1. EHR – Rural Perspective EHR Implementation Challenges for Rural Hospitals EHR Implementation Challenges for Rural Hospitals EHR Implementation Challenges for Rural Clinics EHR Implementation Challenges for Rural Clinics Considerations for an Effective Integrated EHR Considerations for an Effective Integrated EHR Minnesota E-Health Initiative Advisory Committee Minnesota E-Health Initiative Advisory Committee

2. EHR IMPLEMENTATION CHALLENGES FOR RURAL HOSPITALS Lack of capital resources to invest in an EHR (upfront costs seem prohibitive) Lack of capital resources to invest in an EHR (upfront costs seem prohibitive) Lack of standards for interoperability (waiting for national or state standards) Lack of standards for interoperability (waiting for national or state standards) Significant process change is often required Significant process change is often required Lack of internal IT leadership and personnel resources needed to handle the temporary increase in work load often accompanying a software implementation Lack of internal IT leadership and personnel resources needed to handle the temporary increase in work load often accompanying a software implementation Clinical providers’ acceptance of change or impending change Clinical providers’ acceptance of change or impending change Demonstrating the ROI that outweighs the expense, pain, and suffering Demonstrating the ROI that outweighs the expense, pain, and suffering

3. EHR IMPLEMENTATION CHALLENGES FOR RURAL CLINICS Lack of capital resources to invest in an EHR Lack of capital resources to invest in an EHR Concerns with loss of productivity (and revenue) during transition to an EHR system Concerns with loss of productivity (and revenue) during transition to an EHR system Lack of internal IT leadership Lack of internal IT leadership Concern for clinical providers’ ability to input data Concern for clinical providers’ ability to input data Proving ROI Proving ROI

4. CONSIDERATIONS FOR AN EFFECTIVE HOSPITAL/CLINIC EHR Openness and transparency Openness and transparency easy to use and easy to pull, query and analyze data easy to use and easy to pull, query and analyze data Defined limitations Defined limitations who can enter and edit information in the integrated system who can enter and edit information in the integrated system How is confidential information protected How is confidential information protected How is information shared How is information shared Data integrity and quality Data integrity and quality Security and safeguards Security and safeguards Accountability and oversight Accountability and oversight

5. MINNESOTA E-HEALTH INITIATIVE ADVISORY COMMITTEE Advisory Committee Convened by the Commissioner of Health in October - 2004 Advisory Committee Convened by the Commissioner of Health in October - 2004 Diverse representation Diverse representation Public Health, Health Plans, Large Hospitals (Kim Pederson), Rural Hospitals (Mary Klimp), Clinics, Pharmacists, Consumers, Academics and Research, Long Term Care, Stratus Health, Purchasers, MNA, MMA, Senior Federation, HIPAA Collaborative Public Health, Health Plans, Large Hospitals (Kim Pederson), Rural Hospitals (Mary Klimp), Clinics, Pharmacists, Consumers, Academics and Research, Long Term Care, Stratus Health, Purchasers, MNA, MMA, Senior Federation, HIPAA Collaborative

6. Initial Charge Provide recommendations on: Provide recommendations on: Ways to accelerate the adoption of electronic health records systems and other relevant health information technology Ways to accelerate the adoption of electronic health records systems and other relevant health information technology Define the role for MDH and State Government in the development, financing, promotion, and implementation of EHR and HIT Define the role for MDH and State Government in the development, financing, promotion, and implementation of EHR and HIT Address at least the following issues: Address at least the following issues: Barriers to adoption of EHR Barriers to adoption of EHR Identify the core components of an EHR and standards for interoperability Identify the core components of an EHR and standards for interoperability Assess the status of current implementation of EHR Assess the status of current implementation of EHR Assess the costs for primary and acute health care providers in implementation of EHR Assess the costs for primary and acute health care providers in implementation of EHR Identify partnership models and collaboration potential for EHR implementation Identify partnership models and collaboration potential for EHR implementation Monitor the development of federal standards Monitor the development of federal standards Identify barriers and develop a plan to develop a standardized record system Identify barriers and develop a plan to develop a standardized record system