Building Health Information Exchange Capacity Workgroup (2010-2011)

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Charge

The charge to this workgroup is as follows:

  1. Affirm a vision and principles for the exchange of public health data.
  2. Collect information on the data standards currently in place in the electronic health records systems used by LHDs and other states such as North Carolina.
  3. Determine initial business processes focus
    a. Review of business process activities.
    b. Determine common processes and different processes.
    c. Define foundational business processes.
  4. Develop and recommend a set of data standards and resource needs for LHD electronic health record systems that will include standards related to terminology, messaging, and transactions. Due to the diverse type of services provided at LHDs and scope of content, the workgroup will develop data content standards for services affecting the maternal and child health population group.
  5. Assure communication with stakeholders including the Local Public Health Association (LPHA), e-Health Advisory Committee, and primary vendors of electronic health records for LHDs.
  6. Work with the SE Minnesota Beacon grantees to ensure coordination of efforts.
  7. Align efforts with the HIT Meaningful Use requirements for exchanging data relating to immunizations, lab reporting, and coordination of care.
  8. Utilize the important lessons learned from other data standards projects, such as PPMRS and EHKMP, to guide the process.
  9. Utilize resources available from the Public Health Informatics Institute and the MDH Office of Health Information Technology related to data standards and information systems development.
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Scope

The activities surrounding the work of developing data standards can easily lead to expanding the scope of the project and losing focus on the priority decisions. The following outlines what is inside and outside of the scope.

Inside

  • Data standards for electronic health records used in LHDs when providing maternal and child health services to individuals and families.

Outside

  • Information systems based at the Minnesota Department of Health, such as WIC HuBERT, MIIC, Child Health Information System, vital statistics, health data statistics, etc.
  • Electronic health record systems not used by LHDs.
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Background

By January 2, 2015, all local health departments (LHDs) must have in place an interoperable electronic health records (EHRs) system within their practice setting (Minnesota Statutes, section 62J.495). Extensive work has been done and financial investments made by LHDs over the past several years to implement EHRs. The focus of this work has been on the use of EHRs in order to organize clients’ health information (including immunizations), track public health nursing services, and bill for services. The majority of LHDs in Minnesota use one of these three systems: PH-DOC, CHAMPS, and CareFacts.

While these systems have served LHDs very well for their intended purpose, the emerging national and statewide Health Information Technology (HIT) emphasis is now on the exchange of health information with LHDs, health care providers, and the Minnesota Department of Health (MDH). The goals of Health Information Exchange (HIE) are to improve patient health, improve the quality of care, increase efficiency, reduce health care costs, and improve population health.

The key to effective exchange of public health information is having a set of agreed upon data standards. Data standards provide a common and consistent way to record information that allows data to be exchanged between different information systems. For a more in-depth description of Public Health Data Standards, please see the following document created by the Minnesota Public Health Information Network (MN-PHIN) Steering Committee:

Local health departments utilize electronic health records in a variety of service settings, e.g. home health care, family home visiting, public health clinics, long-term care case management, correctional health care, and infectious disease prevention and control. There will soon be greater need to be able to exchange the information in a client’s EHR in public health with health care providers, other LHDs, and state agencies including MDH. The first step down the road of exchanging data is to agree upon a set of data standards for electronic health records used in the local public health setting. The standards that are relevant to public health can be sorted into four categories:

  • terminology (classification systems like ICD-9 CM disease codes, CVX for vaccine products, OMAHA system for nursing interventions);
  • messaging (Health Level 7 or HL7 code for sending information between computer systems);
  • transactions or claims (uniform method for sending bills and getting reimbursed (i.e. Healthcare Common Procedure Coding System (HCPCS)); and
  • data content (Planning and Performance Measurement Reporting System (PPMRS), Minnesota Immunization Information Connection (MIIC), and Environmental Health Knowledge Management Projects (EHKMP) are examples)
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Methods

This workgroup will be comprised of SCHSAC members, LHD staff, MDH staff, and community representatives. The members should represent a diverse array of skills and experience in the areas of electronic health records, data standards development, health information exchange technology, development and use of the PPMRS, and current local information systems (e.g. PH-DOC, CHAMPS, CareFacts). When the workgroup is working on content standards for a selected service area, additional representatives who are content experts in that area will be asked to assist in that work. Since developing standards can be very specific and detailed work, there may be a need to have small task groups established to keep the work moving forward at a steady pace.

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Members

Local Health Department Membership

  • Co-Chair: Diane Thorson, Otter Tail County CHB, SCHSAC member
  • Wendy Bauman, Dakota County CHB, LPHA Informatics subcommittee representative
  • Diane Holmgren/Barb Lescenski, St. Paul-Ramsey CHB
  • Lisa Klotzbach, Olmsted County CHB
  • Greta Siegel, Douglas County CHB
  • Betsy Kremser, Anoka County CHB
  • Connie Hanson Hullstrom/Pat Stewart, Cottonwood-Jackson CHB
  • Jill Bruns, Redwood-Renville CHB
  • Cheryl M. Stephens, Community Health Information Collaborative

Minnesota Department of Health Membership

  • Co-Chair: Janet Olsted, Community and Family Health
  • Deb Burns, Office of Performance Improvement
  • Kari Guida, Office of Health Information Technology

Resources: MDH Project Staff

  • Amy Camp
  • Mark Doerr
  • Kathy Grantham
  • Wendy Nelson
  • Bill O'Brien
  • Other staff as needed
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