Director, Office of Health IT and e Health; State Government HIT Coordinator. Deputy Director, Office of Health IT and e Health

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1 Assignment Location: Minnesota Department of Health St. Paul, Minnesota Primary Mentor: Secondary Mentor: Martin LaVenture, PhD, MPH, FACMI Director, Office of Health IT and e Health; State Government HIT Coordinator Minnesota Department of Health Jennifer Fritz, MPH Deputy Director, Office of Health IT and e Health Minnesota Department of Health Mentor Information Dr. LaVenture is a leading expert in the field of public health informatics and has been a pioneer in establishing an informatics unit within a state health agency. He has been Director of the Center for Health Informatics since 1997, which is currently the Office of Health Information Technology (OHIT) and e Health. The OHIT provides: informatics support to many programs within the department; coordinates the MDH Meaningful Use program; supports the 10 year old Minnesota e Health Initiative and the corresponding legislatively chartered e Health Advisory Committee. The E Health Initiative received the 2014 State Government Innovation Award. (http://sgia.umn.edu/). Dr. LaVenture was the former Assistant State Epidemiologist for Wisconsin Division of Health and has authored numerous articles including: a seminal paper in the field of public health informatics in 2000; lead author for the chapter on public health informatics in the 4th edition of the Shortliffe & Cimino s Textbook of Biomedical Informatics (BMI); lead author for the series of articles on creating and informatics savvy health department. He is an elected fellow to the American College of Medical Informatics and member of public health/e health informatics policy committee of ASTHO since Supervisory Experience: Dr. LaVenture has over 30 years of experience managing public health programs most recently with the Minnesota Department of Health (MDH). He has directed small and large programs with staff from 10 to over 250. He currently directs the Office of Health IT and e Health. The OHIT programs include: the Minnesota e Health initiative; Standards and Interoperability; Health Information Exchange; Certification of and oversight of HIE vendors; meaningful use; informatics profile and evaluation and assessment; privacy and security program; informatics technical assistance and others. 3. Past Mentoring Experience: Dr. LaVenture has served as mentor, preceptor and advisor to graduate students, fellows, medical residents, health professionals, and others for some 30 years. Most recently he has served as mentor for I TIPP fellows and for graduate students from Nursing, Public Health and Health Informatics. 4. Academic Affiliations and Responsibilities: Dr. LaVenture holds Adjunct Faculty appointments at the University of Minnesota (UMN) Institute for Health Informatics (IHI), School of Nursing, and the School of Public Health. He is instrumental in the conceptualization and offering of the first public health informatics course offered for academic credit at

2 UMN. He is also involved in many public health informatics training and education efforts and regularly serves as a guest speaker for PHI seminars and courses. Jennifer Fritz is the Deputy Director from the Office of Health Information Technology at the Minnesota Department of Health. Jennifer is responsible for the direction of Minnesota e Health programs, including the Minnesota e Health Initiative, Minnesota s Health Information Exchange Oversight Program, Minnesota s State Health Information Exchange Cooperative Agreement, and activities related to privacy and security, health informatics and data standards. Prior to serving as Deputy Director, Jennifer was a project manager on the state s health information exchange activities with responsibilities for developing and implementing Minnesota s strategic plan for health information exchange. Jennifer has also worked on a variety of public health informatics projects aiming to improve the development and use of public health information systems. 2. Supervisory Experience: Jennifer has been a supervisor in her current role for approximately 2 ½ years. In her current role, working collaboratively with the Director of the Office of Health Information Technology, Jennifer provides overall leadership and guidance on public health informatics issues and projects to staff both within the Office of Health Information Technology and in consultation capacity outside of the Office to other Minnesota Department of Health staff. 3. Past Mentoring Experience: Jennifer has informally, both as supervisor and peer colleague, served as a mentor to other fellows, particularly ones located within the Office of Health Information Technology. 4. Academic Affiliations and Responsibilities: Jennifer does not hold any formal academic affiliations or responsibilities. Assignment Description Minnesota s public health system is known as one of the best in the nation. It is built upon a strong partnership between the Minnesota Department of Health (MDH), local public health agencies, tribal governments and a range of other organizations. The department s mission is to protect, maintain and improve the health of all Minnesotans. It has about 1,500 employees and an annual budget of approximately $500 million in state, federal and fee based funds. An agency overview can be found here: The MDH Office of Health IT and e Health (OHIT) can offer the Fellow many opportunities to meet IPE objectives and a broad range of other significant learning opportunities and training experiences. MDH has extensive experience with projects, activities and programs that use a collaborative practice approach. Public health informatics by its nature is an interdisciplinary activity and education is a foundational tenet. The MDH OHIT Fellowship projects involve teams with staff from across public health disciplines both internal and external to MDH. The work is charter driven and based on informatics and information sciences practices and consistent with inter professional education (IPE) principles. Examples include training and mentoring in project leadership skills that are essential to building and sustaining teams, including the ability to identify a health team s shared goal and define who is on the team; create and

3 use clear roles and responsibilities, and specific desired goals, roles and responsibilities are championed as well as an effective communications strategy. The Fellow will have many opportunities to be part of activities that strengthen partnerships and linkages among public health, health care systems, non public health governmental agencies, and community based organizations. One key example is that the Fellow will be part of the MN e Health Initiative, a 10 year old effort that engages a diverse and statewide set of stakeholders to support e health goals and is coordinated by OHIT. The Fellow will participate in the planning of the e Health Advisory Committee meetings. In addition the Fellow will participate in co supporting one of the Advisory Committee workgroups. The current workgroups are Health Information Exchange, Standards and Interoperability, and Privacy and Security. The fellow will also participate in several of the innovative programs underway at OHIT. In June 2014, OHIT celebrated the 10 year anniversary of partnerships and linkages with the health systems around the state. The e Health Initiative has produced multiple innovative efforts in using informatics to support community health most recently receiving a 2014 State Government Innovations award for the accomplishments. The Fellow will be encouraged to participate in two or more of these innovative initiatives. o State Innovation Model (SIM) is funded by CMS and designed to support development of innovative communities activities. o MDH Health Equity Initiative recognizes that e health is a tool to advance health equity and access to e health is a social determinant of health. o Community e Health Roadmaps project is a ground breaking effort to establish a community driven approach to develop roadmaps for local public health, long term and post acute care, behavioral health and social services that will provide short and long term steps to use e health to participate in accountable communities of health. o Assessment of lab and long term care settings by creating an informatics profile of the specific domains. o Robust registration and onboarding process for meaningful use o TEFT program is a CMS sponsored program with the Minnesota Department of Human Services that tests feasibility of personal health records for individuals using home and community based services. o The Learning Health System is innovative work that will provide the Fellow with an opportunity to research and explore creative and innovation ideas for advancing the learning health system in Minnesota. In brief, The Fellow s projects are informatics issues associated with several ongoing efforts aimed at creating a more comprehensive, integrated and efficient health system. Day to Day Activities Each day will involve a schedule organized by the Fellow that will have some time for collaborating with the OHIT team and other time to work on specific objectives for the project. Some days the work will be in the office and other days will be with other programs within MDH or involve visits to the community. Participation with the University of Minnesota and academic pursuits are an option as well. The fellow with be engaged as a partner in the OHIT teams as a full member of projects and team meetings and to focus on specific projects.

4 An Informatics Fellowship with the Office of Health IT and e Health (OHIT) at the MDH is a fantastic opportunity to be active and integral part of a multidisciplinary team in a dynamic health informatics environment. The OHIT team consists of experienced professionals with a diverse set of expertise such as health informatics, assessments, data analysis, program management, policy development, regulations, communications and outreach. In addition, support structures are in place to help ensure administrative and operational support for the Fellow. The Fellow will work collaboratively with senior public health leaders and staff on a variety of projects. The Fellow will interface with community stakeholders from across Minnesota beginning with the members of the Minnesota e Health Advisory Committee (www.health.state.mn.us). In addition, the Fellow will have opportunities for a broad range of other significant learning opportunities and training experiences. Potential Projects include: 1. Public Health Informatics Profile and Interoperability Framework This project will create an informatics profile for approximately 30 key MDH program applications with a focus on readiness for interoperability. This includes factors such as technical, organizational policy, workflow process and workforce readiness. In addition, this project will develop a Minnesota interoperability profile for the technical semantic, syntactic and process standards used on transactions with community stakeholders. This work will build on information from the Office of the National Coordinator, meaningful use standards, Public Health Informatics Institute Common Ground project, CDC standards, and previous work at MDH. Public Health impact: This project will identify the interoperability readiness status for approximately 30 MDH program applications including specific barriers and opportunities for actions. The recommendations for priority actions will be a key contribution to the MDH interoperability governance process including setting priorities for on boarding applications to the MDH Public Health Portal and with the health care providers. Based on previous work and interest by MDH programs this is attainable, realistic and time bounded. Project Activities and Deliverables: This project will: Establish a project charter with the study purpose, methods, design, roles, scope, timeline project team and risks. Establish a project team and inventory target public health program applications. Design and create data gathering instruments, frameworks and related factors

5 Interview program staff and collect comprehensive informatics profile information including status, barriers, and opportunities for achieving interoperability. Analyze and summarize the information in table graphs and charts Develop agency wide recommendations for action based on findings. Present information in a variety of venues and formats including slide presentation, abstracts, conferences and meetings 2. Minnesota e Health Framework for Health Equity This project builds on the work of the Institute of Medicine (IOM) and MDH focusing on using e health as a tool to advance health equity. A primary focus will be on engaging the health care community to identify and prioritize social determinants of health (SDH) and standards necessary capture and exchange SDHs across the continuum of care. The Framework will include key elements for using EHRs and repositories to captured, analyze and use SDH to support population goals and improve health equity. Informatics and e health policy issues will be identified and presented to the MN e Health Advisory Committee and its workgroups as well as the MDH Center for Health Equity. Tools, templates and tips will be developed and they will be aligned with Minnesota s work on e health roadmaps and using e health for accountable care and national work such as through the ONC. Public Health impact: This project will review and synthesize current literature and work on e health, healthy equity, and SDH to synthesize a framework for Minnesota focused on implementation with EHRs, and other health information technology. Validation will include interviews with subject matter experts and identification of barriers and opportunities for implementation. Policies and recommendations for statewide implications will be formulated and discussed with the Minnesota e Health Advisory committee for statewide endorsement and actions. Guidance on metrics and assessment of current status will be included. Project Activities and Deliverables: This project will: o Establish a project charter with the study purpose, methods, design, roles, scope, timeline project team and risks. o Establish and facilitate the project team. o Identify health equity and SDH articles and related literature, instruments, frameworks and artifacts o Interview key informants and subject matter experts and collect comprehensive information including status, barriers, and opportunities for managing SDH. o Analyze and summarize the information in tables, graphs and charts. o Develop recommendations for action based on findings.

6 o Present information in a variety of venues and formats including slide presentation, abstracts, conferences and meetings 3. Minnesota Clinical Laboratories Interoperability Survey This project will conduct a survey of Minnesota Clinical laboratories to determine status and readiness for interoperability including public health reporting. The study will: measure Minnesota s status on achieving state and national goals to accelerate adoption and use of electronic health records and other HIT and to achieve interoperability of health information; Identify gaps and barriers to enable effective strategies and efficient use of resources; and Help inform decisions at the local, state and federal levels of government and support community collaborative efforts. The previous survey had 35 questions and was completed in the summer of 2011, by 151 of 163 clinics labs, for a response rate of 93%. The updated survey will consider changes in the EHR and HIT landscapes and issues such as LOINC and SnoMed usage as well as accountable care efforts. The results of this survey will be vital to help inform funding initiatives to onboard laboratories for public health reporting. Recommendations for action will be synthesized and formulated rom the findings. Study results will be presented in a variety of setting and formats. Public Health impact: This project will survey 163 clinical laboratories in Minnesota and border states to determine the key characteristics regarding their readiness for managing electronic orders, electronic results and public health reporting. This includes technical, operational, workforce readiness characteristics as well as barriers, opportunities for achieving interoperability. Findings will be summarized and recommendations for actions will be presented to state wide audiences for options and considerations for actions. Project Activities and Deliverables: This project will: a. Establish a project charter with the study purpose, methods, design, roles, scope, timeline project team and risks. b. Establish project team and set up time line c. Identify ELR related articles and related literature, instruments, frameworks and related past surveys

7 c. Interview key informants and subject matter experts and collect comprehensive information including status, barriers, and opportunities for managing ELR data d. Analyze and summarize the information in table graphs and charts e. Develop agency wide recommendations for action based on findings. f. Present information in a variety of venues and formats including slide presentation, abstracts, conferences and meetings.

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