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MiHIN Brief Overview
- 1. Michigan Health InformationNetwork Overview Copyright 2013 - Michigan Health Information Network 1
- 2. What is HealthInformation Exchange? The term "health information exchange" (HIE) actually encompasses two related concepts: • Verb: The electronic sharing of health-related information among organizations • Noun: An organization that provides services to enable the electronic sharing of health-related information Source: http://www.healthit.gov/providers-professionals/health-information- exchange?utm_source=google&utm_medium=cpc&utm_campaign=technology Copyright 2013 - Michigan Health Information Network 2
- 3. Health Information ExchangeBenefits • Improved patient safety & outcomes • Fewer adverse events • Better quality of life for people who are sick • Reduced unnecessary utilization • Reduce total admissions • Shorten time in the hospital • Fewer duplicate diagnostic tests • Lower costs to find, transmit, and analyze information Copyright 2013 - Michigan Health Information Network 3 Health Plans Physicians Specialty Providers Hospitals & Clinics Patients & Families Lab tests & XRAYs Medications Public Health
- 4. Major HIE UseCases Results Delivery • Lab results • Diagnostic imaging • Other tests • Hospital discharge summaries Public Health Reporting • Immunizations • Chronic disease registries • Disease surveillance • Syndromic surveillance • Birth & death notifications Care Coordination & Patient Safety • Referrals • Care summaries for treatment history & allergies • Notification of transitions of care ( Admit Discharge or Transfer) • Medication reconciliation & therapy change notices Quality & Administrative Reporting • Registry Updates • Physician Quality Reporting measures • Meaningful Use reporting • Electronic verification • Patient satisfaction • Eligibility • Authorization • Claims audit Patient Engagement • Instructions • Health risk appraisals • Medication Compliance • Therapy Compliance • Patient activation and self determination • Health literacy & numeracy 4Copyright 2013 - Michigan Health Information Network
- 5. Types of HIE(Verb): Push or Pull • Push: The ability to send data automatically to a provider, such as replacing the fax machine with an electronic message. Analogy: getting a text message or email (requires that other’s know your email or text address) • Pull: The ability to request on demand that data be instantly returned to you. Analogy: doing a Google search (requires lots of searchable websites) Copyright 2013 - Michigan Health Information Network 5
- 6. MiHIN Background Copyright 2013- Michigan Health Information Network 8
- 7. What is Michigan’sStrategy 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 interconnect networks of networks (MiHIN Shared Services) • relies on qualified health information organizations such as Michigan’s seven sub-state HIEs to connect providers Copyright 2013 - Michigan Health Information Network 9
- 8. Governance • MiHIN isan independent not-for-profit with a board of directors • MiHIN works very closely with Michigan’s Department of Community Health and the State’s HIT Commission • MiHIN has an Operation Advisory Committee that address day-to-day operations, HIE planning, privacy and security items Copyright 2013 - Michigan Health Information Network 10
- 9. Examples of StatewideShared Services 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 HISP Copyright 2013 - Michigan Health Information Network 14
- 10. Qualified Data SharingOrganizations (QO’s) • Health Information Exchanges • Beacon, Great Lakes HIE, Ingenium, Michigan Health Connect, Jackson Community Health Record, South East 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 Michigan Copyright 2013 - Michigan Health Information Network 15
- 11. Virtual Qualified DataSharing Organizations (VQO’s) • Independent entities that primarily utilize MiHIN provided services or participate in a very limited number of Use Case or pilot activities also subject to predetermined conditions of use. VQO’s are not formally involved in the Board or other governance activities. VQO’s are not expected to support more that 1/3 of the Use Cases. • Health Information Service Providers (HISP) • Health Information Organizations (HIO) • Pilot Organizations Copyright 2013 - Michigan Health Information Network 16
- 12. MiHIN Community 17 Copyright 2013- Michigan Health Information Network State of Michigan Health Plans More to Come…
- 13. ORGANIZATION AGREEMENT (QDSOA orVQDSOA) Basic Connection Terms Basic BAA Terms Minimal Operational SLA Contracting & Payment Definitions Termination Cyber Liability Insurance Data Sharing Agreement Use Case #1 Use Case #2 Use Case #3 Legal Infrastructure for Data Sharing 18Copyright 2013 - Michigan Health Information Network
- 14. MDCH Data Hub Medicaid MSSS State LABS Doctors& Community Providers HIEs (QOs, VQOs or sub- state HIEs) Basic Data Flow Data Warehouse Copyright 2013 - Michigan Health Information Network 21 State-wide Shared Services DIRECT HISP Virtual Qualified Organizations Health Plans
- 15. Production Activities Copyright 2013- Michigan Health Information Network 23
- 16. Public Health Reporting •First MiHIN Use Case • Uses the same technology and data flow for reporting to: • Michigan Care Improvement Registry (MCIR) for collecting immunization information • Michigan Disease Surveillance System (MDSS) for reportable labs and conditions • Michigan Disease Surveillance System (MSSS) for public health situational awareness Copyright 2013 - Michigan Health Information Network 24 Public Health Reporting
- 17. Vaccination Reporting 25 MDCH DataHub HIE (QOs, VQOs or sub-state HIEs) Copyright 2013 - Michigan Health Information Network Public Health Reporting State-wide Shared Services
- 18. Health Provider Directory •Source of trusted provider information for secure routing and HIE information • State-wide provider address book • Direct • Referrals • Sets the stage for provider relationship management 27Copyright 2013 - Michigan Health Information Network HPD Direct Address Book Directory Services Provider Relationship Management Routing Preferences
- 19. Current Activities Copyright 2013- Michigan Health Information Network 28
- 20. Qualified Sub-state HIE or VQO Qualified Sub-stateHIE or VQO Transition of Care Notification Copyright 2013 - Michigan Health Information Network Patient to Provider Attribution Delivery Preference Lookup 1) Patient goes to the hospital, hospital sends a registration message 2) MiHIN checks for Patient to Provider Attribution and identifies three providers 3) Using the HPD, MiHIN identifies a Delivery Preference for each provider 4) Notification is routed to the providers based on their preference Primary Care Specialist Care Coordinator Alerts & Notification 29 Animation
- 21. Transition of CareNotification • 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 Delivery Preference Lookup services can be reused Copyright 2013 - Michigan Health Information Network 30 Alerts & Notification
- 22. QUERY-BASED USE CASES Copyright2013 - Michigan Health Information Network 31
- 23. State-wide Record Locator Service Query forPatient History Copyright 2013 - Michigan Health Information Network 35 HIE HIE HIE 1) Doctor see’s a new patient in the Emergency Department (ED) 2) ED sends out a “patient discovery” request for information about the patient DoctorPatient 3) Sources that know the patient respond 4) ED queries for patient clinical information 5) Sources respond with clinical document(s), typically CCDs Care Summary Patient Found Patient Found Patient Not Found Animation
- 24. State-wide Record Locator Service Query forPatient History Copyright 2013 - Michigan Health Information Network 36 HIE HIE HIE • Requester can be in many settings • Primary care provider • Health plan doing eDetermination • Out-of-state provider • Federal agencies Care Summary • Responders can vary as well • State of Michigan • Federal agencies and out-of-state providers MDCH Data Hub Animation
- 25. HIE #2 Cross HIEMessage Routing 38Copyright 2013 - Michigan Health Information Network HIE #1 Provider ID? Referral HPD Routing Primary Care Physician Specialist Animation
- 26. Still on 2011RoadMap 39Copyright 2013 - Michigan Health Information Network Link OperationalActivities PlanningActivities 2011 Staging Activities MU & Public Health Part II (Query) Health Provider Directory Pharmacy Planning VA Linkage Patient Facing Services & PHR Gateway NwHIN Node (Connect & Direct) ADTPilotIm plem entation Planning & Policy Development Security and Consent Management VAVLEHRPilot CCD Gateway (Push) HISPFunction Mi Health Market Place Integration Planning Master Patient Index ConsentM anagement& SecurityPilots Use Case Prioritization (ADT Pilot) MedicationReconcilation Patient Consent Management CommonAuthenticationPrototyping
- 27. More information aboutMiHIN Questions? WWW.MIHIN.ORG 40Copyright 2013 - Michigan Health Information Network Tim Pletcher pletcher@mihin.org
Editor's Notes
- #28 “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.)
- #37 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.