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Minnesota e-Health Initiative Progress and Plans 2005 – 2006 An Update Presenters Marty LaVenture, Director, Center for Health Informatics, MDH Greg Linden, CIO Stratis Health Topics for Discussion Update on Progress

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

  • Presenters

  • Marty LaVenture, Director, Center for Health Informatics, MDH

  • Greg Linden, CIO

  • Stratis Health

Topics for Discussion

Update on Progress

Role of Stratis Health for advancing Goal #2 recommendations for MN-HIE


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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 Records

  • 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 Records

  • “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* Problems Today* Preliminary data – Based on limited surveys


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2004 Goals Problems Today

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

Opportunity: National Framework for Strategic Action*


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What is the Minnesota e-Health Initiative? Problems Today

  • 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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  • Next Action Steps Problems Today

    MN Health Information Exchange

  • Seek further input/commitment

  • Establish Board

  • Business planning for exchange: e.g. Laboratory, Pharmacy, Disease Surveillance

    Advisory Committee

  • Assure broad HIT assessment

  • Advance the roadmap: Goal 1: Goal 3: and Goal 4:

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 Problems Today

“… 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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Statewide Problems Today

Build on National work

In progress

Workgroups

Minnesota e-health InitiativeRoadmap for Strategic Action

Source: Committee Report to the Legislature, January 2005


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Strengths of Minnesota Approach Problems Today

  • 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 Problems Today

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 # 1

Inform Clinical Practice

Goal # 2

Interconnect Clinicians

Goal # 3

Personal Health Record

Goal # 4

Improve Population /Public Health

  • MDH: Rural Health Grants

  • Stratis Health:/QIO: DOQ-IT program

  • Assessment (Stratis Health, MDH/U of M)

  • 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/LPHA: MN-PHIN – Governance, Population Indicators

  • RWJF Funding Application

Rev. 9-25-05


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Minnesota e-Health Initiative Problems TodayMN 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 Problems Today

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 Problems Today

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

Phase I

MN-HIE Initialization

Phase II

MN-HIE Implementation

Phase III

MN-HIE Development &

Maintenance


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Minnesota Health Information Exchange Problems TodayRole 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


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Stakeholder Input to date Problems Today

  • 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 Problems Today

    • 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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    Hospitals Problems Today

    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

    HIT Assessment Domains


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    Ongoing Assessment Collaboration Problems Today

    • 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 Problems Today

    • 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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    Community Hospital Problems Today

    Consumer

    Health Plan

    Hospital System

    Insurance Company

    Pharmacy

    Physician

    Public Health

    Purchaser

    Quality Improvement Organization

    State Government

    Interim Board Composition

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


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    Phased Approach Problems Today

    • 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 Problems Today

    • 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 Problems Today

    • 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 Problems Today

    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 Health

      Marty LaVenture, PhD– Director of Health Informatics

      612 676-5017 [email protected]

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


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