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首页> 美国卫生研究院文献>Online Journal of Public Health Informatics >Health Reform in Minnesota: An Analysis of Complementary InitiativesImplementing Electronic Health Record Technology and CareCoordination
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Health Reform in Minnesota: An Analysis of Complementary InitiativesImplementing Electronic Health Record Technology and CareCoordination

机译：明尼苏达州的医疗改革：补充性举措分析实施电子病历技术和护理协调

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Background: Minnesota enacted legislation in 2007 that requires all health care providers in the state to implement an interoperable electronic health record (EHR) system by 2015. 100% of hospitals and 98% of clinics had adopted EHR systems by end of 2015. Minnesota’s 2008 health reform included a health care home (HCH) program, Minnesota’s patient centered medical home. By end of 2014, 43% of HCH eligible clinics were certified with 335 certified HCHs and 430 eligible but not certified clinics.Objectives: To study the association between adoption and use of EHRs in primary care clinics and HCH certification, including use of clinical decision support tools, patient registries, electronic exchange of patient information, and availability of patient portals.Methods: Study utilized data from the 2015 Minnesota Health Information Technology Clinic Survey conducted annually by the Minnesota Department of Health. The response rate was 80% with 1,181 of 1,473 Minnesota clinics, including 662 HCH eligible primary care clinics. The comparative analysis focused on certified HCHs (311) and eligible but not certified clinics (351).Results: HCH clinics utilized the various tools of EHR technology at a higher rate than non-HCH clinics. This greater utilization was noted across a range of functionalities: clinical decision support, patient disease registries, EHR tosupport quality improvement, electronic exchange of summary care records andavailability of patient portals. HCH certification was significant for clinicaldecision support tools, registries and quality improvement.Conclusions: HCH requirements of care management, care coordination and qualityimprovement can be better supported with EHR technology, which underscores thehigher rate of utilization of EHR tools by HCH clinics. Optimizing electronicexchange of health information remains a challenge for all clinics, includingHCH certified clinics. This research presents the synergy between complementaryinitiatives supporting EHR adoption and HCH certification. Ultimately,improvement in health outcomes depends on effective intersection of people,processes and technology.
机译：背景：明尼苏达州于2007年颁布法规，要求该州所有医疗保健提供者在2015年前实施可互操作的电子健康记录（EHR）系统。到2015年底，100％的医院和98％的诊所已采用电子病历系统。明尼苏达州2008年医疗改革包括明尼苏达州以病人为中心的医疗之家（HCH）计划。截至2014年底，有43％的HCH合格诊所获得335个HCH合格认证和430个但未经认证的合格诊所的认证。目的：研究初级保健诊所采用和使用EHR与HCH认证之间的关联，包括临床决策的使用方法：该研究利用了明尼苏达州卫生部每年进行的2015年明尼苏达州健康信息技术诊所调查的数据。明尼苏达州1,473家诊所中的1,181家，其中包括662家符合HCH资格的初级保健诊所，回复率为80％。比较分析的重点是经过认证的HCH诊所（311）和合格但未经认证的诊所（351）。结果：HCH诊所使用EHR技术的各种工具的比率高于非HCH诊所。在更大范围的功能中注意到了这种更大的利用：临床决策支持，患者疾病登记，EHR到支持质量改进，汇总护理记录的电子交换以及患者门户的可用性。 HCH认证对临床意义重大决策支持工具，注册管理机构和质量改进。结论：HCH对护理管理，护理协调和质量的要求电子病历技术可以更好地支持改善，这强调了HCH诊所对EHR工具的利用率更高。优化电子卫生信息的交换仍然是所有诊所的挑战，包括HCH认证的诊所。这项研究提出了互补之间的协同作用支持采用EHR和HCH认证的计划。最终，健康结果的改善取决于人们的有效交往，流程和技术。

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