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Assessing and Improving Local Health Departments’ e-Health Capability and Capacity. Karen Soderberg, MS Office of Health Information Technology, Minnesota Department of Health. Bethany Bradshaw, MPH Applied Public Health Informatics Fellow, Wisconsin Department of Health Services.
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Assessing and Improving Local Health Departments’ e-Health Capability and Capacity Karen Soderberg, MS Office of Health Information Technology, Minnesota Department of Health Bethany Bradshaw, MPH Applied Public Health Informatics Fellow, Wisconsin Department of Health Services
Background: Minnesota Local public health (LPH) is engaged in e-health • Active participation and leadership in the Minnesota e-Health Initiative • Significant part of the Minnesota Southeast Beacon Project • Received over $750,000 in e-health loans and grants between 2011-2013from 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)
Background: Wisconsin • Minimal LPH engagement with e-health • LPH 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/
Methods Minnesota Wisconsin Voluntary, 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) • Required part of annual web-based assessmentsince 2010 • 52 Community Health Boards • 11 questions • Minnesota e-Health Profile
Common Questions • Electronic 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
EHR Adoption by LPH Minnesota Wisconsin 60% response rate 40% EHR adoption Most common : CHAMP Of those with no EHR, 60% have no plans to adopt 75%: paper is primary system • 100% response rate • 100% EHR adoption across CHBs • 2 Local Health Departments (LHDs) do not have EHRs • PH-Doc, CHAMP, CareFacts
Health Information Exchange Activities in LPH, Minnesota vs. Wisconsin
HIE Partners for LPH Minnesota (n= 52) 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.” • Health or county-based purchasing plans (44%) • Minnesota Department of Health (42%) • Minnesota Department of Human Services (29%) • County/city department outside jurisdiction (21%)
Top 3 HIE Challenges for LPH Minnesota (n= 52) Wisconsin (n= 58) Insufficient information (48%) Unclear return on investment (38%) Lack of technical support (34%) • Competing priorities (42%) • Do not know exchange partners’ HIE ability (40%) • Exchange partners do not have HIE ability (40%)
Most Needed EHR-Related Skills in LPH, Minnesota vs. Wisconsin
Findings • Importance 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.
Recommendations • States 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.
Resources • Public 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)
Acknowledgements • Minnesota Office of Health Information Technology • Minnesota Office of Performance Improvement • Minnesota Local Public Health Association • Wisconsin Department of Health Services, Division of Public Health • Wisconsin Local Health Departments • Wisconsin Tribal Health Agencies • Applied Public Health Informatics Fellowship Program
Contact Information Karen Soderberg, MS Office of Health Information Technology Minnesota Department of Health Karen.Soderberg@state.mn.us (651) 201-3576 Bethany Bradshaw, MPH Office of Health Informatics Wisconsin Department of Health Services Bethany.Bradshaw@gmail.com (608) 267-6782