Health Reform in Minnesota: An Analysis of Complementary Initiatives Implementing Electronic Health Record Technology and Care Coordination

Authors

  • Karen Soderberg Office of Health Information Technology, Minnesota Department of Health
  • Sripriya Rajamani Public Health Informatics Program, University of Minnesota
  • Douglas Wholey Public Health Informatics Program, University of Minnesota
  • Martin LaVenture Office of Health Information Technology, Minnesota Department of Health

DOI:

https://doi.org/10.5210/ojphi.v8i3.7094

Abstract

Background: Minnesota enacted legislation in 2007 that requires all health care providers in the state to implement an interoperable electronic health record (EHR) system by 2015. 100% of hospitals and 98% of clinics had adopted EHR systems by end of 2015. Minnesota’s 2008 health reform included a health care home (HCH) program, Minnesota’s patient centered medical home. By end of 2014, 43% of HCH eligible clinics were certified with 335 certified HCHs and 430 eligible but not certified clinics.

Objectives: To study the association between adoption and use of EHRs in primary care clinics and HCH certification, including use of clinical decision support tools, patient registries, electronic exchange of patient information, and availability of patient portals.

Methods: Study utilized data from the 2015 Minnesota Health Information Technology Clinic Survey conducted annually by the Minnesota Department of Health. The response rate was 80% with 1,181 of 1,473 Minnesota clinics, including 662 HCH eligible primary care clinics. The comparative analysis focused on certified HCHs (311) and eligible but not certified clinics (351).

Results: HCH clinics utilized the various tools of EHR technology at a higher rate than non-HCH clinics. This better utilization was noted across a range of functionalities: clinical decision support, patient disease registries, EHR to support quality improvement, electronic exchange of summary care records and availability of patient portals. HCH certification was significant for clinical decision support tools, registries and quality improvement.

Conclusions: The rapid uptake in EHR technology, combined with health reform efforts focusing on accountability and care coordination, pose opportunities and challenges for providers. Opportunities are availability of tools that support decision making, quality improvement and reporting. Challenges remain for clinics to optimize health information exchange. The need to meet various care coordination requirements were likely drivers for better EHR utilization by HCH clinics. This research presents the synergy between complementary initiatives supporting EHR adoption and HCH certification.

Author Biographies

Karen Soderberg, Office of Health Information Technology, Minnesota Department of Health

Karen Soderberg is Research Scientist and Assessment and Evaluation Coordinator at the Office of Health Information Technology at the Minnesota Department of Health. She coordinates and directs the statewide informatics profile of adoption and use of electronic health records and secure exchange and interoperability of health information (e-health).

Sripriya Rajamani, Public Health Informatics Program, University of Minnesota

Sripriya Rajamani is an Assistant Professor in Public Health Informatics program at University of Minnesota. She is a physician with medical training from India and completed her doctoral training in Health Informatics part of NLM informatics fellowship. She also holds a MPH in public policy and administration. She was a senior health informatician at the Minnesota Department of Health and oversaw standards and interoperability activities.

Douglas Wholey, Public Health Informatics Program, University of Minnesota

Douglas Wholey is a Professor in Health Policy and Management at the University of Minnesota and is Chair of the Public Health Informatics program. He has done extensive research on managed care, including studies of diffusion of administrative innovations and HIT diffusion. He led the evaluation of Minnesota’s Health Care Home initiative.

Martin LaVenture, Office of Health Information Technology, Minnesota Department of Health

Martin LaVenture is the Director of the Office of Health Information Technology at the Minnesota Department of Health and Director of the Minnesota e-Health Initiative. He is a highly regarded leader in Minnesota’s eHealth efforts, pioneer in public health informatics and his office leads survey/assessment for the eHealth Initiative.

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Published

2016-12-28

How to Cite

Soderberg, K., Rajamani, S., Wholey, D., & LaVenture, M. (2016). Health Reform in Minnesota: An Analysis of Complementary Initiatives Implementing Electronic Health Record Technology and Care Coordination. Online Journal of Public Health Informatics, 8(3). https://doi.org/10.5210/ojphi.v8i3.7094

Issue

Vol. 8 No. 3 (2016)

Section

Original Articles

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