Minnesota e-Health Initiative Progress and Plans 2005 – 2006 An Update Topics for Discussion Update on Progress Role of Stratis Health for advancing Goal.

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

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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

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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 don’t 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

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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

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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

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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

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Opportunity: National Framework for Strategic Action*

2004 Goals 1. Inform Clinical Practice

2. Interconnect Clinicians

3. Personalize Care

4. 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

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

2004 2005 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

Next Action StepsMN Health Information ExchangeSeek further input/commitment Establish BoardBusiness planning for exchange: e.g. Laboratory, Pharmacy, Disease Surveillance

Advisory CommitteeAssure broad HIT assessmentAdvance the roadmap: Goal 1: Goal 3: and Goal 4:

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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

Minnesota e-health InitiativeRoadmap for Strategic Action

Source: Committee Report to the Legislature, January 2005

Statewide

Build on National work

In progress

Workgroups

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Strengths of Minnesota Approach

Statewide approach Private-Public initiativeBroad participation and strong collaborationBuild on existing initiativesComprehensive vision- e.g. includes many

settings and disciplinesGlobal vision, incremental – sustainable

implementations

Minnesota e-Health InitiativeA 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

Rev. 9-25-05

Goal # 2Interconnect

Clinicians

Goal # 4Improve

Population /Public Health

Goal # 1Inform Clinical

Practice

Goal # 3Personal Health

Record

Statewide Advisory Committee

Example Statewide Activities by Goal

•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

Minnesota e-Health InitiativeMN Health Information Exchange

Update from Stratis Health10/21/05

Topics for DiscussionMN-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

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

Phase IIMN-HIE Implementation

Phase IIIMN-HIE Development &

Maintenance

Phase IMN-HIE Initialization

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Minnesota Health Information ExchangeRole of Stratis Health

Build on Year 1 recommendationsGather stakeholder input for transition

phaseUpdate HIT Assessment frameworkRecommend Board of DirectorsEstablish legal structure for MN-HIEDevelop business plan for three identified

business areasDevelop framework for funding

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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

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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

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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

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

– Physician– Public Health– Purchaser– Quality Improvement

Organization– State Government

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

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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 GoalsEncourage state wide coordination Assure underserved needs are metAddress population health issues Include readiness for preparedness and

response Effective communications and education

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Key Contacts for More Information:

www.health.state.mn.us/e-health

Stratis Health (Minn. Exchange Planning)Greg Linden - VP/Chief Information Officer(952) 853-8514 [email protected]

Minnesota Department of HealthMarty LaVenture, PhD– Director of Health Informatics612 676-5017 [email protected]

Barb Wills – 651 282-6373 - [email protected]

Thank You! - Questions