www.health.state.mn.us/e-health/ mark schoenbaum, office of rural health & primary care the...

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


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


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


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


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


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


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


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


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%


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


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


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


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


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


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


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– [email protected]

• 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

mailto:[email protected]


For More InformationFor More Information

• www.health.state.mn.us/e-health

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

www.health.state.mn.us/e-health/ mark schoenbaum, office of rural health & primary care the...

Documents

health care quality

health care costs

local health departments

home health care systems

rural health resource

electronic health records

hit financing

private financing