Michigan Health Information NetworkOverviewCopyright 2013 - Michigan Health Information Network 1
What is Health Information Exchange?The term "health information exchange" (HIE) actuallyencompasses two related concepts:...
Health Information Exchange Benefits• Improved patient safety &outcomes• Fewer adverse events• Better quality of life for ...
Major HIE Use CasesResultsDelivery• Lab results• Diagnostic imaging• Other tests• Hospital dischargesummariesPublic Health...
Types of HIE (Verb): Push or Pull• Push: The ability to send data automatically to aprovider, such as replacing the fax ma...
MiHIN BackgroundCopyright 2013 - Michigan Health Information Network 8
What is Michigan’s Strategy for HIE?The Michigan approach:• employs a public-private model vs. only complete state control...
Governance• MiHIN is an independent not-for-profit with a board ofdirectors• MiHIN works very closely with Michigan’s Depa...
Examples of Statewide SharedServices Across the Nation• Security services• Health Provider Directory (Master Clinicians In...
Qualified Data Sharing Organizations (QO’s)• Health Information Exchanges• Beacon, Great Lakes HIE, Ingenium, Michigan Hea...
Virtual Qualified Data SharingOrganizations (VQO’s)• Independent entities that primarily utilize MiHIN providedservices or...
MiHIN Community17Copyright 2013 - Michigan Health Information NetworkState of MichiganHealthPlansMore toCome…
ORGANIZATION AGREEMENT(QDSOA or VQDSOA)Basic Connection TermsBasic BAA TermsMinimal Operational SLAContracting & PaymentDe...
MDCH Data HubMedicaidMSSSStateLABSDoctors & CommunityProvidersHIEs(QOs, VQOs or sub-state HIEs)Basic Data FlowDataWarehous...
Production ActivitiesCopyright 2013 - Michigan Health Information Network 23
Public Health Reporting• First MiHIN Use Case• Uses the same technology and data flow for reporting to:• Michigan Care Imp...
Vaccination Reporting25MDCH Data HubHIE(QOs, VQOs orsub-state HIEs)Copyright 2013 - Michigan Health Information NetworkPub...
Health Provider Directory• Source of trusted providerinformation for secure routing andHIE information• State-wide provide...
Current ActivitiesCopyright 2013 - Michigan Health Information Network 28
QualifiedSub-state HIEor VQOQualifiedSub-state HIEor VQOTransition of Care NotificationCopyright 2013 - Michigan Health In...
Transition of Care Notification• Can be expanded to other message types• HL7 lab results• Discharge summaries• Continuity ...
QUERY-BASED USE CASESCopyright 2013 - Michigan Health Information Network 31
State-wideRecord LocatorServiceQuery for Patient HistoryCopyright 2013 - Michigan Health Information Network 35HIEHIEHIE1)...
State-wideRecord LocatorServiceQuery for Patient HistoryCopyright 2013 - Michigan Health Information Network 36HIEHIEHIE• ...
HIE #2Cross HIE Message Routing38Copyright 2013 - Michigan Health Information NetworkHIE #1ProviderID?ReferralHPDRoutingPr...
Still on 2011Road Map39Copyright 2013 - Michigan Health Information NetworkLinkOperationalActivitiesPlanningActivities2011...
More information about MiHINQuestions?WWW.MIHIN.ORG40Copyright 2013 - Michigan Health Information NetworkTim Pletcherpletc...
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MiHIN Brief Overview

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  • “Find Dr. Waldo” and find out where does Dr. Waldo want information sent & howAdditional Use CasesGiant address book for HIT applicationsIdentity & role-based access supportMechanism to advertise services for referral or any information routingCore data for other provider centric tracking (program participation like ACO affiliation, workforce, credentialing, etc.)
  • Healthcare payers frequently request that providers submit additional medical documentation for a specific claim, to support claims processing and other administrative functions, such as the identification of improper payments. Currently, Medicare Review Contractors request approximately 2 million medical documents per year by mailing a paper request letter via US Postal Service to healthcare providers.
  • MiHIN Brief Overview

    1. 1. Michigan Health Information NetworkOverviewCopyright 2013 - Michigan Health Information Network 1
    2. 2. What is Health Information Exchange?The term "health information exchange" (HIE) actuallyencompasses two related concepts:• Verb: The electronic sharing of health-related informationamong organizations• Noun: An organization that provides services to enablethe electronic sharing of health-related informationSource: http://www.healthit.gov/providers-professionals/health-information-exchange?utm_source=google&utm_medium=cpc&utm_campaign=technologyCopyright 2013 - Michigan Health Information Network 2
    3. 3. Health Information Exchange Benefits• Improved patient safety &outcomes• Fewer adverse events• Better quality of life for peoplewho are sick• Reduced unnecessaryutilization• Reduce total admissions• Shorten time in the hospital• Fewer duplicate diagnostictests• Lower costs to find, transmit,and analyze informationCopyright 2013 - Michigan Health Information Network 3HealthPlansPhysiciansSpecialtyProvidersHospitals & ClinicsPatients& FamiliesLab tests &XRAYsMedicationsPublic Health
    4. 4. Major HIE Use CasesResultsDelivery• Lab results• Diagnostic imaging• Other tests• Hospital dischargesummariesPublic HealthReporting• Immunizations• Chronic diseaseregistries• Diseasesurveillance• Syndromicsurveillance• Birth & deathnotificationsCareCoordination &Patient Safety• Referrals• Care summariesfor treatmenthistory & allergies• Notification oftransitions of care (Admit Discharge orTransfer)• Medicationreconciliation &therapy changenoticesQuality &AdministrativeReporting• Registry Updates• Physician QualityReportingmeasures• Meaningful Usereporting• Electronicverification• Patient satisfaction• Eligibility• Authorization• Claims auditPatientEngagement• Instructions• Health riskappraisals• MedicationCompliance• TherapyCompliance• Patient activationand selfdetermination• Health literacy &numeracy4Copyright 2013 - Michigan Health Information Network
    5. 5. Types of HIE (Verb): Push or Pull• Push: The ability to send data automatically to aprovider, such as replacing the fax machine with anelectronic message. Analogy: getting a text message oremail (requires that other’s know your email or textaddress)• Pull: The ability to request on demand that data beinstantly returned to you. Analogy: doing a Googlesearch (requires lots of searchable websites)Copyright 2013 - Michigan Health Information Network 5
    6. 6. MiHIN BackgroundCopyright 2013 - Michigan Health Information Network 8
    7. 7. What is Michigan’s Strategy for HIE?The Michigan approach:• employs a public-private model vs. only complete state control• emphases common data sharing use cases and multi-stakeholder participation (hospitals, physicians, health plans,state government)• promotes the use of national standards & public transparency(via HIT commission)• leverages public health & meaningful use• established a designated nonprofit entity to interconnectnetworks of networks (MiHIN Shared Services)• relies on qualified health information organizations such asMichigan’s seven sub-state HIEs to connect providersCopyright 2013 - Michigan Health Information Network 9
    8. 8. Governance• MiHIN is an independent not-for-profit with a board ofdirectors• MiHIN works very closely with Michigan’s Department ofCommunity Health and the State’s HIT Commission• MiHIN has an Operation Advisory Committee thataddress day-to-day operations, HIE planning, privacyand security itemsCopyright 2013 - Michigan Health Information Network 10
    9. 9. Examples of Statewide SharedServices Across the Nation• Security services• Health Provider Directory (Master Clinicians Index)• Message routing• Identity management• Transaction logging & Universal Audit Repository• Consent management• Terminology services• Transformation services• Master Person Index• Record Locator Service & Patient Directory Services• NwHIN gateway• Sub-scribe to Alerts & Notifications• DIRECT HISPCopyright 2013 - Michigan Health Information Network 14
    10. 10. Qualified Data Sharing Organizations (QO’s)• Health Information Exchanges• Beacon, Great Lakes HIE, Ingenium, Michigan HealthConnect, Jackson Community Health Record, SouthEast Michigan HIE, Upper Peninsula HIE• Health Plans• Blue Cross Blue Shield of Michigan• Michigan Association of Health Plans• Health Alliance Plan*• Priority Health*• State of MichiganCopyright 2013 - Michigan Health Information Network 15
    11. 11. Virtual Qualified Data SharingOrganizations (VQO’s)• Independent entities that primarily utilize MiHIN providedservices or participate in a very limited number of UseCase or pilot activities also subject to predeterminedconditions of use. VQO’s are not formally involved in theBoard or other governance activities. VQO’s are notexpected to support more that 1/3 of the Use Cases.• Health Information Service Providers (HISP)• Health Information Organizations (HIO)• Pilot OrganizationsCopyright 2013 - Michigan Health Information Network 16
    12. 12. MiHIN Community17Copyright 2013 - Michigan Health Information NetworkState of MichiganHealthPlansMore toCome…
    13. 13. ORGANIZATION AGREEMENT(QDSOA or VQDSOA)Basic Connection TermsBasic BAA TermsMinimal Operational SLAContracting & PaymentDefinitionsTerminationCyber Liability InsuranceData Sharing AgreementUse Case#1Use Case#2Use Case#3Legal Infrastructure for Data Sharing18Copyright 2013 - Michigan Health Information Network
    14. 14. MDCH Data HubMedicaidMSSSStateLABSDoctors & CommunityProvidersHIEs(QOs, VQOs or sub-state HIEs)Basic Data FlowDataWarehouseCopyright 2013 - Michigan Health Information Network 21State-wideShared ServicesDIRECTHISPVirtualQualifiedOrganizationsHealthPlans
    15. 15. Production ActivitiesCopyright 2013 - Michigan Health Information Network 23
    16. 16. Public Health Reporting• First MiHIN Use Case• Uses the same technology and data flow for reporting to:• Michigan Care Improvement Registry (MCIR) forcollecting immunization information• Michigan Disease Surveillance System (MDSS) forreportable labs and conditions• Michigan Disease Surveillance System (MSSS) forpublic health situational awarenessCopyright 2013 - Michigan Health Information Network 24Public HealthReporting
    17. 17. Vaccination Reporting25MDCH Data HubHIE(QOs, VQOs orsub-state HIEs)Copyright 2013 - Michigan Health Information NetworkPublic HealthReportingState-wideShared Services
    18. 18. Health Provider Directory• Source of trusted providerinformation for secure routing andHIE information• State-wide provider address book• Direct• Referrals• Sets the stage for providerrelationship management27Copyright 2013 - Michigan Health Information NetworkHPDDirect AddressBookDirectoryServicesProvider RelationshipManagementRoutingPreferences
    19. 19. Current ActivitiesCopyright 2013 - Michigan Health Information Network 28
    20. 20. QualifiedSub-state HIEor VQOQualifiedSub-state HIEor VQOTransition of Care NotificationCopyright 2013 - Michigan Health Information NetworkPatient to ProviderAttributionDeliveryPreferenceLookup1) Patient goes to the hospital, hospital sends a registration message2) MiHIN checks for Patient to Provider Attribution and identifies three providers3) Using the HPD, MiHIN identifies a Delivery Preference for each provider4) Notification is routed to the providers based on their preferencePrimary CareSpecialistCareCoordinatorAlerts &Notification29Animation
    21. 21. Transition of Care Notification• Can be expanded to other message types• HL7 lab results• Discharge summaries• Continuity of Care Documents (CCD)• Care Gap Alerts• Both Patient to Provider Attribution and DeliveryPreference Lookup services can be reusedCopyright 2013 - Michigan Health Information Network 30Alerts &Notification
    22. 22. QUERY-BASED USE CASESCopyright 2013 - Michigan Health Information Network 31
    23. 23. State-wideRecord LocatorServiceQuery for Patient HistoryCopyright 2013 - Michigan Health Information Network 35HIEHIEHIE1) Doctor see’s a new patient in the EmergencyDepartment (ED)2) ED sends out a “patient discovery” requestfor information about the patientDoctorPatient3) Sources that know the patient respond4) ED queries for patient clinical information5) Sources respond with clinical document(s),typically CCDsCareSummaryPatient FoundPatient FoundPatient Not FoundAnimation
    24. 24. State-wideRecord LocatorServiceQuery for Patient HistoryCopyright 2013 - Michigan Health Information Network 36HIEHIEHIE• Requester can be in many settings• Primary care provider• Health plan doing eDetermination• Out-of-state provider• Federal agenciesCareSummary• Responders can vary as well• State of Michigan• Federal agencies and out-of-state providersMDCHData HubAnimation
    25. 25. HIE #2Cross HIE Message Routing38Copyright 2013 - Michigan Health Information NetworkHIE #1ProviderID?ReferralHPDRoutingPrimaryCare PhysicianSpecialistAnimation
    26. 26. Still on 2011Road Map39Copyright 2013 - Michigan Health Information NetworkLinkOperationalActivitiesPlanningActivities2011StagingActivitiesMU & Public Health Part II (Query)Health Provider DirectoryPharmacy PlanningVA LinkagePatient Facing Services & PHR GatewayNwHIN Node (Connect & Direct)ADTPilotImplementationPlanning & Policy DevelopmentSecurity and Consent ManagementVAVLEHRPilotCCD Gateway (Push)HISPFunctionMi Health Market Place Integration PlanningMaster Patient IndexConsentManagement&SecurityPilotsUse Case Prioritization (ADT Pilot)MedicationReconcilationPatient Consent ManagementCommonAuthenticationPrototyping
    27. 27. More information about MiHINQuestions?WWW.MIHIN.ORG40Copyright 2013 - Michigan Health Information NetworkTim Pletcherpletcher@mihin.org

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