As the Office of the National Coordinator for Health IT works on its ambitious plans to reshape healthcare interoperability with its Trusted Exchange Framework and Common Agreement, states continue their work to improve health information exchange regionally. In Minnesota, an e-Health HIE Task Force is being created to address priority use cases and gaps, including care transitions between the organizations that use Epic’s EHR and organizations that do not; and the Department of Human Services’ event alerting service.
The 2016 Minnesota Legislature directed the Minnesota Department of Health (MDH) to assess Minnesota’s legal, financial and regulatory framework for health information exchange. The resulting study provided recommended modifications that would strengthen the ability of Minnesota providers to securely exchange data in compliance with patient preferences and in a way that is efficient and financially sustainable.
The study’s primary recommendation is to move Minnesota in the direction of a “connected networks” approach that will provide essential HIE services accessible to all stakeholders statewide, and to align with and build upon national HIE initiatives and networks. To achieve this goal, MDH is establishing an HIE task force of the e-Health Advisory Committee to develop implementation plans for the connected networks approach by focusing on actions and policies to:
•. Expand exchange of clinical information to support care transitions between organizations that use Epic and those that do not. In Minnesota 51 percent of clinics use Epic. Those 641 clinics dwarf the second-highest number, which is eClinicalWorks at 112 or 9 percent. No other provider has more than 5 percent. (Fifty-eight percent of primary care doctors use Epic.)
• Expand event alerting (for admission, discharge, and transfer) to support effective care coordination.
• Identify, prioritize and scope needs for ongoing connected networks and HIE services with the goal of optimal HIE.
By December 2018, the Minnesota e-Health HIE Task Force will develop a report for the Minnesota e-Health Advisory Committee including, but not limited to, the following:
1. Action steps for 2018-2019 to implement connected networks by building upon existing HIO and national network connections to address priority use cases and gaps, including: care transitions between organizations that use the Epic EHR software and organizations that do not; and the Department of Human Services (DHS) event alerting service (EAS).
2. An implementation plan for 2018-2019 with measureable targets that includes agreed-upon transactions, standards and specifications; requirements for how organizations will commit and participate; and financial requirements and costs.
3. A plan for five-year interim governance, authority, and financing needed to establish expansion of connected networks (future transactions/use cases, shared services) with the goal of optimal HIE and including the role for the HIE Task Force going forward.
4. Recommended updates to Minnesota’s Health Information Exchange Oversight Law to ensure effective support for HIE and allow timely updates based on changing markets and technology.
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