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www.Health.state.mn.us/e-health/
Mark Schoenbaum, Office of Rural Health & Primary Care
The MinnesotaThe Minnesota
e-Health Initiativee-Health Initiative
Smart Health for Rural communitiesJuly 19, 2005
www.Health.state.mn.us/e-health/
Health & Health Care System Health & Health Care System ChallengesChallenges
• Error rates are too high• Quality is inconsistent• Costs are escalating• Research results are not
rapidly used• Demographics of baby
boomers increasing demand
• Capacity for early detection & response to threats is minimal
www.Health.state.mn.us/e-health/
Health Information Technology: Health Information Technology: What is it?What is it?
• Electronic Health Records (EHR), but also:• Computerized provider order entry (CPOE), Including
applications like:– E-Pharmacy (Formulary, History and Prescribing)– Diagnostic applications for Laboratory, Radiology
• Secure e-mail communication• Telehealth & Imaging Technology• Public Health monitoring and disease surveillance, and
prevention– Communicable Disease Reporting– Immunization Registries
• Computerized decision support systems• Personal health records
www.Health.state.mn.us/e-health/
Minnesota e-Health Minnesota e-Health InitiativeInitiative
What is it?What is it?• Based on:
• National Framework for Strategic Action 2004
• State legislation 2004, 2005
www.Health.state.mn.us/e-health/
Minnesota e-Health InitiativeMinnesota e-Health InitiativeWhat is it?What is it?
• Public - Private collaboration• 2004,2005 Advisory Committees
• Designed to accelerate the use of Health Information Technology in all areas of the state
• Purpose is to: - Improve health and health care quality, - Increase patient safety, - Reduce health care costs, and - Improve public health
Minnesota RoadmapMinnesota Roadmap
www.Health.state.mn.us/e-health/
Minnesota Minnesota Challenges and Gaps*Challenges and Gaps*
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
Hospital Emergency Departments
~ 129 ~ 10% - 12% Rural & smaller, Connect across systems
Local Public Health Departments
~ 91 Varies Limited access to community data
No Interoperability
* Preliminary data – Based limited surveys
www.Health.state.mn.us/e-health/
Vision: A Minnesota Vision: A Minnesota Health Information Health Information
ExchangeExchangeMN-HIE will
interconnect clinicians and be the connection point for:
• National Health Information Network (NHIN)
• Community-Based Initiatives
www.Health.state.mn.us/e-health/
Framework for HIT Financing in Framework for HIT Financing in MinnesotaMinnesota
MN & National
Goals
Goal 1
Inform Clinical Practice
Goal 2 Interconnect Physicians
Goal 3 Personalize
Care
Goal 4 Improve
Population and Public Health
System Technology
(Initial Focus)
Electronic Health Record
RHIO Infrastructure/Hub
Personal Health Record (PHR)
Disease Surveillance
MN-PHIN
Startup Phase
Ongoing Operations
Phase
www.Health.state.mn.us/e-health/
Nat’l Critical Access Nat’l Critical Access Hospital HIT Survey (May Hospital HIT Survey (May
05, n = 361)05, n = 361)• Conducted by Rural Health Resource Center, Duluth
• Biggest Barriers to Initiating HIT:– Capital Needs – 81% of respondents noted– Staff Time - 50%
• Biggest Barriers to Continuing HIT:– Acquiring hardware/software – 50%– Staff time – 50%
• Most Helpful Resources?– Grants/loans – 92%– Access to best practices – 46%
www.Health.state.mn.us/e-health/
Financing Needs & SourcesFinancing Needs & Sources
Finance Needs - Who,What, Where:• Locations and Institutions: Clinics, Clinic Systems, Nursing
Homes, Hospitals, Pharmacies, Home Health Care Systems, Local Health Departments, etc.
• Persons: Physicians, Nurses, other providers• What: Infrastructure, hardware, software, education,
conversion initiatives
Potential Funding Sources:• Employers, Purchasers/Insurers, Private Financing, Self-
funded, State Loans/Grants, Federal Grants, Non-profit Grants
www.Health.state.mn.us/e-health/
Financing Financing PrinciplesPrinciples
• Financially “able” entities are expected to make investments as part of their regular budget and IT planning
• State financing will complement, not displace, private or federal investments
• Public financing will:– Support small, rural, or underserved communities– Require resource commitments from recipients– Require interoperable system investment
www.Health.state.mn.us/e-health/
Financing Financing PrinciplesPrinciples
• Investments need to:
– Advance interoperability
– Improve quality
– Be consistent with national standards & certifications
• Align the cost of HIT investment with benefits received
www.Health.state.mn.us/e-health/
Doctor’s Office Quality Information Technology Doctor’s Office Quality Information Technology
(DOQ-IT)(DOQ-IT)
• Stratis - Medicare QIO
• Will help small/med clinics implement EHR systems – readiness assessment– vendor selection– practice redesign– implementation and change management
www.Health.state.mn.us/e-health/
Grants/Loans for HITGrants/Loans for HIT• MN Rural Hospital Capital Improvement Grant
Program• MN Rural Hospital Planning/Transition Grants• MN Community Clinics Grant Program• Healthier MN Community Clinic Fund• USDA RUS Telemedicine Grant Program• US Office for Advancement of Telehealth• US Agency for Healthcare Research & Quality• Loans – various sources• Iron Range Resources
www.Health.state.mn.us/e-health/
Opportunities for Opportunities for
Action/SupportAction/Support
• Conduct readiness assessment for HIT• Participate in community/regional
collaboration• Increase health informatics knowledge &
education• Educate your elected representatives on
your needs on this issues• Help shape Minnesota directions
www.Health.state.mn.us/e-health/
SummarySummary
• Critical need & readiness for change leadership & innovation
• Rural issues on the radar, we need to keep them there!
• Call us!– Mark Schoenbaum– 651.282.3859– mark.schoenbaum@state.mn.us
• Thanks!
“…Doctors deserve to focus on the quality of their care, not the quantity of their paperwork. And both patients and doctors deserve systems that will prevent medical errors before they become medical and legal problems.”
Secretary Thompson – July 2004
www.Health.state.mn.us/e-health/
For More InformationFor More Information
• www.health.state.mn.us/e-health
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