1. 1 Minnesota e-Health Initiative Update on EHR Adoption & Use in MN Minnesota Ambulatory Surgical Center Association Friday, April 15, 2011 Marty LaVenture, MPH, PhD Director, Office of Health Information Technology & Center for Health Informatics & MN e-Health Initiative Minnesota Department of Health Rebecca Reibestein, MPP Communications, Office of Health Information Technology Minnesota Department of Health

2. 2 Topics for Discussion  Minnesota e-Health Landscape  What are MN EHR adoption rates?  What does this data mean?  Opportunities  Federal HITECH programs funded in Minnesota  Other Resources  Recommendations  What are some key actions you can do now

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.” 3

4. Minnesota HIT Landscape is Changing Moving from Analog-Paper to Digital

5. Assessment Status of Key Settings / Domains for EHR Adoption and Use in Minnesota Minnesota Department of Health, rev 2011 DomainNumber*Current Status/ Assessment Plan Ambulatory Clinics 1300 2010 EHR Adoption Rate: 67% (750/1121) MN HIT Ambulatory Clinic Survey (Annual): Results June 2011 Hospitals150 2009 EHR Adoption Rate: 86% (111/129) Acute Care Hospitals AHA Annual Survey: Information Technology Supplement: Results June 2011 Clinical Laboratories 180 Minnesota Clinical E-Laboratory Assessment for HIT Adoption and Use: Results in July 2011 Nursing Homes 380 2008 EHR Adoption Rate: 32% (92/297; 2008 Stratis Nursing Home Survey) MN HIT Nursing Home Survey: Results in September 2011 Local Health Departments 78LPH PPMRS questions (Annual): Results in July 2011 Pharmacies1240Surescripts quarterly reports and necessary follow-up Dentists40002011/2012 Dentist HIT Survey (tentative) *Estimated

6. MN Clinic EHR Adoption Rates 6 Source: MDH, OHIT, 2010 MN HIT Ambulatory Care Clinic Survey Response Rate 87% (1121/1285) Status of EHR AdoptionNumber of Clinics (percent of clinics) EHR installed and used in all/some areas of clinic 750 (67%) Purchased/begun installation but not using 101 (9%) Have no EHR270 (24%) Total1121 (100%)

7. MN Acute Care Hospital EHR Adoption Rates 7 Source: MDH, OHIT, 2009 AHA Annual Survey Information Technology Supplement Response Rate: 98% (129/131 Acute Care Hospitals)

8. Freestanding Ambulatory Surgical Centers EHR Adoption Rates: Maryland Source: Maryland Health Care Commission. 2009 Freestanding Ambulatory Surgical Center Health Information Technology Survey.

9. FASC Health IT Use Rates: Maryland 9 Source: Maryland Health Care Commission. 2009 Freestanding Ambulatory Surgical Center Health Information Technology Survey. CPOE use (Computerized Provider Order Entry) Approx. 38% of Centers using Health IT have CPOE capabilities 46% are undecided in their planning efforts 17% plan to assess or implement CPOE in the future CDS use (Clinical Decision Support) In Centers reporting CPOE use: Approx. 80% use CDS for medication prescribing 22% use CDS for diagnosis, standards of care and chronic conditions

10. Key Drivers for EHRs  Care Delivery and Quality needs  Business Needs of Organizations  Increasing evidence relating to improvement in quality and safety  Consumer needs and interest  Minnesota Law for Using an Interoperable Electronic Health Record by 2015  Federal financial incentives and disincentives programs 10

11. Benefits of HIT Review of the Recent Literature Findings:  Study included evaluation of 154 previous studies  96 (62 percent) were considered positive with measurable benefits  Majority of recent articles/studies show measureable benefits from adopting HIT  Benefits of HIT beginning to emerge in small and large practices that were early adopters Source: Beeuwkes Buntin M, Burke M, Hoaglin M, Blumenthal D. The Benefits of Health Information Technology: A Review of the Recent Literature Shows Predominantly Positive Results. Health Aff March 2011; 30:3464-471.

12. Common Barriers to Implementation Minnesota 2010 Survey  Cost of implementation  Concerns about return on investment  Lack of knowledge/resources  Provider support  Staff education & training  Security & privacy concerns 12

13. Surgical Centers and EHRs Benefits:  Remain competitive  Efficiencies gained from technology  Improved patient outcomes, reduce medical errors Challenges:  Not eligible for MU incentives (but some physicians are)  Smaller size, less capital, lack of support  Certified surgical EHR systems, lack of surgical templates

14. Resources  Minnesota Resources  Federal Resources

15. Minnesota Model for Adopting Interoperable Electronic Health Records Assess Plan Interoperate ReadinessEffective UseImplementSelect Achievement of 2015 Mandate Continuum of EHR Adoption Adopt Exchange Utilize  From the Minnesota’s Statewide Implementation Plan - 2008  Breaks achieving the 2015 Mandate into manageable steps  Applies across organizational settings

16. Minnesota e-Health Initiative Resources & Learning Opportunities  Minnesota e-Health “GovDelivery” List  Weekly Updates – sign up a the web page.  Monthly HITECH Update Calls  Third Thursday of the Month 4:00-4:45 p.m.  Minnesota e-Health Web Page  www.health.state.mn.us/e-health www.health.state.mn.us/e-health  2011 Mn-e-Health Summit  Save the Date - Thursday June 16 th, 2011

17. Federal HITECH Funding in Minnesota Funding Initiative & Focus Regional Extension Centers Support providers in adopting & being meaningful users Workforce Development Education/Training for education of HIT professionals CMS Incentives Incentive payments to eligible professionals and hospitals participating in Medicare and Medicaid Health Information Exchange Support state programs to ensure availability of health information exchange across their jurisdictions Beacon Community Program Demonstration communities for meaningful use of EHRs to achieving improvement in quality & outcomes Strategic Health IT Advanced Research Projects (SHARP) Achieving breakthrough advances to address key problems 17 Minnesota Recipients REACH : Key Health Alliance [$~19M ] UP-HI : University Partnership for Health Informatics [~$5 M] DHS: Eligible professionals and hospitals in Minnesota - [~ $450 – 800 M] MN e-Health Connect – MDH [$~ 9.6 M] South East MN BEACON : Mayo & Partners [~$12M] SHARP Mayo & Partners [~$15 M] Research Focus Area: 4. Secondary Use of EHR Data

18. REACH  Field Consultants provide technical assistance  Are beginning to work with Ambulatory Surgical Centers in MN and ND  http://www.khareach.org http://www.khareach.org  1-877-331-8783 x222

19. Key Actions  Surgical Centers  Surgical Center-related organizations

20. Key Actions & Considerations Surgical Centers  Tap into federal resources e.g.:  REACH – technical assistance for adoption and use  DHS/CMS for incentive funding (possible resource for physicians)  If you are looking to buy an EHR be sure to plan thoroughly before you buy  If you have an EHR, implement techniques that support effective use  Plan for e-prescribing  Consider state-certified HIE service providers 20

21. Key Actions & Considerations Surgical Center Organizations  Support assessment of the adoption and use rates for EHR’s in surgical centers in Minnesota  Provide/support learning opportunities for ASCs state- wide on meaningful use and other HIT topics  Create/update/ support standard surgery systems requirements  Encourage vendors to have their software certified & staying certified/qualified 21

22. Acknowledgements  Advisory Committee Co-Chairs and Members  Co-chairs: Walter Cooney & Dr. Marty Witrak  Workgroup Co-chairs & Participants  Standards and Interoperability Workgroup: Bobbie McAdam & Barb Billing  Health Information Exchange Workgroup: Alan Abramson & Joanne Sunquist  Adoption and Meaningful Use Workgroup: Paul Kleeberg & Bonnie Westra  Privacy, Legal, Policy Workgroup: Laurie Beyer-Kropuenske & LaVonne Wieland  Communications & Outreach Workgroup: Becky Schierman & Mark Sonneborn  MDH Department Leaders  Liz Cinqueonce, Dr. Priya Rajamani, Jennifer Fritz, Kari Guida

23. For More Information www.health.state.mn.us/e-health Marty LaVenture Minnesota Department of Health Office of Health Information Technology martin.laventure@state.mn.us 651-201-5950 Rebecca Reibestein, MPP Minnesota Department of Health Office of Health Information Technology rebecca.reibestein@state.mn.us 651-201-5092