework

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HIT Assessment Domains

• Hospitals
• Clinics
• Long Term Care Facilities
• Emergency depts
• Local Pub Health depts
• Pharmacies
• Clinical Laboratories
• Home Care and Home Health Agencies
• Health systems
• Health Plans

• Tele-medicine Sites
• Persons/Consumers
• Physicians
• Registered Nurses
• Stand-Alone Radiology Practices
• State agencies represented by the Health Care
  Cabinet
• MN Dept of Health
• MN Dept of Human Services

21
Ongoing Assessment Collaboration

• Working with MDH and the U of MN Health
  Informatics division to develop a comprehensive
  informatics framework for ongoing assessment on
  Minnesota
• It will include assessment needs for all 4
  Minnesota strategic goals, across all the domains

22
MN-HIE Interim Board

• Recommendation The MN e-Health Steering
  Committee recommended (June 23, 2005)
  establishing an Interim Board for the MN-HIE
• Key principle for the MN-HIE Board
• MN-HIE will be operated with a multi-stakeholder
  Board of Directors

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Interim Board Composition

• Recommendation The workgroup recommends that
  the Interim Board represents interests in the
  following areas

• Community Hospital
• Consumer
• Health Plan
• Hospital System
• Insurance Company
• Pharmacy

• Physician
• Public Health
• Purchaser
• Quality Improvement Organization
• State Government

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Phased Approach

• Recommendation Once MN-HIE is established,
  composition of the Board will evolve over time as
  the organization moves through three phases of
  development
• Phase I Initialization
• Establish a governance structure that will be
  used to define, plan, and design the MN-HIE

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Interim Board Next Steps

• Identify candidates to represent the interests
  identified by the Governance Workgroup
• An update on this process will be presented to
  the Advisory Committee as part of the November
  update
• The objective is to finalize selection of the
  Interim Board and convene its first meeting in
  1Q06

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Next Steps and Challenges

• Priority for the work plan
• Advance strategic topics for the 4 Goals
• Encourage state wide coordination
• Assure underserved needs are met
• Address population health issues
• Include readiness for preparedness and response
• Effective communications and education

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Thank You! - Questions

• Key Contacts for More Information
• www.health.state.mn.us/e-health
• Stratis Health (Minn. Exchange Planning)
• Greg Linden - VP/Chief Information Officer
• [phone] glinden_at_mnqio.sdps.org
• Minnesota Department of Health
• Marty LaVenture, PhD Director of Health
  Informatics
• 612 676-5017 martin.laventure_at_health.state.mn.us
• Barb Wills 651 282-6373 - Barb.wills_at_health.sta
  te.mn.us