Marty LaVenture MPH PhD, Director

1
Immunization Registries and the National Context
for Health Information Technology
American Immunization Registry Association
Meeting October, 19, 2004

• Marty LaVenture MPH PhD, Director
• Public Health Informatics
• Minnesota Department of Health

2
Congratulations AIRA!

• For your successful efforts to help protect the
  children and all people of the United States from
  vaccine preventable disease morbidity and
  mortality.

3
What Do These Phrases Have in Common?

• The Perfect Storm
• The Stars and Planets are aligned.
• The Tipping Point

4
What Do These Phrases Have in Common?

• The Perfect Storm
• The Stars and Planets are aligned.
• Reaching the Tipping Point

• metaphor's used to describe the status of
  Health Information Technology (HIT) in the US.

5
Topics for Discussion

• National Context
• From a state perspective
• Implications for AIRA and Registries

6

• the most remarkable feature of this
  twenty-first century medicine is that we hold it
  together with nineteenth-century paperwork. This
  is just inexcusable. And it has to change.
• HHS Secretary Thompson
• July 2004

7
Health Care System Challenges

• Error rates are too high
• Quality is inconsistent
• Costs are escalating
• Research results are not rapidly used
• Demographics of baby boomers will greatly
  increase demand
• Capacity for early detection response to
  bioterrorism is minimal

8
National Expert Panel Reports
9
NHII A Shared Vision

• Sharing information and knowledge
  appropriately so it is available to people when
  they need it to make the best possible health
  decisions.

National Committee on Vital and Health
Statistics, November, 2001
10
Three Dimensions and Their Overlap
Personal Health Dimension
Healthcare Provider Dimension
Population Health Dimension
11
National Health Information Infrastructure(NHII)
- Four Domains
NHII
Clinical
Consumer
Population Health
Research/ Policy
12
NHII Key Concepts

• Knowledge-based network of interoperable systems
• Decision support enabled
• Anywhere, anytime health care information
• Standards Messaging Content
• Electronic Health Record (EHR) Systems
• Consumer Health Information Systems
• Local health information infrastructures (LHIIs)
• NOT a central database of medical records
• Requires National Leadership

13
National Calls for Action Leadership - 2004

• President Bush gt Establish EHRs for Most
  Americans in 10 Years
• Secretary Thompson gt Executive order to
  Accelerate progress for EHRs
• Dr. David Brailer gt Issues Framework for
  Strategic (National coordinator of HIT) Action
• National Responsibility for
• Coordinating all Federal and private sector
  efforts toward NHII

14
Framework for Strategic ActionDecade of Health
Information Technology Delivering
Consumer-centric and Informationrich Health Care
July 2004

• Goals
• Inform Clinical Practice
• Interconnect Clinicians
• Personalize Care
• Improve Population Health

July 2004 http//www.hsrnet.net/nhii/materials
/strategic_framework.pdf
15
Example HIT Stakeholder Commitment / Roles
16
Transforming Healthcare Quality through HIT
(THQIT)

• AHRQ Grant Solicitations
• Planning
• assist healthcare systems and their partners in
  planning for activities that will lead to
  successful HIT implementation
• Nearly 1,000 letter of intent yielded 600
  completed applications
• Applications from every State 26 awarded
• Implementation
• support organizational and community-wide
  implementation and diffusion of HIT

17
Health Information Technologyis information and
communication technology in healthcare and
includes

• Cornerstone technology
• Other technology

• Electronic Health Record (EHR)
• Person focused (information across facilities)
• Computerized provider order entry (CPOE)
• Secure e-mail communication
• Clinical alerts and reminders
• Public Health monitoring and disease
  surveillance, health alerts
• Computerized decision support systems
• Bar-coding, Hand-held computers
• Personal health records

18
(No Transcript)
19
Tipping PointAction - Momentum
20
National LHII Related ActivityExamples

• Operational
• Indiana Network for Primary Care
• Santa Barbara County Care Data Exchange
• Planning
• Many Estimated 50 projects nationwide

21
StandardsData - Vocabulary
22
Minnesota e-Health Initiative accelerating the
use of Health Information Technology in Minnesota
Minnesota Health Information Infrastructure
Consumer (PHR)
Clinical (EHR)

• Initial Focus
• Electronic Health Record (EHR)
• MN Public Health Information Network (MN-PHIN)

Research/ Policy
Public Health (MN-PHIN)
23
Opportunities for ActionWhat You Can Do Now

• Increase your personal knowledge of HIT
  support training for staff and others
• Identify and participate in LHII/RHII in your
  state and community
• Monitor / apply funding opportunities
• Provide active input to HIT efforts at state,
  local, national

24
What Does This Mean for Registries?

• Resource and Opportunity
• Goals of Registries are consistent with NHII /
  LHII and the strategic framework
• Valuable / useful / clinically relevant Data
• Knowledge for decision support - prediction
  algorithms
• Trusted partner / Experience with Collaborations
• Technical expertise with HL7 / Patient Index /
  de-duplication

25
What Does This Mean for Registries? (continued)

• There is a critical need and readiness for change
  to overcome real challenges
• New era of Prevention-Modules for HIT
• You and AIRA have an opportunity for continued
  leadership and innovation in a rapidly changing
  landscape

26
The only real voyage of discovery consists not in
seeking new landscapes but in having new eyes. -
Marcel Proust

• Thank You
• Marty LaVenture, Director
• Public Health Informatics
• Minnesota Department of Health
• martin.laventure_at_health.state.mn.us
• [phone]

27
EXTRA - EXTRA
28
Community Health Information Exchange

• Substantial benefits to all
• First mover disadvantage
• Seed funding needed
• Focus of current Federal initiatives

10
44
77
29
NHII Benefits Net National Savings
TOTAL 121.04
TOTAL 131
Source Center for Information Technology Leadersh
ip, Partners Health Care, Harvard (2004)
10
44
77
30
Power of AIRA

• Have
• A common Passion
• Share a common vision
• Collaboration
• One voice

31
(No Transcript)
32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
35
E. Advantages of LHII Approach

• Existing HII systems are local
• Health care is local ? benefits are local
• Facilitates high level of trust needed
• Easier to align local incentives
• Local scope increases probability of success
• Specific local needs can be addressed
• Can develop a repeatable implementation process
• Parallel implementation ? more rapid progress
• Use of standards allows connectivity between
  LHIIs ? NHII

36
National Health IT Resource Center

• Awarded Sept 27, 2004
• 5 year multi-million dollar contract
• NORC with substantial partnerships with
  Vanderbilt university, Center for IT leadership
  at partners healthcare, Indiana university,
  foundation for the eHealth Initiative
• Dan Gaylin, program director

37
National Health IT Resource Center

• Provide technical assistance to grantees
• Serve as a repository for best practice
  assimilation and diffusion
• Help develop, maintain, and export executable
  knowledge for clinicians and patients
• Offer expert health IT support for providers and
  communities
• Perform and sponsor educational activities
• Develop and disseminate tools to help providers
  and organizations utilize health IT to improve
  patient safety and quality of care

38
Framework for Strategic ActionDecade of Health
Information Technology Delivering
Consumer-centric and Informationrich Health Care
July 2004

• Goals
• Inform Clinical Practice
• Interconnect Clinicians
• Personalize Care
• Improve Public health
• 50-90 million in grants in 2004-2005 to
  communities

July 2004 http//www.hsrnet.net/nhii/materials
/strategic_framework.pdf