The State of Minnesota published the “2016 Minnesota HIT Ambulatory Clinics Survey, an annual survey of clinics in the state that details the state’s progress implementing e-health. Nearly all ambulatory clinics in the state have adopted EHRs representing 1,257 clinics in 2016. Epic is the dominant EHR vendor system used by 51 percent of clinics in the state.
Since Minnesota began measuring e-health implementation in 2010, the state’s clinics have made great strides towards implementing EHRs. Also electronic exchange of health information has improved for clinics that have this capability built within their EHR systems. Even among clinics that exchange information, most of these clinics do not find that the system is completely interoperable.
Progress to date can be attributed to state grant and loan programs supporting e-health and federal meaningful use incentives to promote implementation of EHRs. In addition, Minnesota law requires all providers to utilize interoperable EHR systems.
Today, clinics still need resources to advance e-health. The survey found that 99 percent of the clinics with EHRs used CPOE for some or all provider orders. Ninety percent of the clinics with EHRs provided patients with the option to view their patient health information online.
It was found that 69 percent of clinics with EHRs electronically exchanged health information with unaffiliated hospitals or clinics. Also, ninety two percent of the clinics with EHRs were able to generate an electronic summary of care record, but most clinics do not provide an electronic record for patients who require transfer or referral. Less than half of clinics with EHRs receive automated alerts from hospitals when a patient is admitted, discharged, or transferred.
The survey found that 54 percent of clinics used telemedicine services with 72 percent of rural clinics using telemedicine as compared to 51 percent of urban clinics. Two in three primary care clinics used telemedicine as compared to 39 percent within specialty care clinics.
According to the survey, out of the 699 clinics that use telemedicine, the most common services include chronic disease management, for consumer medical and health information, after-hours pharmacy prescribing, remote patient monitoring, and provider and staff medical education.
Among all clinics, the most commonly identified barriers to using telemedicine relates to the cost providing services, cost of equipment, and insufficient reimbursement. Urban clinics noted additional barriers such as lack of staff, support, availability of providers, and lack of demand.
Despite many e-health advances by Minnesota’s clinics, the clinics need additional resources to integrate patient data from external resources into their EHRs, and/or to develop infrastructure to support HIEs.
Other resources needed include managing workflow changes, developing policies and procedures for managing data quality, technical assistance to support HIEs, establishing HIE agreements with exchange partners, and/or mitigating security risks.
Go to www.health.state.mn.us/e-health/summaries/reportclinic2016.pdf to view the Minnesota Clinics E-Health Report containing the section surveying ambulatory clinics published in 2016.