Minnesota is home to the Mayo Clinic – a world-renowned institution for medical care, research and education, employing more than 3,700 of the smartest physicians and scientists and scientists in the world and caring for patients from across the globe.

It is also home to congresswoman and former GOP presidential candidate Michele Bachmann – a person whose healthcare expertise includes calling the Affordable Care Act the "the crown jewel of socialism," and charging that Democrats' efforts at health reform are tantamount to "reaching down the throat and ripping the guts out of freedom." But that's a topic for another story.

Truly, the North Star State is a land of contrasts. From the thriving Twin Cities of Minneapolis and St. Paul, to remote, frozen outposts like International Falls, the so-called "Icebox of the Nation," Minnesota – often ranked as the healthiest state – covers a huge geographic and demographic area and has many different healthcare needs. It is also an early leader when it comes to deploying healthcare IT to meet those needs.

Leading up to the Minnesota caucus on Feb. 7, Healthcare IT News Managing Editor Mike Miliard spoke to Marty LaVenture, director of the Office of Health Information Technology and the Center for Health Informatics and e-Health in the Minnesota Department of Health, about the Gopher State's healthcare needs – and how they're addressed by its health IT infrastructure.

Q: Can you talk a bit about healthcare – and healthcare information technology – in Minnesota?
A: The environment related to health IT is one that has a strong history of collaboration between the public and private sectors, starting with 2004, with the establishment of the Minnesota eHealth Initiative – a public-private effort chartered by the legislature to bring together, under the Commissioner of Health, a cross-section of the healthcare and public and private sectors to work together on the successful adoption of electronic health records and other technologies.

There's a very high adoption rate in clinical ambulatory settings in Minnesota – one of the highest in the nation, with around 72 percent of ambulatory clinics having adopted EHRs. And more than 90 percent of hospitals have adopted electronic health records.

Lower but, importantly, growing, is the second key element: the actual effective use of the systems and their environments: things like clinical decision support and e-prescribing are other factors that lead to use of that tool effectively to improve individual care and care of the entire community. Progress is moving there.

A third factor is a number of opportunities for continued improvement related to the exchange of health information, and the factors associated with that.

[See also: Minnesota awards grants to providers for interoperable EHRs.]

Q: How do you grade the extent of Minnesota's HIE deployment?
A: Minnesota has chosen to support an open market strategy for secure health information exchange that allows for the private sector innovation and initiative. It uses a model for limited government oversight to assure fair practices and compliance with state privacy protections.

It's chosen that model. It lags behind in adoption and use, in terms of the proportion of clinics and hospitals that are reporting exchange activities. It's higher among those [providers] that exchange standard transactions within the health system, but a little lower outside of, say, your own affiliated partners. So those [organizations] that are not affiliated are a little bit further behind.

ePrescribing is moving rapidly. There is a requirement in Minnesota to use e-prescribing, and more than 68 percent of the clinics report using it as their method of preparing prescriptions. About 40 percent or so of the hospitals are involved in e-prescribing with outside prescriptions, and certainly within their own organization they're using CPOE as a method for ordering medications as well. Most of the pharmacies in Minnesota – more than 90 percent – are actively engaged in e-prescribing. So there's a lot of progress, but a long way to go, as well.

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