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Ramsey County uses electronic health records (EHR) to improve health information accessibility

April 6, 2018 Case Study 3 min read

Ramsey County, Minn., the second most populous county in a prominent Midwestern state, with a rapidly growing population of over a half million, faced issues adopting and utilizing multiple electronic health record (EHR) systems. Here's how they improved health information accessibility.

Photo og hospital staff discussing electronic health records.

The challenge

With a growing refugee population, many constituents required county-based medical services. The county created the Health and Wellness Administrative Division, which provides support for a diverse group of government health services including: social services (adult and children’s mental health, chemical health, and detoxification), public health (family health, sexually transmitted diseases, immunization clinics, and adult and adolescent corrections), home health, and long-term care. Over time, the county implemented multiple EHR systems to gather and track constituent health information. Unfortunately, EHR adoption, utilization, and success were inconsistent and uncoordinated.

The county maintained several disparate EHR systems. Each was independently operated and maintained with no ability to link county resident’s health information across the continuum of care. This resulted in significant manual processing. The county sought to identify and evaluate options to efficiently and effectively standardize, maintain, upgrade, and optimize these technology services to better align departments and support the county’s long-term needs.

The solution

The county engaged our experts to develop an EHR maintenance and support model that would ensure the systems satisfy county objectives; are well-maintained and supported; end users are properly engaged and trained; and that a governance structure is developed to support coordination of EHR practices across all county health and wellness services.

While working side by side with the Health and Wellness Service Team, we designed a model for ongoing end-user support. Our experts:

  • Provided detailed recommendations for user engagement, training, and management to ensure the county receives its ROI for the system.
  • Enhanced the county’s EHR governance structure by providing recommendations for data governance, usage, and quality requirements and controls.
  • Developed a matrix of maintenance and support requirements for all health and wellness services to clearly delineate current and future capabilities.
  • Provided a comprehensive list of policies required to safeguard, monitor, and effectively manage the EHRs and protected health information.
  • Conducted an in-depth EHR maintenance and support benchmarking study of comparable county health departments to ascertain public industry EHR maintenance and support practices.
  • Provided insight on current healthcare information technology trends, including population health, alternative payment models, health information exchange, personal identification tracking, mobile technologies, cloud-based and internet services, provider and patient portals, and HITRUST security.
  • Designed a roadmap including immediate, mid-term, and long-term tasks and resources required to build out a centralized EHR support unit capable of assisting all EHR maintenance and support functions.

The benefit

With a revised and robust EHR service model and support system, the county can properly support the needs of their constituents through improved consistency, efficiency, and efficacy of service. The optimized support model not only allows for cost savings for the county and its taxpayers, but it improves employee and resident morale through the improved service.

  • End-user adoption is orchestrated as a fundamental component of the EHR implementation. This allows for consistent and efficient use of the EHR systems.
  • Business and clinical processes are reviewed, optimized, and properly documented prior to EHR implementation.
  • Data analytics and reporting are built in to administrative dashboards. The data and ease of reporting allows the county to plan and prepare for future changes. The dashboards also enable the county to more quickly and easily prepare grant applications and meet federal reporting requirements.
  • Response to service requests are relevant and timely as EHR systems are now considered to be “business-critical” applications.
  • End users receive appropriate and relatable EHR training ensuring the county is proactive with supporting the system into the future.
  • The EHR governance includes all Health and Wellness Services stakeholders.

“I feel confident, and our board is assured, that we've done our due diligence and that we'll be able to support and maintain the electronic health record systems we are implementing well into the future," said Karen Saltis, Health and Wellness Administrative Division Director. "The Plante Moran assessment validated our concerns around support and maintenance of our EHR systems and provided us with the recommendations and resources we needed to properly build that support.”

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