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Assessing and Improving Local Health Departments e-Health
Capability and Capacity
Bethany Bradshaw, MPHApplied Public Health Informatics
Fellow,Wisconsin Department of Health Services*
Karen Soderberg, MSOffice of Health Information
Technology,Minnesota Department of Health
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Background: MinnesotaLocal public health (LPH) is engaged in
e-healthActive participation and leadership in the Minnesota
e-Health InitiativeSignificant part of the Minnesota Southeast
Beacon ProjectReceived over $750,000 in e-health loans and grants
between 2011-2013 from Office of Health Information Technology
(OHIT)Developed and responded to annual informatics survey
Preparing for the Minnesota 2015 Interoperable EHR Mandate
http://www.health.state.mn.us/e-health/hitimp/index.html
Note: In Minnesota, local public health services are provided
through Community Health Boards (CHBs), which have statutory
responsibilities for public health (Minnesota Stat. Chapter
145A)*
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Background: WisconsinMinimal LPH engagement with e-healthLPH has
not received any e-health related grant funding
Survey is first e-health assessment of Wisconsin LPH
Healthiest Wisconsin 2020: access to high-quality health
services that are coordinated across health, public health, and
other care systems Focus area: Systems to manage and share health
information and knowledge including with LPH
Source: Healthiest Wisconsin 2020,
http://www.dhs.wisconsin.gov/hw2020/ *
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MethodsMinnesotaRequired part of annual web-based assessment
since 2010
52 Community Health Boards
11 questions
Minnesota e-Health Profile
WisconsinVoluntary, stand-alone survey (Select Survey)
Distributed by email: 88 City/County/City-county Health
Departments, 11 Tribal Health Centers
5 questions from Minnesota survey; several definitions
20 questions (skip pattern)
*
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Common QuestionsElectronic health record (EHR) adoption
Health information exchange (HIE) activities used
HIE partners
Largest challenges to HIE
Most needed EHR-related skills and/or roles for new and/or
existing staff
*
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EHR Adoption by LPHMinnesota100% response rate
100% EHR adoption across CHBs 2 Local Health Departments (LHDs)
do not have EHRsPH-Doc, CHAMP, CareFacts
Wisconsin60% response rate
40% EHR adoption Most common : CHAMP
Of those with no EHR, 60% have no plans to adopt
75%: paper is primary system*
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Health Information Exchange Activities in LPH, Minnesota vs.
Wisconsin*
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HIE Partners for LPHMinnesota (n= 52)Health or county-based
purchasing plans (44%)Minnesota Department of Health (42%)Minnesota
Department of Human Services (29%)County/city department outside
jurisdiction (21%)Wisconsin (n= 58)Wisconsin Department of Health
Services (74%)No HIE (26%)Hospitals (22%)Laboratories (22%)*HIE was
defined as the electronic transmission of health related
information between organizations according to nationally
recognized standards. Health information exchange does not include
paper, mail, phone, fax, or standard/regular email exchange of
information.
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Needed HIE Connectivity for LPH*
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Top 3 HIE Challenges for LPHMinnesota (n= 52)Competing
priorities (42%)
Do not know exchange partners HIE ability (40%)
Exchange partners do not have HIE ability (40%)Wisconsin (n=
58)Insufficient information (48%)
Unclear return on investment (38%)
Lack of technical support (34%)*
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Most Needed EHR-Related Skills in LPH, Minnesota vs.
Wisconsin*
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FindingsImportance of education and buy-in to advance LPH
e-health capacity and capability.No clear picture of EHR capability
in LPH because no certification or standards.LPH agencies are not
meeting their HIE needs.Comparison across states identifies
differences and opportunities for collaboration and
sharing.Assessment of LPH e-health is necessary to:Identify gaps.
Identify barriers to effective strategies and efficient use of
resources (local and state).Evaluate e-health programs.
*
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RecommendationsStates should implement a statewide e-health /
informatics assessment for LPH.Work with NACCHO to access
state-specific data.LPH associations in collaboration with states
should develop a LPH e-health workgroup.Provide policy and
guidance; develop an e-health roadmap and shared vision; and offer
trainings and education.LPH should engage in e-health
collaborations and opportunities for funding.e-health can support
LPH participation in Accountable Care Organizations.LPH staff
should continue their learning.Online courses (e.g., MOOCs), Public
Health Informatics Institute, Minnesota e-Health
Initiative.Leverage current resources and tools.
*
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ResourcesPublic Health & Electronic Health Information
Exchange: A Guide to Local Agency Leaderships (www.phii.org) ONC
Beacon Program Learning Guides
(http://www.healthit.gov/policy-researchers-implementers/beacon-community-program/learning-guides)
Minnesota e-Health Profile
(http://www.health.state.mn.us/e-health/assessment.html) E-Health
toolkits
(http://www.stratishealth.org/expertise/healthit/index.html)Minnesota
e-Health Guides
(http://www.health.state.mn.us/e-health/reports.html) Wisconsin
survey report
(http://www.dhs.wisconsin.gov/localdata/index.htm)
*
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AcknowledgementsMinnesota Office of Health Information
TechnologyMinnesota Office of Performance ImprovementMinnesota
Local Public Health Association
Wisconsin Department of Health Services, Division of Public
Health Wisconsin Local Health DepartmentsWisconsin Tribal Health
AgenciesApplied Public Health Informatics Fellowship Program
*
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Contact Information
Karen Soderberg, MSOffice of Health Information
TechnologyMinnesota Department of [email protected]
(651) 201-3576
Bethany Bradshaw, MPHOffice of Health InformaticsWisconsin
Department of Health [email protected](608)
267-6782
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****Alternatively we can present the full questions:Which of the
following health information exchange activities are currently used
by your local health department to electronically exchange health
information (send or receive) with other organizations, assuming
appropriate consents have been obtained. (multi-select)Does your
local health department electronically receive health information
via health information exchange from any of the organizations
listed below? (multi-select)Does your local health department
electronically send health information via health information
exchange to any of the organizations listed below?
(multi-select)Which EHR-related skills and/or roles are in greatest
need within your organization? This includes adding new staff or
developing the current staff. (select up to 3)Indicate the largest
challenges related to electronic exchange of health information via
health information exchange with outside organizations (select up
to 3)
*It is important to note that although MN CHBs have EHRs, 10%
were planning to assess and plan for a new year and 17% to select
and implement a new EHR*Shows WI is still in initial phases of HIE
activities and EHR adoption. MN is in more advanced phase where
LHDs are limited by resources and partners, not their own technical
abilities.*Person to manage and process that data: shows that MN is
further along with EHR utilization with WI is still mostly focused
on implementation*