@article{Patnoe_LaVenture_Johnson_Fritz_Frohnert_Mbinda_Soderberg_Allen_2017, title={An Informatics Framework to Support Surveillance System Interoperability in Minnesota}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7609}, DOI={10.5210/ojphi.v9i1.7609}, abstractNote={<div style="left: 90px; top: 355.758px; font-size: 14.1667px; font-family: sans-serif; transform: scaleX(1.08129);" data-canvas-width="63.778333333333336">Objective</div><div style="left: 105px; top: 370.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.06399);" data-canvas-width="383.0354999999998">To create an informatics framework and provide guidance</div><div style="left: 90px; top: 387.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.02328);" data-canvas-width="396.7785833333333">to help Minnesota’s public health surveillance systems achieve</div><div style="left: 90px; top: 404.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.04532);" data-canvas-width="399.53966666666685">interoperability and transition to standards-based electronic</div><div style="left: 90px; top: 420.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.03143);" data-canvas-width="394.5388333333333">information exchange with external health care providers using the</div><div style="left: 90px; top: 437.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00323);" data-canvas-width="310.44833333333327">state’s birth defects registry as an initial pilot program.</div><div style="left: 90px; top: 469.091px; font-size: 14.1667px; font-family: sans-serif; transform: scaleX(1.11768);" data-canvas-width="82.63416666666666">Introduction</div><div style="left: 105px; top: 484.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.970505);" data-canvas-width="380.14691666666664">The Minnesota Department of Health (MDH) needs to be able</div><div style="left: 90px; top: 500.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.04035);" data-canvas-width="397.2248333333331">to collect, use, and share clinical, individual-level health data</div><div style="left: 90px; top: 517.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.03163);" data-canvas-width="394.2200833333333">electronically in secure and standardized ways in order to optimize</div><div style="left: 90px; top: 534.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.999032);" data-canvas-width="395.9498333333333">surveillance capabilities, support public health goals, and ensure</div><div style="left: 90px; top: 550.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.99426);" data-canvas-width="393.2794166666666">proper follow-up and action to public health threats. MDH programs,</div><div style="left: 90px; top: 567.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.01347);" data-canvas-width="394.0529166666667">public health departments, and health care providers across the state</div><div style="left: 90px; top: 584.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.987915);" data-canvas-width="393.0584166666666">are facing increasing demands to receive and submit electronic health</div><div style="left: 90px; top: 600.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.03149);" data-canvas-width="394.47508333333315">data through approaches that are secure, coordinated, and efficient;</div><div style="left: 90px; top: 617.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.02399);" data-canvas-width="394.4566666666666">use appropriate data standards; meet state and federal privacy laws;</div><div style="left: 90px; top: 634.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.03581);" data-canvas-width="394.6266666666666">and align with best practices. This framework builds upon existing</div><div style="left: 90px; top: 650.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.99539);" data-canvas-width="393.2949999999998">informatics models and two past studies assessing health information</div><div style="left: 90px; top: 667.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.989782);" data-canvas-width="393.02583333333297">exchange (HIE) conducted by the MDH Office of Health Information</div><div style="left: 90px; top: 684.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.03609);" data-canvas-width="394.52750000000015">Technology (OHIT) to provide MDH surveillance systems with an</div><div style="left: 90px; top: 700.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.960163);" data-canvas-width="394.9950000000002">outline of the key elements and considerations for transitioning to</div><div style="left: 90px; top: 717.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00099);" data-canvas-width="317.06416666666655">more secure, standards-based, electronic data exchange.</div><div style="left: 90px; top: 749.091px; font-size: 14.1667px; font-family: sans-serif; transform: scaleX(1.07287);" data-canvas-width="58.23916666666666">Methods</div><div style="left: 105px; top: 764.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.05263);" data-canvas-width="385.05283333333335">Development of the informatics framework incorporates</div><div style="left: 90px; top: 780.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.998995);" data-canvas-width="395.63533333333334">information gathered in several phases. The first phase involves</div><div style="left: 90px; top: 797.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00115);" data-canvas-width="396.08724999999987">additional analysis of data collected from the MDH Informatics</div><div style="left: 90px; top: 814.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00502);" data-canvas-width="225.9965833333334">Assessment of Interoperability and HIE</div><div style="left: 315.996px; top: 814.417px; font-size: 8.5px; font-family: serif;">1</div><div style="left: 320.246px; top: 814.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.0095);" data-canvas-width="163.53858333333332">that was conducted in 2015</div><div style="left: 90px; top: 830.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.96785);" data-canvas-width="395.012">to evaluate the current state of interoperability and HIE readiness</div><div style="left: 90px; top: 847.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00933);" data-canvas-width="396.2813333333332">across the agency. The second phase involves a comprehensive</div><div style="left: 90px; top: 864.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.02375);" data-canvas-width="396.4966666666669">environmental scan and literature review of existing standards,</div><div style="left: 90px; top: 880.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.02666);" data-canvas-width="394.6663333333336">practices, models, toolkits, and other resources related to electronic</div><div style="left: 90px; top: 897.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.969879);" data-canvas-width="392.59091666666654">HIE and interoperability. The third phase involves gathering additional</div><div style="left: 90px; top: 914.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00469);" data-canvas-width="395.84783333333326">information on programmatic needs, workflows, and capabilities</div><div style="left: 90px; top: 930.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.02302);" data-canvas-width="394.5799166666665">through key informant interviews. Key informants include program</div><div style="left: 90px; top: 947.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.984821);" data-canvas-width="393.02583333333325">managers, staff, and content-area experts from select MDH programs,</div><div style="left: 90px; top: 964.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00135);" data-canvas-width="393.465">the state’s central information technology organization (MN.IT), and</div><div style="left: 90px; top: 980.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00143);" data-canvas-width="356.85833333333323">external health care provider organizations including hospitals.</div><div style="left: 105px; top: 1014.04px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.03245);" data-canvas-width="379.35499999999973">Minnesota’s birth defects registry, the Birth Defects Information</div><div style="left: 90px; top: 1030.71px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.962768);" data-canvas-width="394.95958333333334">System (BDIS), was selected as the pilot program because it was</div><div style="left: 90px; top: 1047.38px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.993049);" data-canvas-width="393.21425">identified in the 2015 MDH Informatics Assessment as having a high</div><div style="left: 90px; top: 1064.04px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.989453);" data-canvas-width="389.86100000000016">level of interest in implementing an interoperable and standards-</div><div style="left: 90px; top: 1080.71px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.994581);" data-canvas-width="393.3403333333333">driven approach to electronic health data exchange. The BDIS is also</div><div style="left: 90px; top: 1097.38px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.955667);" data-canvas-width="394.62666666666655">exploring options for being designated as an eligible public health</div><div style="left: 90px; top: 1114.04px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.97578);" data-canvas-width="395.38599999999997">registry for Meaningful Use. As a pilot program for this project,</div><div style="left: 90px; top: 1130.71px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.998786);" data-canvas-width="395.9852500000003">the BDIS assists in the development and implementation of the</div><div style="left: 90px; top: 1147.38px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00071);" data-canvas-width="133.76166666666668">informatics framework.</div><div style="left: 90px; top: 1179.09px; font-size: 14.1667px; font-family: sans-serif; transform: scaleX(1.08488);" data-canvas-width="51.17">Results</div><div style="left: 105px; top: 1194.04px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.02001);" data-canvas-width="379.34225">The 2015 MDH Informatics Assessment identified and evaluated</div><div style="left: 90px; top: 1210.71px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.996552);" data-canvas-width="393.4054999999999">21 MDH programs with information systems that accept and manage</div><div style="left: 510px; top: 354.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.01925);" data-canvas-width="394.3291666666666">clinical, individual-level health information. Among these 21 MDH</div><div style="left: 510px; top: 370.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.971694);" data-canvas-width="394.7669166666669">programs, wide variations exist regarding information system size</div><div style="left: 510px; top: 387.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.976989);" data-canvas-width="392.65183333333323">(range, 400 to 10,000,000 individuals), staffing numbers (range, 0.2 to</div><div style="left: 510px; top: 404.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.972056);" data-canvas-width="395.335">21 FTEs), budgets (range, $20,000 to $1,876,000), and other key</div><div style="left: 510px; top: 420.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.0186);" data-canvas-width="394.434">characteristics. Despite these variations, programs identified similar</div><div style="left: 510px; top: 437.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.993367);" data-canvas-width="393.2241666666666">barriers and needs related to achieving interoperability and electronic</div><div style="left: 510px; top: 454.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.996572);" data-canvas-width="393.3799999999999">HIE. Areas of need include management and information technology</div><div style="left: 510px; top: 470.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.01121);" data-canvas-width="394.01891666666666">support to make interoperability a priority; policies and governance;</div><div style="left: 510px; top: 487.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.971386);" data-canvas-width="394.99783333333323">additional application functionality to support HIE; and additional</div><div style="left: 510px; top: 504.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.985886);" data-canvas-width="393.0399999999998">skills for the workforce. Results from the environmental scan and key</div><div style="left: 510px; top: 520.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.995468);" data-canvas-width="393.3261666666666">informant interviews will be incorporated with additional analyses of</div><div style="left: 510px; top: 537.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.987647);" data-canvas-width="393.03433333333334">the 2015 MDH Informatics Assessment to inform the development of</div><div style="left: 510px; top: 554.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.995444);" data-canvas-width="393.33324999999996">an agency-wide informatics framework to support MDH programs in</div><div style="left: 510px; top: 570.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.00717);" data-canvas-width="149.51500000000004">achieving interoperability.</div><div style="left: 510px; top: 602.425px; font-size: 14.1667px; font-family: sans-serif; transform: scaleX(1.10336);" data-canvas-width="85.01416666666667">Conclusions</div><div style="left: 525px; top: 617.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.966317);" data-canvas-width="380.03641666666664">MDH surveillance systems are calling for practical guidance to</div><div style="left: 510px; top: 634.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.987185);" data-canvas-width="395.74583333333317">help implement and maintain a more efficient and effective way</div><div style="left: 510px; top: 650.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.984713);" data-canvas-width="395.7231666666665">to electronically collect, use, and share health data with external</div><div style="left: 510px; top: 667.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(0.966037);" data-canvas-width="394.6904166666667">and internal stakeholders. This informatics framework provides an</div><div style="left: 510px; top: 684.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.01687);" data-canvas-width="394.1903333333332">outline of the key elements and considerations for achieving greater</div><div style="left: 510px; top: 700.709px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.05998);" data-canvas-width="398.00399999999985">interoperability across MDH surveillance systems. Additional</div><div style="left: 510px; top: 717.376px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.03836);" data-canvas-width="394.3348333333332">research is required to assess how system interoperability and HIE</div><div style="left: 510px; top: 734.043px; font-size: 14.1667px; font-family: serif; transform: scaleX(1.0007);" data-canvas-width="353.7133333333332">can improve data quality and advance population health goals.</div>}, number={1}, journal={Online Journal of Public Health Informatics}, author={Patnoe, Sameul and LaVenture, Martin and Johnson, Rebecca E. and Fritz, Jennifer and Frohnert, Barbara and Mbinda, Geoffrey and Soderberg, Karen and Allen, Bree}, year={2017}, month={May} }