Noting that Minnesota is at a crossroads in efforts to ensure that essential health information is exchanged appropriately, the Minnesota Department of Health (MDH), in collaboration with the Minnesota e-Health Advisory Committee and Health Information Exchange Task Force, is seeking input from stakeholders in the state on recommendations for building a “connected networks” approach for health information exchange in Minnesota.
Among the proposals the state is seeking input on are the designation of a health information organization (HIO) to fill HIE connectivity gaps as well as three centralized services/capabilities: a routing mechanism to allow participating organizations to send or request robust information from other participants; a centralized provider/healthcare directory; and a centralized patient directory that could provide a common key service to improve patient matching across a connected networks approach.
As a first step, the HIE Task Force recommends connecting all providers using the national eHealth Exchange network. This would address a gap in the exchange of clinical information to support care transitions between organizations that use Epic and those that do not. By the end of 2019, it is expected that large health systems using the Epic EHR and providers participating with a Minnesota state-certified HIO will be able to query for summary-of-care documents from another care provider using the national eHealth Exchange network.
This step will help ensure that summary-of-care information moves with the patient to any provider that patient sees. However, it is limited to a query to – and response from – a single organization at a time, the Task Force notes. The responses may or may not be in a format that provides discrete data, include multiple unconsolidated documents, and include a limited set of data elements.
The Task Force notes that while using the eHealth Exchange network for exchange of summary-of-care documents is a good starting point, it is not sufficient. Clinicians on the HIE Task Force presented a “wish list” of key health information they would like to be easily accessible. Many of these items are not included with the summary-of-care document and include categories of information such as notes, lab, radiology and pathology results, images, event alerts and others.
The Task Force also noted that a connected networks approach will require agreement on a governing process and the formation of a governing entity to address the need for authority, accountability and decision making. Governance for a connected networks approach in Minnesota will help ensure better coordination and alignment with other HIE activities, including:
• The eHealth Exchange;
• Public health reporting to MDH;
• Minnesota Department of Human Services’ Encounter Alerting Service (EAS); and
• The Trusted Exchange Framework and Common Agreement (TEFCA) and other federal recommendations.
The HIE Task Force recommended that the governing entity of a connected networks approach be a public-private entity that includes representation from a broad set of stakeholders.
The HIE Task Force also recommends that at least one HIO be designated as a way to fill the HIE connectivity gap for stakeholders with limited capabilities and resources.
The HIE Task Force suggested that, because the designated HIO will serve a limited market, it will need financial support in order to sustainably operate throughout Minnesota and to ensure that stakeholders have confidence in using its services.
The state is seeking e-mail responses from Minnesotans by Aug. 28, 2019, to [email protected]. Use the subject line: Public Input on a Connected Networks Approach.
