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Michigan HIE Model- Cynthia Edwards
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Michigan HIE Model- Cynthia Edwards


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  • 1. Presenters:Tina R. Scott, MDCHPaul Groll, DTMBCynthia Green-Edwards, MDCHSOM HIE
  • 2. Unraveling the Current Information TangleInsuranceCompaniesPhysiciansSpecialtyProvidersHospitals & ClinicsPatients& FamiliesLab tests &XRAYsMedicationsPublic Health2* One Directional* Not Real-Time* Lacks Standards
  • 3. Desired SolutionHealth Information ExchangeInsuranceCompaniesPhysiciansSpecialtyProvidersHospitals & ClinicsPatients& FamiliesLab tests &XRAYsMedicationsPublic HealthHIE3Standards govern:Form, Content and Response
  • 4. SOM HIEMedicaidDWMSSSDoctors &CommunityProviders EHRsSUB-STATE HIEsMichigan HIE ModelRoutingAuditTrail4State LabsStarLIMS
  • 5. 5SOM HIEDoctors EHRsSUB-STATE HIEMichigan HIE ModelEarly 2012SOM HIE Phase I* Implement interim solution for HL7 messages* Direct Connect to SOM HIE* Send immunization records to MCIR* Compliance with CDC Grant* Send hospital reportable labs to MDSS* Ability to send message acknowledgements
  • 6. 6SOM HIEMedicaidDoctors &CommunityProviders EHRsSUB-STATE HIEsMichigan HIE ModelCurrentDoctors &Local PH Dept EHRsSOM HIE Phase II* Implement production solution* Establish MiHIN – SOM HIE connection* Continued Infrastructure Development* Gather new functional requirements
  • 7. 7MedicaidDWMSSSSOM HIE Phase III*MiHIN – SOM HIE – connection viaVPN*Next SOM Use Cases* MSSS* MCIR forecast/history* State Labs (StarLIMS)*HPD – Health Provider Directory* Not Limited to Licensed ProvidersMichigan HIE ModelPlanningState LabsStarLIMS
  • 8. 8MedicaidDWMSSS*Match person-levelrecords across data sets*Link data from multipledata sources for anindividual person*Include data sets beyondHIE*Phased implementationapproachSOM Master Person IndexState LabsStarLIMS
  • 9. **Affordable Care Act and other healthcareinitiatives are driving data sharing*Comprehensive view of individuals in multipleprograms making it possible to*effectively assess and analyze healthcareprogram data*make better and faster decisions*manage and measure programs*reduce costs*improve outcomes9
  • 10. **Phase 1 – Replace Unique Client Identifier (UCI)on Data Warehouse with COTS product (IBMInitiate)*Phase 2 – Establish real-time MCIR interface*Future – additional sources, Householdidentification10
  • 11. **Completed March 2012*Deployed the Initiate Citizen Hub*Implemented Initiate Inspector for dataresolution*Replaced Data Warehouse UCI*UCI originally implemented 2001*Configured single input and output streamscombining 17 data sources*Initial conversion included 38 million records11
  • 12. 12MPI Phase IISSHIE- PIDDC -PIDSSO- PIDSSO -DDE* Establish real-time interfacebetween MCIR and MPI* Data Warehouse to acceptMCIR updates from MPI* Establish process to addadditional MDCH systemsMPI Future Phases* MDSS and StarLIMS* other SOM systems* Household identification
  • 13. 13 Step 1: Optimizes data for statistical comparisons– Normalizes & compacts data, creates derived data layer,source data remains intact– Phonetic equivalences, tokenization, nicknames, etc. Step 2: Finds all the potential matches– Casts a wide net – all matches on current or historical attributes, prevents misses– Partial matches, reversals, anonymous values, etc. Step 3: Scores accurately via probabilistic statistics– Compares attributes one-by-one and producesa weighted score (likelihood ratio)– Frequency weights specific to your business– Edit distance, proximity of match– Allows custom deterministic rules Step 4: Custom threshold settings– Single or dual threshold models– Link, don’t link, don’t know – “learns”from manual input– Manage cost/quality trade-offs– Manage the linkages, workflow reviewManual ReviewLowestPossibleScoreHighestPossibleScoreDon’tLink LinkLowestThresholdUpperThresholdShould be linkedShould not be linked*
  • 14. *14Alerts data stewards to potential data qualityand relationship issues delivering the abilityto collaboratively inspect data, visualizerelationships and resolve issues Inspect and resolve dataquality issues Resolve duplicates within samesource Manually link records across multiplesystems Visualize and manage relationships Centralize and leverage data across theenterprise…with a single toolIBM® INITIATE® INSPECTORIBM® INITIATE® INSPECTORIssueResolutionHierarchy/RelationshipManagementCentralData Store
  • 15. 15CONSUMINGSOURCESDATASOURCESSource 1 Source 2 Source ‘n’Source 3System 1 System 2 System 3Catherine Lamb763543Dr Kath J. Jones 1:N4456 15/06/1970 9263462232 Sussex St 0415266721763543Dr Kate Lamb 2:2736 Female 02-9263-4622763543Mrs. K. Jones 3:S7846 15/06/1970 9263-4622Level 1, 32 Sussex Rd +61415266721763543n:97662 15/06/2006 Female 92630-6000 0415-266-721605586055860558Local ID: EID:Name: DOB: Sex: Home Phone:Address 1: Mobile:Zip Code:763543Dr Kath J. Jones 15/06/1970 Female 02 9263 4622 0415 266 721Level 1, 32 Sussex St 60558System ‘n’*
  • 16. **Administrators*Assign tasks to data stewards*Resolve tasks*Link records*Identify target record*Assign trusted source*Data Stewards*Review potential linkages*Resolve data integrity issues*Ensure source-record quality*Monitor and maintain data accuracy16
  • 17. **Limited to authorized users (data stewards)and to specific data/levels of information*Identifier information is not shared*Data can be linked without being visible*Oversight by MDCH Security Office17
  • 18. **Collaboration with MiHIN for development ofHealth Provider Directory*Leverage development to expand to ProviderIndex*Include provider/organizations beyond HIE18
  • 19. 19
  • 20. *20SOM HIE