e-health in Minnesota: Opportunities for Public Health Interoperability and Vital Records
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1 e-health in Minnesota: Opportunities for Public Health Interoperability and Vital Records Marty LaVenture, MPH, PhD FACMI Director, Office of Health Information Technology, MN e-health Initiative Minnesota Department of Health 2012 NAPHSIS/NCHS Shooting for the North Star: Our Journey from Good to Great Minneapolis, Minnesota June 3, 2012
2 The Landscape is Changing Rapidly Electronic Health Records (EHRs): Paper to Digital
3 Key Questions and Perspectives What is Context for e-health & Public Health? e-public health is part of larger e-health transformation What new skills and knowledge are needed public health informatics, tools and practice What are opportunities for NAPHIS & NCHS? e-vitals roadmap / initiative and informatics Savvy organizations
4 Key Drivers for Investing in e-health Support for clinical / public health practice Increasing evidence relating to improvement in quality, safety and health outcomes Consumer needs and interest Demand for information to follow the patient, i.e. around transitions of care Policy: Minnesota laws: 2011 electronic -prescribing mandate 2015 interoperable electronic health records (EHR) mandate Federal financial incentives and disincentives programs ( meaningful use)
5 Do You Speak Language of Texting? What do these mean to you? BRB be our backup be right back bad for our business BTW By the way Beginning to wonder Before the weekend WE whatever weekend whenever PAW party all weekend plant and water parents are watching
6 Become Conversational in The Language of e-health E-Health and HIT Electronic Health Record Health Information Exchange and Interoperability Standards - HL7 and CCD/CDA Public Health Informatics Meaningful Use / ONC MDH Glossary can be accessed at:
7 Public Health Information Systems Today New Era Increase use certified electronic health records Expected to use standards and achieve interoperability Necessity of collaboration, for requirements & re-use Emerging role of the statelevel Public Health Informatician Seeking a more informatics savvy organization Public Health Implications More primary source data in electronic form Understand need for bidirectional movement of data and information Contribute to collaborative efforts & promote innovation Requires new skills, training for public health professionals Requires modernization of our information systems
8 Public Health Benefit: Measured Automated electronic laboratory reporting: Identified 4.4 times as many cases as traditional spontaneous, paper-based methods and Identified those cases 7.9 days earlier than spontaneous reporting Improvements in completeness and accuracy of the data Source: Overhage JM, et al A Comparison of the Completeness and Timeliness of Automated Electronic Laboratory Reporting and Spontaneous Reporting of Notifiable Conditions, AJPH, 2008
9 Minnesota Model for Adopting Interoperable EHRs Breaks achieving the 2015 Mandate into manageable steps Applies across organizational settings Developed by the Minnesota e-health Initiative
10 State Mandates that Advance e-health 2011 e-prescribing Mandate All providers, group purchasers, prescribers, and dispensers establish and maintain an electronic prescription drug program that complies with applicable standards by January 2011 [Minnesota Statute 62J.497] 2015 Interoperable EHR Mandate All healthcare providers and hospitals have interoperable EHRs by 2015 [Minnesota Statute 62J.495]
11 Minnesota Pharmacies e-prescribing ( )
12 Adoption of Electronic Health Records (EHRs) and Related (HIT) in Minnesota
13 Electronic Exchange of Health Information by Minnesota Clinics and Hospitals (2011)
14 Using Informatics to Change Public Health Practice
15 Role for Public Health Informatics Is about the effective application of information technology of informatics harnessing the available technology to meet the information needs of public health practitioners in particular. Public Health Informatics is the science about the effective use of information to improve practice systematic application of information and computer science and technology to public health practice, research, and learning. Source: Art Davidson & O Carroll P. Pub Health Informatics & Information Systems,2003; LaVenture & colleagues 2009, Yasnoff 2000,
16 Focus for Public Health Informatics PH Systems Require More Than IT: Technology Content Processes Workforce IT Focus Informatics Focus
17 MDH Office of Health Information Technology (OHIT) Focus Strategic Initiatives Health Informatics Projects Health Informatics Capacity Example Minnesota e-health Initiative Policy & oversight program and privacy e-health Advisory Committee and Workgroups RWJF Common Ground Project Public health informatics profile toolkit EHR assessment and evaluation Standards monitoring and recommendations Health information exchange Immunization interoperability e-vital Records Interoperability Mentoring and training of informatics graduate students Teaching, advising and consultation
18 MN e-vital Records Initiative Proposed Minnesota Project Objectives Evaluate the stakeholder feasibility and readiness for standards - based VR exchange using the EHR at stakeholder sites. Evaluate the MDH Vital Records Program s feasibility and readiness for standards-based VR exchange with stakeholder Implement a pilot (test data) and a demonstration (real data)
19 Key Actions: Organizations/Professionals CDC-NCHS States Think collaboration Between organizations and other health care settings Expand current education/training opportunities Expand CDC/ASTHO/CSTE Informatics Fellowship to States Public Health Informatics Institute PH Academy Leverage/align federal HITECH & other e-health programs Initiate / accelerate CDC-NCHS NAPHIS e-health / evitals Initiative Establish / Update roadmap for e-health Interoperability standards
20 Resources Resources Joint Public Health Informatics Task Force (JPHIT) ASTHO, NACCHO, CSTE, APHL, NAPHSIS, NAHDO, PHDSC, AIRA Each organization has an e-health committee CDC Public Health Informatics and Technology Program Office; PHII Public Health Informatics Fellowship Program; AMIA AMIA Public Health Informatics;
21 Acknowledgements MDH Department of Health Rebecca Johnson Kari Guida, Dr. Priya Rajamani Jennifer Fritz Steve Elkins Sally Almond
22 Building Common Ground If you want to go fast, go alone; If you want to go far, go together. African proverb 22
23 Marty LaVenture, MPH, PhD Minnesota e-health website Guides on, standards, effective use of EHRs Sign up for the e-health Weekly Updates
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