The Minnesota Health Data Institute. Minnesota Medical Association.
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Data Collection↗
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Results for “Minnesota Health Data Institute”
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Data organizations and data networks in Minnesota.
The state of Minnesota offers examples of data-driven organizations as well as a statewide effort to electronically link these into an integrated network. The examples provided by Blue Cross Blue/Shield of Minnesota demonstrate an array of analytical tools to improve quality and enhance financial performance. Blue Cross/ Blue Shield of Minnesota uses a clinical severity measurement system to aid in the development of an inpatient hospital reimbursement methodology which enables hospitals to better manage the quality of care delivered to the patient population. They also make use of population-based utilization analysis in a collaborative environment with providers to improve quality and efficiency of care. The Minnesota Health Data Institute was created by the state legislature to support the information needs of the health care stakeholders in Minnesota. One of its first initiatives is to develop a uniform method of comparing health care plans.
Computer Communication Networks↗
Data privacy under MinnesotaCare.
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Computer Security↗
A survey of community-based violence prevention and control efforts in Minnesota.
Rates of interpersonal violence at the national level in the United States exceed those of other industrialized nations; evidence of violence exists at the state level as well. Yet, data that identify the magnitude of the problem, pertinent risk factors, and efficacy of intervention efforts are limited. Faculty at the University of Minnesota School of Public Health conducted a survey to assess the extent to which violence prevention research and programmatic efforts exist statewide. Study findings served as a basis for developing a relevant research agenda and prioritizing limited academic resources. This paper describes the survey and development of an academic-community partnership that fosters collaborative research on violence prevention that will hopefully contribute to control of the violence epidemic.
Adolescent↗
Contributions of autopsy to population-based cancer epidemiology: targetted intervention to improve ascertainment.
The importance of autopsy data in cancer epidemiological investigation is well appreciated by researchers at the Mayo Clinic. The Rochester Epidemiology Program Project is a complete population-based collection of morbidity and mortality data in Olmsted County, Minnesota (population, 100,000), funded by the National Institutes of Health since 1964. Comprehensive ascertainment of cancer in this community cohort has been augmented by initial diagnosis at autopsy for 12% of colorectal cancers, 35% of intracranial neoplasms, 45% of phaeochromocytomas and 37% of renal-cell carcinomas. These rates are in stark contrast to autopsy diagnoses in our cancer registry--usually less than 1%. The difference is attributable to the denominator in these comparisons, a concept of vital importance to the epidemiological interpretation of autopsy findings. Despite the enormous value of the autopsy in our research, social and economic factors diminished autoptic rates in Olmsted County from 63% in 1970 to 39% in 1984. These rates are well above that for the USA as a whole but parallel our national decline in frequency of autopsy. The major factors responsible for this reduction appear to be the increasing proportion of deaths in nursing homes and the advent of declining reimbursement in US health care.
Autopsy↗
Problems with surveillance methods for alcoholism: differences in coding systems among federal, state, and private agencies.
Social indicator systems can serve as a social accounting method to guide public policy on alcoholism, utilizing data which are routinely collected at public expense. An attempt to develop an alcoholism social indicator system for Minnesota demonstrated many differences in the coding schemes used by various state agencies and institutions. These findings have relevance to other social indicator systems being developed to assess public policies regarding the people's health.
Alcoholism↗
Using STAT properly.
The misuse of the term STAT has long been a problem in many hospitals. Instead of being the universal word for "immediate," it has become a convenient phrase used, in some cases, to get what the physician wants now. Although the principles of this article may be applied to many modalities in the healthcare field, this article deals solely with portable chest x-rays performed at the University of Minnesota Medical Center, Fairview in Minneapolis. The diagnostic radiology department performed a 2-week analysis of orders in August 2004. The results showed that 74% of all portable chest x-rays were ordered as STAT. The manager, along with a staff radiologist, then created a list of clinical reasons that were appropriate for STAT, ASAP, or Routine orders. Then, there was a 2-week period of time delegated for education, during which the list was brought to the nurse managers of several patient care areas as well as some chief residents at the university's medical school. These individuals then shared the list with their staff. A second analysis conducted in November 2004 showed that an 11% decrease had been achieved. Given that 20,000 portable chest x-rays are performed at the medical center annually, the figure represents a 2,200 reduction in STAT portables per year. With the success of this endeavor, the radiology department piloted a second program to further decrease the number of STAT orders. Since the radiology department was using computed radiography (CR) and a picture archiving and communication system (PACS), research began to unearth the response times. The idea was to advertise to physicians how fast they could get their images, using the theory that if the times were quick enough, perhaps there would less of a tendency to order STATs. The results showed that a STAT order could be completed and viewable on PACS in an average of 17 minutes, and an ASAP in 28 minutes. A poster advertising these response times was generated and distributed to the nurse managers and residents to post in the inpatient units. The poster was well received. A two-week survey conducted in March 2005 showed that STATs now accounted for 54% of the portable chest x-rays. With this two-pronged approach, the radiology department was able to decrease the number of portable chest X-rays by 20%. Another 2-week survey conducted in May 2005 showed that number of portable chest x-rays ordered as STAT declined further to 52%.
Academic Medical Centers↗
The Minnesota model--the pace car. In the race to integrate, the Twin Cities market leads the pack.
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Catchment Area, Health↗
Investing in research: the impact of one academic health center's research grant program.
External research funding provides the core support for a medical center's research enterprise, and is a major or sole criterion for comparing and ranking institutions. Most grant programs are sufficiently competitive that awards are not granted without the availability of preliminary data. Therefore, institutions may find it necessary to supplement external research funds, particularly as matching funds or as seed funds. The authors report their experience at the University of Minnesota Academic Health Center with two internal grant programs, a seed grant program and an interdisciplinary/intercollegiate Faculty Research Development (FRD) grant program. Seed grants are one-year, one-time $25,000 awards to investigators to initiate a new direction in research or to develop innovative projects allowing faculty to expand into new research areas. FRD grants are one-time $200,000 awards for a one- to three-year project that support innovative interdisciplinary and interscholastic research with a high potential for future grants. The authors based their analysis of program outcomes on investigators' self-reports of subsequent external grants and peer-reviewed publications stemming from the initial grants. Six annual cycles of the seed grant program (1998-2003) yielded a financial return on investment (ROI) of 560%. Five annual cycles of the FRD grant program (1998-2002) yielded an ROI of 237%. The authors conclude that the AHC grant program has been successful in generating external research funds (primarily National Institutes of Health) and publications; stimulating risk-taking; and developing interdisciplinary and intercollegiate collaboration. They plan to continue the AHC grant program and recommend similar programs to other institutions.
Academic Medical Centers↗
Presenting quality measurement data to the public.
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Annual Reports as Topic↗
Is rheumatoid arthritis care more costly when provided by rheumatologists compared with generalists?
OBJECTIVE: Controversy surrounds the cost-effectiveness of rheumatologist care compared with generalist care for patients with rheumatoid arthritis (RA). Rheumatologists can provide 2 distinct types of care for RA patients: primary care and specialist care. We sought to examine the relationship between cost and type of care in a population-based cohort of patients with RA. METHODS: Data regarding specialty of care and use of health services (i.e., total direct medical costs, surgeries, radiographs, laboratory tests, hospital days) were collected from a community sample of 249 patients with RA (defined using the 1987 American College of Rheumatology diagnostic criteria) among Rochester, Minnesota residents > or =35 years of age. In a randomly selected subset of 99 of these RA patients, detailed information on all physician encounters was collected and categorized according to whether or not the care received constituted "primary care" according to the Institute of Medicine definition. Using these data, we evaluated the influence of type of care as well as specialty of provider on utilization. For these analyses, total direct costs included all inpatient and outpatient health care costs incurred by all local providers (excluding outpatient prescription drugs). RESULTS: The 249 patients with RA (mean age 64 years, 75% women) were followed up for a median of 5.4 years, while the subset of 99 RA patients (mean age 64 years, 77% women) were followed up for a median of 4.7 years. The overall median direct medical costs per person per year were $2,749 and $2,929 for the total cohort and for the subset of 99 patients, respectively. Generalized linear regression analyses (considering all visits of the 249 RA patients) revealed that after adjusting for demographics and disease characteristics, rheumatologist care (compared with nonrheumatologist care) was not associated with higher total direct medical costs (P = 0.85) or more hospital days (P = 0.35), but was associated with slightly more radiographs (P = 0.037) and significantly more laboratory tests (P < 0.0001). When considering only primary care, such care by rheumatologists was, again, not associated with higher total direct medical costs (P = 0.11) or more hospital days (P = 0.69) or more laboratory tests (P = 0.54), but was associated with slightly more radiographs (P = 0.035). CONCLUSION: Rheumatologist care is not more costly than generalist care for patients with RA. Important differences (especially in the use of laboratory tests) become apparent when the type of care provided as well as the specialty of the provider are considered in the analyses.
Adult↗
Medical records and privacy: empirical effects of legislation.
OBJECTIVE: To determine the effects of state legislation requiring patient informed consent prior to medical record abstraction by external researchers for a specific study. DATA SOURCES/STUDY SETTING: Informed consent responses obtained from November 1997 through April 1998 from members of a Minnesota-based IPA model health plan. STUDY DESIGN: Descriptive case study of consent to gain access to medical records for a pharmaco-epidemiologic study of seizures associated with use of a pain medication that was conducted as part of the FDA's post-marketing safety surveillance program to evaluate adverse events associated with approved drugs. DATA COLLECTION: The informed consent process approved by an institutional review board consisted of three phases: (1) a letter from the health plan's medical director requesting participation, (2) a second mailing to nonrespondents, and (3) a follow-up telephone call to nonrespondents. PRINCIPAL FINDINGS: Of 140 Minnesota health plan members asked to participate in the medical records study, 52 percent (73) responded and 19 percent (26) returned a signed consent form authorizing access to their records for the study. For 132 study subjects enrolled in five other health plans in states where study-specific consent was not required, health care providers granted access to patient medical records for 93 percent (123) of the members. CONCLUSION: Legislation requiring patient informed consent to gain access to medical records for a specific research study was associated with low participation and increased time to complete that observational study. Efforts to protect patient privacy may come into conflict with the ability to produce timely and valid research to safeguard and improve public health.
Cohort Studies↗
Predictors of burnout and job satisfaction among Turkish physicians.
BACKGROUND: Burnout is associated with decreased job performance and low career satisfaction. It has a special significance in health care, where staff experience both psychological-emotional and physical stress. AIM: To investigate levels of job satisfaction and burnout among Istanbul physicians, and the relationships between demographic characteristics, job characteristics, job satisfaction and burnout. DESIGN: Questionnaire-based survey. METHODS: We collected data from a randomly selected sample group of 598 physicians from different health-care institutions in Istanbul. A questionnaire regarding sociodemographic characteristics of the physicians, the Maslach Burnout Inventory (MBI) and the Minnesota Job Satisfaction Questionnaire (MSQ) were all administered during face-to-face interviews. RESULTS: Job satisfaction was inversely correlated with emotional exhaustion and depersonalization, and positively correlated with personal accomplishment. Under multilevel regression, the most significant and common predictors of all burnout dimensions and job satisfaction were the number of vacations at individual level, and public ownership of healthcare facilities at group level. Number of shifts per month was also a significant predictor of all burnout dimensions. DISCUSSION: Organizational efforts aimed at increasing the level of job satisfaction among physicians could help to prevent burnout.
Adult↗
Workers' compensation claims from latex glove use: a longitudinal analysis of Minnesota data from 1988 to 1997.
Allergic reaction experienced by health care workers from latex glove use has increasingly become the focus of researchers evaluating occupational sources of injury in health care settings. Many studies have attempted to estimate the prevalence of latex sensitization among health care workers by using various methods, but the findings have been inconsistent and do not predict reactivity. This study used workers' compensation data from Minnesota from 1988 to 1997 to assess allergic reactivity rates, injury severity, and costs associated with latex allergic reactions. The average reactivity rate was 7.1 claims per 100,000 health care workers, and total cost associated with the claims averaged $0.295 per health care employee. Using empirical cost data from another study, it was found that it is not cost-beneficial for health care institutions to globally adopt latex glove-free policies solely on the basis of workers' compensation costs.
Adult↗
Pancreas transplantation.
The data on vascularized pancreas transplant cases reported to the old American College of Surgeons/National Institutes of Health Organ Transplant Registry from December 17, 1966, through December 31, 1984, are summarized in this article. Also described is the experience at the University of Minnesota, where more than one fifth of the transplants have been performed. The authors conclude that pancreas transplantation is now an effective treatment for human diabetes.
Diabetes Mellitus↗
Adult blood lead epidemiology and surveillance--United States, first quarter 1996, and annual 1995.
CDC's National Institute for Occupational Safety and Health Adult Blood Lead Epidemiology and Surveillance program (ABLES) monitors laboratory-reported elevated blood lead levels (BLLs) among adults in the United States. Twenty-three states reported surveillance results to the ABLES program in 1995. Ohio and Minnesota joined ABLES in 1996; their data are included for the first quarter of 1996. This report presents ABLES data for the first quarter of 1996 compared with the first quarter of 1995 and annual data for 1995 compared with 1994.
Humans↗
Benchmarking in health-system pharmacy: experience at MeritCare Medical Center.
The experience of MeritCare Medical Center (MMC) with the Benchmarking Program coordinated by The Clinical Pharmacokinetics Laboratory at Millard Fillmore Hospital is described. MMC is a community-based teaching institution in Fargo, North Dakota, that serves patients in North Dakota, South Dakota, and Minnesota. MeritCare began participating in the Benchmarking Program in 1997. Data from the individual hospital report raised concern about the high cost of antimicrobials at MMC relative to peer-group institutions. The staff conducted an evaluation of antimicrobial prophylaxis for noncardiovascular surgery, concluded that cefazolin use was suboptimal, and attempted to encourage more cost-effective utilization. MMC's participation in the Benchmarking Program also prompted more appropriate use of various other antimicrobial agents, including i.v. and oral ciprofloxacin. An i.v.-to-oral switching program was begun for various agents. Preliminary analysis after 15 months demonstrated direct cost savings for drug acquisition of $60,000 to $80,000 per year and a reduced length of stay. Initiatives undertaken by MeritCare on the basis of data obtained through the Benchmarking Program resulted in substantial estimated savings in drug acquisition costs.
Anti-Bacterial Agents↗
Fish consumption advisories and outreach programs for Southeast Asian immigrants.
Southeast Asian immigrants and refugees, in particular the Hmong people of Laos, have settled in large numbers in metropolitan areas of Minnesota. These communities, accustomed to hunting and fishing for food in Laos, now fish in some of the most contaminated waters of Minnesota. Fishing and fish-preparation customs of their homeland emphasize using all fish caught and discarding very little waste. These practices result in a potentially high exposure to PCBs and mercury. Educational outreach efforts to inform this population of the potential health hazards from consuming the fish are hindered by language and cultural barriers. While most Hmong anglers welcome information about contaminants and fishing, the typical press releases and mailings that convey fish advisory information to the public do not reach this community. The Minnesota Department of Health and the Minnesota Department of Natural Resources collaborated to determine the health messages and communication methods that would best meet the needs of these communities. Using the results of interviews and a behavioral survey, the Minnesota Department of Health has tailored fish consumption advisories to meet the unique needs of Southeast Asian anglers. Over the past four years, educational programs involving specialized advisories, translations, signs, a Hmong language video, and workshops have been used to inform Hmong anglers and other Southeast Asians about fish contaminants.
Asia, Southeastern↗