As the nation’s healthcare system pushes forward to meet healthcare reform’s goals of improving quality, lowering costs and providing more coordinated care, Minneapolis-St. Paul finds itself in an enviable position.
“What really makes the Twin Cities unique from a healthcare perspective is the deep collective knowledge that people in this community have.”
The Twin Cities region consistently tops lists for the best hospitals, healthiest population, most-wired physicians and highest quality healthcare services. Several recent successful initiatives are models for better patient care and improved outcomes.
“As far as healthcare goes, Minnesota is where a lot of innovation happens,” says Rajiv Shah, M.D., founder and CEO of Minneapolis-based MyMeds, a medication management mobile application. “When you think about the different parts of healthcare and how things are changing nationally, this is the country’s lab, and we get to be in the thick of it.”
Minnesota healthcare often is synonymous with the world famous Mayo Clinic, which is located about 90 miles southwest of Minneapolis in Rochester, Minn. The greater Twin Cities region also is home to UnitedHealth Group, Medtronic and the University of Minnesota. Retail health’s poster child, MinuteClinic, previously known as QuickMedx, launched in the Twin Cities in 2000.
At the Forefront of Healthcare Innovation
The region has won numerous healthcare-related accolades, most recently:
It’s no surprise, considering the Twin Cities and Minnesota’s dedication to healthcare improvement and innovation. Whether it’s in reducing hospital readmissions, better aligning payment with outcomes, sharing health information electronically, reducing medical errors or training the next generation of providers and innovators, the Twin Cities is a model of excellence. But where does it go from here?
A Focus on Quality and Transparency
Since 2011, most Minnesota hospitals have been collaborating to reduce avoidable hospital readmissions. Some 83 hospitals and 100 community partners are sharing information to achieve the mutual goal of fewer readmissions through the RARE Campaign, or Reducing Avoidable Readmissions Early. The campaign focuses on five elements: discharge planning, medication management, patient and family engagement, transition care support and transition planning. The initiative prevented 4,750 readmissions between 2011 and 2012, an inpatient cost savings of $40 million. Participating hospitals represent 97% of all discharges statewide.
Closer collaboration on mutual care goals is becoming de rigueur in the Twin Cities. Three out of the 23 Pioneer Accountable Care Organizations nationwide are in the Minneapolis area. The three-year program by the Centers for Medicare and Medicaid Services seeks to align provider incentives to improve care quality and outcomes while lowering costs. Park Nicollet Health Services of St. Louis Park, Minn., and Fairview Health Services and Allina Health, both based in Minneapolis, are the local health systems participating in the Pioneer ACO program.
Minnesota also is among the most health IT savvy. In 2007, the state legislature passed a law requiring all Minnesota hospitals and free-standing surgery centers to have interoperable EHR systems in place by January 2015. As of 2013, 94% of Minnesota physicians had implemented EHR systems — the highest percentage in the nation, according to the Centers for Disease Control and Prevention.
The Twin Cities’ providers are using that IT savvy to improve care and lower costs. For example, Allina implemented a health information exchange tool called Care Everywhere in its hospitals. A peer-reviewed study of adoption of Care Anywhere at three of Allina Health’s hospital emergency departments indicated that it prevented 560 duplicative diagnostic procedures over just six months.
Minnesota has led the way on hospital quality transparency. In 2003, Minnesota became the first state to adopt mandatory adverse event reporting by hospitals and other care facilities. Today, at least 27 other states have followed suit with similar reporting systems.
Minnesota hospitals must report 28 adverse events to the state within 15 days of the event’s discovery. These adverse events — including wrong-site surgery and serious medication errors — are made public through a searchable database. Facilities are also required to convene teams to discover the root causes of the event. A 10-year evaluation of the reporting system showed that it has raised awareness about patient safety and introduced best practices to prevent adverse events. In the last annual reporting period ending October 2013, 258 adverse events were reported, an 18% decline over the prior year.
Training the Next Generation
One notable side-effect of the healthcare-focused way of life in the Twin Cities is the intense competition for qualified professionals to provide high-quality care.
“The Twin Cities is really a healthcare-centric community,” says Amy Nelson, founder and CEO of Accurate Home Care. “So it makes the competition a little bit harder. Nurses and doctors and caregivers are a little more picky about where they work and what they do.”
To address this, the University of Minnesota announced in October 2013 that it would educate 500 additional advanced practice nurses over the next decade. The initiative is being funded with a $10 million gift from the local Bentson Foundation.
The “U” is also training the next-generation of healthcare innovators through its Innovations Fellows Program at its Medical Devices Center in Minneapolis. The program began in 2008 and readies fellows in product development, including FDA approvals, prototyping, creativity techniques and intellectual property.
Look to the Twin Cities for more innovation in the near future, says Peter Kane, founder of Healthcaremn, a healthcare startup accelerator.
“What really makes the Twin Cities unique from a healthcare perspective is the deep collective knowledge that people in this community have,” Kane says. “We’re in a healthcare hotbed here in the Twin Cities, and what our community is realizing is just how many new ideas we have to transform healthcare.”