ehealth and Health Information Exchange in Minnesota Connecting Minnesota Providers at the Point of Care Lisa Moon, RN Director Privacy Security and HIE Oversight Program Office of Health Information Technology & e-health
What is e-health? e-health is the adoption and effective use of electronic health records (EHR) systems and other health information technology including health information exchange to: improve health care quality increase patient safety reduce health care costs enable individuals and communities to make the best possible health decisions 2
Drivers of e-health Triple Aim Improved consumer experience Improved population health Lower per capita health care costs Care Coordination Activities Policies Federal Meaningful Use Incentive Program Minnesota 2011 e-prescribing Mandate Minnesota 2015 Interoperable EHR Mandate 3
The Minnesota e-health Initiative A public-private collaboration established in 2004 Legislatively chartered Coordinates and recommends statewide policy on e-health Develops and acts on statewide e-health priorities Reflects the health community s strong commitment to act in a coordinated, systematic and focused way Vision: accelerate the adoption and effective use of Health Information Technology to improve healthcare quality, increase patient safety, reduce healthcare costs, and enable individuals and communities to make the best possible health decisions.
Office of Health Information Technology Minnesota e-health responsibilities (Minnesota Statutes 62J.495 to 62J.4982): Statewide e-health assessment Create a comprehensive and unified vision and strategy for use of EHRs and Health Information Exchange in MN Policy alignment and guidance, including e-health standards Health Information Exchange Oversight Provide expertise in health informatics and EHRs to guide e- health policy development and implementation 5
Achieving e-health Minnesota Model for Adopting Interoperable Electronic Health Records Developed by the Minnesota e-health Initiative to Provide guidance for providers in achieving the Minnesota mandates and improving care Assess progress and barriers 6 6
2015 Interoperable EHR Mandate The 2007 Minnesota Legislature mandated in Minnesota Statute 62J.495 By January 1, 2015, all hospitals and health care providers must have in place an interoperable electronic health records system within their hospital system or clinical practice setting. The commissioner of health, in consultation with the Minnesota e-health Advisory Committee, shall develop a statewide plan to meet this goal, including uniform standards to be used for the interoperable system for sharing and synchronizing patient data across systems. 7
Minnesota Adoption of EHRs Clinical Labs* (2011) 97% Hospitals (2012) 96% Local Health Depts (2012) 94% Clinics (2013) 87% Nursing Homes (2011) 69% Chiropractic Offices (2011) 25% 0% 20% 40% 60% 80% 100% Percent of Providers with EHRs Source: Minnesota Department of Health, Office of Health Information Technology, www.health.state.mn.us/ehealth/assessment.html, data from 2013 clinic survey, 2012 hospital survey, and 2011 nursing home survey. 8
Effective Use Source: Minnesota Department of Health, Office of Health Information Technology, www.health.state.mn.us/ehealth/assessment.html, data from 2013 clinic survey, 2012 hospital survey, and 2011 nursing home survey. 9
Health Information Exchange Source: Minnesota Department of Health, Office of Health Information Technology, www.health.state.mn.us/ehealth/assessment.html 10
Components of Interoperability Technical Transmitting the data Hardware, software, networks Semantic Communicating the meaning of the data Data content, terminologies and structure Process Best practices on the use of data People interacting with the system Workflow, user roles, etc. 11
Direct Protocol Simple. Connects healthcare stakeholders through direct address (like email) using simple push transaction to move information from one health care provider to another. Secure. Users can easily verify messages are complete and not tampered with in travel. Scalable. Enables Internet scale with no need for central network authority. Standards-based. Built on common Internet standards for secure e-mail communication. How it works: Standard Transport Protocols for HIE Get a Direct Address (email) and a security certificate Contract with a HIO or HISP that performs authentication, encryption and trust verification on your behalf 12
CONNECT Protocol CONNECT is an open source software solution that supports health information exchange Provider A can send a request for information to Provider B and the information is then retrieved and brought back to Provider A Query based exchange Benefits: Many data sources can be searched Used for population health and data analytics Used for care coordination activities- alerts, closed loop referrals, clinical decision support tools How it works: Standard Transport Protocols for HIE Contract with a HIO or HDI that provides a robust suite of technical capabilities
Governance of Health Information Exchange in Minnesota Minn. Stat. 62J.498-4982 (the Minnesota HIE Oversight Law ) Establishes oversight by Commissioner of Health to protect the public interest on matters pertaining to health information exchange Requires State Certificate of Authority to operate Health Information Organizations (HIO) and Health Data Intermediaries (HDI) Allows market-based approach for provision of HIE services; multiple HIE service providers (HIO/HDI) may be certified and operate in the state
Goals for State Certification and Oversight of HIE Ensure that information follows the patient across the full continuum of care Prevent the fragmentation of health information that can occur when there is a lack of interoperability or cooperation between health information exchange service providers Ensure that organizations engaged in health information exchange are adhering to nationally recognized standards Ensure that HIE Service Providers properly protect patient privacy and security Ensure that MN has a reliable HIE infrastructure in place to allow providers and hospitals to achieve meaningful use 15
State-Certified Health Information Exchange Service Providers State-Certified HIOs Community Health Information Collaborative (CHIC) State-Certified HDIs - Sandlot Solutions, Inc. - IOD - Emdeon - Surescripts - Several entities are currently in the process of obtaining state certification For more information on State-Certified HIE Service Providers: http://www.health.state.mn.us/divs/hpsc/ohit/certified.html 16
Resources Guide 1: Addressing Barriers to EHR Adoption Guide 2: Recommended Standards Guide 3: e-prescribing Guide 4: Effective Use of EHRs Guide 5: Health Information Exchange http://www.health.state.mn.us/e-health/reports.html 17
Become Involved (1 of 3) Health Care Professionals and Organizations Collaborate with organizations and other health care settings Participate in e-health training, education and committees or workgroups Use, adapt and share e-health tools Join/participate in the Minnesota e-health Initiative Subscribe to e-health updates Participate in the e-health Initiative and workgroups http://www.health.state.mn.us/e-health 18
Become Involved (2 of 3) Associations Achieve or move towards consensus: E-health needs and requirements for your setting Policies for e-health specific to your setting Create/offer trainings Create/support opportunities for collaboration statewide and regionally Watch for and respond to the Request for Proposals to be released this Winter/Spring regarding the Minnesota Accountable Health Model (MAHM), funded by federal SIM dollars. www.mn.gov/sim 19
Become Involved (3 of 3) Consumer/Patient Request your provider send a prescription to pharmacy electronically (e-prescribing) Communicate with your doctor through the internet/computer (secure email, patient portal) Receive text message to remind you to take medication (mobile health, m-health) Request a summary of your clinic visit Use a mobile app or website to track healthy living activities (water, calories, yoga, meditation) 20