SlideShare a Scribd company logo
Presenters:
Tina R. Scott, MDCH
Paul Groll, DTMB
Cynthia Green-Edwards, MDCH
SOM HIE
Unraveling the Current Information Tangle
Insurance
Companies
Physicians
Specialty
Providers
Hospitals & Clinics
Patients
& Families
Lab tests &
XRAYs
Medications
Public Health
2
* One Directional
* Not Real-Time
* Lacks Standards
Desired Solution
Health Information Exchange
Insurance
Companies
Physicians
Specialty
Providers
Hospitals & Clinics
Patients
& Families
Lab tests &
XRAYs
Medications
Public Health
HIE
3
Standards govern:
Form, Content and Response
SOM HIE
Medicaid
DW
MSSS
Doctors &
Community
Providers EHRs
SUB-STATE HIEs
Michigan HIE Model
Routing
Audit
Trail
4
State Labs
StarLIMS
5
SOM HIE
Doctors EHRs
SUB-STATE HIE
Michigan HIE Model
Early 2012
SOM 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
SOM HIE
Medicaid
Doctors &
Community
Providers EHRs
SUB-STATE HIEs
Michigan HIE Model
Current
Doctors &
Local PH Dept EHRs
SOM HIE Phase II
* Implement production solution
* Establish MiHIN – SOM HIE connection
* Continued Infrastructure Development
* Gather new functional requirements
7
Medicaid
DW
MSSS
SOM HIE Phase III
*MiHIN – SOM HIE – connection via
VPN
*Next SOM Use Cases
* MSSS
* MCIR forecast/history
* State Labs (StarLIMS)
*HPD – Health Provider Directory
* Not Limited to Licensed Providers
Michigan HIE Model
Planning
State Labs
StarLIMS
8
Medicaid
DW
MSSS
*Match person-level
records across data sets
*Link data from multiple
data sources for an
individual person
*Include data sets beyond
HIE
*Phased implementation
approach
SOM Master Person Index
State Labs
StarLIMS
*
*Affordable Care Act and other healthcare
initiatives are driving data sharing
*Comprehensive view of individuals in multiple
programs making it possible to
*effectively assess and analyze healthcare
program data
*make better and faster decisions
*manage and measure programs
*reduce costs
*improve outcomes
9
*
*Phase 1 – Replace Unique Client Identifier (UCI)
on Data Warehouse with COTS product (IBM
Initiate)
*Phase 2 – Establish real-time MCIR interface
*Future – additional sources, Household
identification
10
*
*Completed March 2012
*Deployed the Initiate Citizen Hub
*Implemented Initiate Inspector for data
resolution
*Replaced Data Warehouse UCI
*UCI originally implemented 2001
*Configured single input and output streams
combining 17 data sources
*Initial conversion included 38 million records
11
12
MPI Phase II
SSHIE
- PID
DC -
PID
SSO
- PID
SSO -
DDE
* Establish real-time interface
between MCIR and MPI
* Data Warehouse to accept
MCIR updates from MPI
* Establish process to add
additional MDCH systems
MPI Future Phases
* MDSS and StarLIMS
* other SOM systems
* Household identification
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 produces
a 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 review
Manual Review
Lowest
Possible
Score
Highest
Possible
Score
Don’t
Link Link
Lowest
Threshold
Upper
Threshold
Should be linked
Should not be linked
*
*
14
Alerts data stewards to potential data quality
and relationship issues delivering the ability
to collaboratively inspect data, visualize
relationships and resolve issues
 Inspect and resolve data
quality issues
 Resolve duplicates within same
source
 Manually link records across multiple
systems
 Visualize and manage relationships
 Centralize and leverage data across the
enterprise…with a single tool
IBM® INITIATE® INSPECTORIBM® INITIATE® INSPECTOR
Issue
Resolution
Hierarchy/
Relationship
Management
Central
Data Store
15
CONSUMING
SOURCES
DATA
SOURCES
Source 1 Source 2 Source ‘n’Source 3
System 1 System 2 System 3
Catherine Lamb
763543Dr Kath J. Jones 1:N4456 15/06/1970 9263462232 Sussex St 0415266721
763543Dr Kate Lamb 2:2736 Female 02-9263-4622
763543Mrs. K. Jones 3:S7846 15/06/1970 9263-4622Level 1, 32 Sussex Rd +61415266721
763543n:97662 15/06/2006 Female 92630-6000 0415-266-721
60558
60558
60558
Local 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 60558
System ‘n’
*
*
*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 accuracy
16
*
*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 Office
17
*
*Collaboration with MiHIN for development of
Health Provider Directory
*Leverage development to expand to Provider
Index
*Include provider/organizations beyond HIE
18
19
*
20
SOM HIE

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Michigan HIE Model- Cynthia Edwards

  • 1. Presenters: Tina R. Scott, MDCH Paul Groll, DTMB Cynthia Green-Edwards, MDCH SOM HIE
  • 2. Unraveling the Current Information Tangle Insurance Companies Physicians Specialty Providers Hospitals & Clinics Patients & Families Lab tests & XRAYs Medications Public Health 2 * One Directional * Not Real-Time * Lacks Standards
  • 3. Desired Solution Health Information Exchange Insurance Companies Physicians Specialty Providers Hospitals & Clinics Patients & Families Lab tests & XRAYs Medications Public Health HIE 3 Standards govern: Form, Content and Response
  • 4. SOM HIE Medicaid DW MSSS Doctors & Community Providers EHRs SUB-STATE HIEs Michigan HIE Model Routing Audit Trail 4 State Labs StarLIMS
  • 5. 5 SOM HIE Doctors EHRs SUB-STATE HIE Michigan HIE Model Early 2012 SOM 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. 6 SOM HIE Medicaid Doctors & Community Providers EHRs SUB-STATE HIEs Michigan HIE Model Current Doctors & Local PH Dept EHRs SOM HIE Phase II * Implement production solution * Establish MiHIN – SOM HIE connection * Continued Infrastructure Development * Gather new functional requirements
  • 7. 7 Medicaid DW MSSS SOM HIE Phase III *MiHIN – SOM HIE – connection via VPN *Next SOM Use Cases * MSSS * MCIR forecast/history * State Labs (StarLIMS) *HPD – Health Provider Directory * Not Limited to Licensed Providers Michigan HIE Model Planning State Labs StarLIMS
  • 8. 8 Medicaid DW MSSS *Match person-level records across data sets *Link data from multiple data sources for an individual person *Include data sets beyond HIE *Phased implementation approach SOM Master Person Index State Labs StarLIMS
  • 9. * *Affordable Care Act and other healthcare initiatives are driving data sharing *Comprehensive view of individuals in multiple programs making it possible to *effectively assess and analyze healthcare program data *make better and faster decisions *manage and measure programs *reduce costs *improve outcomes 9
  • 10. * *Phase 1 – Replace Unique Client Identifier (UCI) on Data Warehouse with COTS product (IBM Initiate) *Phase 2 – Establish real-time MCIR interface *Future – additional sources, Household identification 10
  • 11. * *Completed March 2012 *Deployed the Initiate Citizen Hub *Implemented Initiate Inspector for data resolution *Replaced Data Warehouse UCI *UCI originally implemented 2001 *Configured single input and output streams combining 17 data sources *Initial conversion included 38 million records 11
  • 12. 12 MPI Phase II SSHIE - PID DC - PID SSO - PID SSO - DDE * Establish real-time interface between MCIR and MPI * Data Warehouse to accept MCIR updates from MPI * Establish process to add additional MDCH systems MPI 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 produces a 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 review Manual Review Lowest Possible Score Highest Possible Score Don’t Link Link Lowest Threshold Upper Threshold Should be linked Should not be linked *
  • 14. * 14 Alerts data stewards to potential data quality and relationship issues delivering the ability to collaboratively inspect data, visualize relationships and resolve issues  Inspect and resolve data quality issues  Resolve duplicates within same source  Manually link records across multiple systems  Visualize and manage relationships  Centralize and leverage data across the enterprise…with a single tool IBM® INITIATE® INSPECTORIBM® INITIATE® INSPECTOR Issue Resolution Hierarchy/ Relationship Management Central Data Store
  • 15. 15 CONSUMING SOURCES DATA SOURCES Source 1 Source 2 Source ‘n’Source 3 System 1 System 2 System 3 Catherine Lamb 763543Dr Kath J. Jones 1:N4456 15/06/1970 9263462232 Sussex St 0415266721 763543Dr Kate Lamb 2:2736 Female 02-9263-4622 763543Mrs. K. Jones 3:S7846 15/06/1970 9263-4622Level 1, 32 Sussex Rd +61415266721 763543n:97662 15/06/2006 Female 92630-6000 0415-266-721 60558 60558 60558 Local 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 60558 System ‘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 accuracy 16
  • 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 Office 17
  • 18. * *Collaboration with MiHIN for development of Health Provider Directory *Leverage development to expand to Provider Index *Include provider/organizations beyond HIE 18
  • 19. 19