e-local Public Health Kari Guida, MPH, MHI Senior Health Informatician Office of Health Information Technology Minnesota Department of Health
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1 e-local Public Health Kari Guida, MPH, MHI Senior Health Informatician Office of Health Information Technology Minnesota Department of Health
2 Points Most CHBs have EHRs but without certification or standards there is no clear understanding of needs and capability CHBs are not meeting their needs for health information exchange but are making improvements Organization and workforce needs persist Many current and future opportunities and resources to build e-public health capability and capacity
3 e-public Health
4 What do we mean by e-public health? Not a new definition of the core mission and functions of governmental public health But captures the impact of the digital era on the information roles and practices of agencies Happening at different paces for different programs at all levels of public health Adapted from Bill Brand, Public Health Informatics Institute, Are You Ready for e-public Health?, January 2014.
5 e-public health is the effective use of information and information technologies to monitor and promote the conditions in which people can be healthy Adapted from Bill Brand, Public Health Informatics Institute, Are You Ready for e-public Health?, January 2014.
6 Vision Information at the fingertips of those who need it, supporting actions to advance community-centered health. Adapted from Bill Brand, Public Health Informatics Institute, Are You Ready for e-public Health?, January 2014.
7 Status of e-local Public Health 2013 PPMRS Informatics Result
8 EHR Systems Used by CHBs, 2013 EHR System Number Percent PH-Doc 23 46% CHAMP 20 40% CareFacts 8 16% Custom-built local system 4 8% Digital Health Department 3 6% Decade 1 2% Other 4 8% Total* 50
9 Planned Changes to EHR Systems and Capabilities, 2013 Increase functional capabilities or use of the EHR system Electronically exchange health information w/ another system (66%) (66%) Select and implement a new EHR system 8 (16%) Assess and plan for a new EHR system No major changes planned to current EHR system 4 4 (8%) (8%) Do not know 1 (2%) Number (Percent) of CHBs (N=50)
10 Informatics Activities Conducted, 2013 Review current system and determine information needs of your organization Create a strategic direction or plan for the public health EHR Conduct or review security risk analysis information and privacy/confidentiality control 18 (36%) 29 (58%) 42 (84%) Conduct a readiness assessment for exchange 15 (30%) Implement formal project management process 14 (28%) Other 8 (16%) None 2 (4%) Number (Percent) of CHBs (N=50)
11 Health Information Exchange Activities Used, 2012 and (N=50) 2012 (N=52) Receive secure messages or attachments from providers/facilities/organizations (78%) (67%) Send secure messages or attachments to providers/facilities/organizations (52%) (74%) Securely query for patient records from providers/facilities/organizations 12 (24%) 6 (12%) Do not exchange or do not know 8 (16%) 13 (25%) Number (Percent) of CHBs
12 Current and Need HIE Activity, 2013 Need to Exchange Currently Exchanging Hospitals Primary Care Clinics Minnesota Department of Health Local health departments/chbs outside jurisdiction Health or county-based purchasing plans Long Term Care Facilities Minnesota Department of Human Services Home Health Agencies County/city departments /program outside or inside jurisdiction but outside local health dept. Pharmacies Laboratories Jail/Correctional Health (96%) 21 (42%) 47 (94%) 20 (40%) 42 (84%) 35 (70%) 35 (70%) 20 (40%) 33 (66%) 25 (50%) 31 (62%) 10 (20%) 31 (62%) 22 (44%) 29 (58%) 7 (14%) 26 (52%) 16 (32%) 19 (38%) (8%) 18 (36%) 9 (18%) 14 (28%) (8%) Number (Percent) of CHBs (N=50)
13 Challenges to HIE, 2013 Do not know exchange partners ability to electronically exchange health 23 (46%) HIPAA, privacy or legal concerns 20 (40%) Competing priorities Exchange partners do not have the ability to electronically exchange (34%) (34%) Lack of or access to technical support or expertise Subscription rates for exchange services are too high (26%) (24%) Inability of our organization s EHR system to handle electronic 8 (16%) Insufficient information on exchange options available 5 (10%) Unclear value on return on investment 4 (8%) Limited broadband/internet access CHB Support 2 (4%) 2 (4%) Other 5 (10%) Number (Percent) of CHBs (N=50)
14 EHR-Related Staffing Skills Needed, 2013 People to manage and process the data, information, and knowledge 31 (60%) A person to lead the implementation of an EHR 23 (44%) People to train staff on how to use the EHR 22 (42%) People to help design, maintain and customize an EHR for use in our facility People to develop and write reports from an EHR (23%) (33%) People to get the EHR ready for use 8 (15%) Other 5 (10%) Number (Percent) of CHBs (N=50)
15 Top Strengths and Gaps in CHB Workforce, 2013 Top strengths and gaps in CHB workforce, Strengths Gaps Community engagement 2 2 Leadership 4 Communication 11 Policy development/ program planning Cultural competency 8 Financial planning and management Analytical/ assessment 3 Informatics 1 Public health sciences
16 e-public Health Resources & Opportunities
17 Minnesota e-health Guides Addressing Common Barriers Recommended Standards Electronic Prescribing Effective Use of EHR Systems Health Information Exchange
18 e-health Toolkits Local Health Departments and Behavioral health Home Health Nursing Homes Social Services More information can be found at
19 2015 Interoperable EHR Mandate The Minnesota Department of Health (MDH) recognizes that some providers may not be able to achieve the 2015 Interoperable EHR Mandate by January 1, Currently, there is no fine or formal penalty for not complying with the mandate. Nonetheless, the e-health Advisory Committee and MDH recommend that all providers demonstrate progress toward achieving the EHR and interoperability requirements. Potential benefits of compliance may include: increased efficiency and quality outcomes; improved ability to avoid adverse events; and timely access to information from your patients other providers. More information on the mandate can be found at
20 Additional Resources & Opportunities Minnesota Accountable Health Model and SIM-Minnesota Activities ( Minnesota e-health Initiative ( Public Health Informatics Institute Informatics Academy (
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