Come to the Table

1. Come to the Table Public Health Informatics for MCH Leaders

2. Overview • Define Public Health Informatics • Review Terminology • Describe the context • Relate Public Health Informatics to the role of MCH leaders

3. Definitions Common terms we’ll be using today

4. What is Informatics? • We define public health informatics as the: Systematic application of information and computer science and technology to public health practice, research and learning

5. Integration • An integrated data system allows authorized users to access a consolidated view or record for an individual child • Authorized users can view-at a glance-the services provided by a public health agency to an individual child • Authorized users can determine the status of that child’s involvement with Public Health Services

7. Medical Home • A medical home is defined as primary care that is accessible, continuous comprehensive, family centered, coordinated, compassionate, and culturally comprehensive

8. Why Informatics is important for MCH leaders • Information is the very foundation of public health practice • Expectations of service from the public • Accountability

9. Examples of Real World Informatics Practice • Overview • Key elements in successful integration projects • Examples of informatics practices in maternal and child health

10. Minnesota’s Experience Informatics activities Statewide e-Health MCH informatics

11. Different stages

12. Minnesota Infrastructure • Center for PH Informatics at MDH • e-Health support and activities • 2007 Legislation

13. Minnesota e-Health Initiative Vision “… accelerate the adoption and 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.” Source: Committee Report to the Legislature, January 2004

14. MN e-Health 2007 Policy Actions State mandate that all healthcare providers have interoperable EHRs by 2015 State mandate to establish health data standards by 2009 Revise and recodify MN Health Records Act $14M in grants and loans for rural providers and community clinic 14

15. EHR Mandate Applies to all healthcare providers Includes LTC, home care, ancillary services EHRs need to be able to exchange data with others; i.e., be interoperable Target data of 2015 HIT Plan Workgroup addressing: “What is an EHR?” “What does ‘implemented’ mean?” “What level of interoperability is enough?” “What do sectors do when there is no acceptable EHR product for them?” 15

16. Health Data Standards Key to interoperability Mandate for MDH to establish by 01/09 Will adopt nationally established standards as approved Bigger challenges: How to develop detailed implementation guides How to get venders to incorporate the standards Long term project 16

17. E-Health Grants and loans $3.5M in grants will be available in 2008 Up to $750,000 for implementation Up to $50,000 for planning Requires a community collaborative of two or more unrelated organizations 1:3 match required $3.13M in no-interest loans also available 6-year payback; starts after 2 years 17

18. Recommendations: Four Focus Areas, 17 Priority Projects Empower Consumers Accelerate the availability and use of accessible, portable “My Personal Health Record.” Inform and Connect Healthcare Workers Fund and implement interconnected health information technology statewide, focusing on secure health information exchange. Protect Communities Improve population health and protect communities through accessible prevention resources, widespread knowledge of community risks, and rapid detection of and response to public health threats. Provide Infrastructure Ensure the e-Health vision and mission are fulfilled.

19. Initiating Key Projects Mn Health Care Connection Privacy & Security Steering-Advisory Committee New Projects MN Public Health Information Network 04 05 06 07 08 09 10 11 12 Years

20. Examples of Some 45 Projects Emerging Statewide • Exchange Projects • MnHCC – Statewide coordination • CHIC/SISU – Northeast MN • Shared Abstract: (AHRQ grant) • MIIC – Immunization registry • Medications – e-prescribing through the HIPAA Collaborative • Winona community exchange project • Itasca County Health Network • HIT-based Regional Medication Mgmt Pharmacy System • Telehealth • University of MN • Personal Health Records • Fairview • HealthPartners • Children’s • Public Health • MN Public Health Information Network • Informatics Education • St. Scholastica • University of MN

21. www.health.state.mn.us/ehealth 21

22. ICHISIntegrating Child Health Information Systems • The birth of an concept • PHII methodology • Our approach

23. Conceptual Model: Integrating Child Health Information Systems in Minnesota (8/06)

24. Collaborative Requirements

25. Data Flow Diagram

26. ICHIS deliverables to date: Charter Road map Task Flow Diagrams Data Flow Diagrams Data Exchange Grids

27. Leveraged opportunities • MN-PHIN / PHWG • DHS initiated contact • Newborn Screening Follow-Up • Data Inventory Project • Other MDH data system projects • Updates of VR, NBS, WIC • Chronic disease project • Infectious disease project

28. Current and developing activities/opportunities • Resource requests at MDH • MCH Bureau • SSDI (shifting our thinking and planning) • TA request to MCH Bureau • Next legislative session (2009)

29. MCH leadership • Be at the table • Seek and develop resources and opportunities • Build capacity and competencies in your workforce • Patience & persistence • Advocate ! • At state level • At federal level • MCHB, related national projects, PHII

30. Break

31. KIDSNET • Vision: • All Rhode Island children receive appropriate and timely preventive healthcare as a result of access to and utilization of comprehensive data on preventive health services by authorized users.

32. KIDSNET Mission: KIDSNET facilitates the collection and appropriate sharing of health data with healthcare providers, parents, MCH programs and other child service providers for the provision of timely and appropriate preventive health services and follow up.

33. KIDSNET Affiliated Programs • 4 Targeted: • WIC • Early Intervention • Family Outreach (Home Visiting) • Birth Defects • 6 Universal: • Newborn Developmental Risk • Newborn Bloodspot Screening • Newborn Hearing Assessment • Immunization • Childhood Lead Poisoning • Birth Certificate

34. KIDSNET System Users • Primary Care Providers seeing young children (95%) • Family Practice • OB/GYN • Maternal Child Health Programs • Head Start Agencies • School Nurse Teachers • Home Visitors • Certified Lead Centers

35. KIDSNET Uses - reports Examples: • Kids overdue for lead screening by PCP • 20-month-old children overdue for immunizations by PCP • Pre-filled school health form • Newborn screening-missing specimen report at 6 days • Medicaid birth report

37. Other KIDSNET Uses • Quality Assurance • Program Evaluation/Performance Measures • School Entry Requirements • Immunization Decision Support • Data to learn about MCH population

38. Immunization Decision Support

40. System Quality Issues Identified • Discharged home with no specimen • Transferred with no specimen (usually screened out of state at hospital of transfer) • Specimens collected late • Shipping delays • Cancelled orders (due to computer programming!!!!!) • NICU policies are critical!

41. Medical Home

42. Specific Roles for MCH Leaders and Managers New skills in leadership are needed: • Strategic vision of information use • Understanding the “business” of public health • Development of an “informatics savvy” organization

43. Resources KIDSNET DATA BOOK JOURNAL SUPPLIMENTSOURCE BOOK SELF-ASSESSMENT BUSINESS CASE MODEL