Minnesota e-Health Initiative Progress and Plans 2005 – 2006 An Update

1. 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

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 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

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

7. 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 Opportunity: National Framework for Strategic Action*

8. 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. Next Action Steps 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

10. 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

11. Statewide Build on National work In progress Workgroups 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

13. 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 # 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

14. 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

15. 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

16. Recommendation: Form a Minnesota Health Information Exchange • 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

17. 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!

19. 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

20. 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 HIT Assessment Domains

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

23. Community Hospital 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:

24. 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

25. 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

26. 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

27. 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 (952) 853-8514 glinden@mnqio.sdps.org • Minnesota Department of Health Marty LaVenture, PhD– Director of Health Informatics 612 676-5017 martin.laventure@health.state.mn.us Barb Wills – 651 282-6373 - Barb.wills@health.state.mn.us