The Michigan Health Information Network

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The Michigan Health Information Network

• Janet Olszewski,
• Director
• Michigan Department of Community Health

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Welcome!

• First Annual MiHIN Conference
• 250 Attendees
• 20 Sponsors
• From 15 different states and 2 countries
• Backgrounds include healthcare providers, Major
  employers, health plans and HMOs, community
  leaders, technology vendors More

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Welcome!

• HIT Commission
• MiHIN Regional HIE grantees
• MiHIN Resource Center

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Overview

• Current State of Health Care
• Health Information Exchange 101
• The Michigan Health Information Network
• Background
• Vision for the future
• Groundwork

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Current State of Health Care
Fragmented Data ( care)
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Current State of Health Care

• Change is Necessary
• Healthcare must be more efficient
• Physicians spend 20-30 of their time searching
  for information they need at the point of care
• The U.S. is number one in health care spending
  per capita (4,187), and 37th in overall health
  system performance (WHO 2000)
• Healthcare quality must be improved
• At least 1.5 million Americans are injured every
  year by medication errors with about 7,000 deaths
  annually (IOM 2006)
• Healthcare must move into the 21st century
• Healthcare is currently one of the last major
  industries to rely primarily on hand written
  notes, paper records and silos of information

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CARFAX Vehicle History Reports are available on
all used cars and light trucks model year 1981 or
later CARFAX receives information from more
than 20,000 data sources including every U.S. and
Canadian provincial motor vehicle agency plus
many auto auctions, fire and police departments,
collision repair facilities, fleet management and
rental agencies, and more
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Health Information Exchange 101

• HIT
• Health Information Technology (noun)
• Software and hardware that processes health care
  information electronically within a health care
  organization
• examples include, Electronic Medical Record (EMR)
  systems, administrative systems and clinical
  information systems (clinical documentation and
  computerized physician order entry).

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Health Information Exchange 101

• HIE
• Health Information Exchange (verb)
• The electronic movement of any and all
  health-related data according to an agreed-upon
  set of interoperability standards, processes and
  activities across non-affiliated organizations in
  a manner that protects the privacy and security
  of that data and the entity that organizes and
  takes responsibility for the process

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Health Information Exchange 101

• RHIO
• Regional Health Information Organization (noun)
• A multi-stakeholder governance entity that
  convenes non-affiliated health and
  healthcare-related providers and the
  beneficiaries they serve, for the purpose of
  improving health care for the communities in
  which it operates.
• A RHIO takes responsibility for the processes
  that enable the electronic exchange of
  interoperable health information within a defined
  contiguous geographic area

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Health Information Exchange 101

• Michigan is focused on enabling HIE through RHIO
  formation
• Why?
• Effective HIE makes HIT applications more
  valuable
• Major HIT investment already in place in MI
• Providers do not need to change their workflow
  significantly or immediately to participate in
  HIE (and reap the benefits)
• Health care is mostly delivered locally, so
  multiple RHIO solutions fits better than one,
  statewide HIE solution

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Health Information Exchange 101

• HIE is a growing movement nationally

• ONC Office of the National HIT Coordinator
  within Health Human Services Dept.

ONC

• AHIC - American Health Information Community

• HITSP Health IT Standards Panel

• CCHIT Certification Commission for Health IT

• NHIN - Nationwide Health Information Network
  Related Activities

• HISPC Health Information Security and Privacy
  Collaboration

• SLHIE State-level Health Information Exchange
  Initiatives Consensus Project

SLHIE
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Health Information Exchange 101

• Michigan HIE projects are progressing

• The Michigan Health Information Network or MiHIN
  is the collection of HIE activities within in the
  state

MiHIN

• A stakeholder consensus driven project to build
  an HIE roadmap for the state of Michigan

• HIT Commission provides recommendations for
  action to the state of MI

• MiHIN Grants have been awarded to planning and
  implementation HIE projects

• MiHIN Resource Center provides guidance and
  support to regional HIEs

Regional efforts

• Regional HIE efforts are underway in almost every
  county in Michigan

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MiHIN Background
2006
2008

• May 2006
• MiHIN Roadmap building begins
• 200 Healthcare stakeholders
• Intensive 180 day mission
• 5 workgroups delve into specific HIE issue areas
• National consultants add expertise
• A Steering Committee guides the entire process

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MiHIN Background
2006
2008

• October 2006
• Michigan HIT Commission convenes
• 13 members appointed by Governor
• Begins deliberation on HIT/HIE issues
• December 2006
• MiHIN Conduit to Care released

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MiHIN Background
2006
2008

• May 2007
• MiHIN Resource Center formed
• MSU Institute for Healthcare Studies
• Supports state regional HIE activity
• Develops strategies conducts research

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MiHIN Background
2006
2008

• June 2007
• Grants to seven regional HIEs awarded
• 5 planning grants
• 2 implementation grants

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MiHIN Background
2006
2008

• November 2007
• Michigan receives 20.9 million FCC grants
• Supports broadband connections to rural health
  care systems

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MiHIN Background
2006
2008

• Spring 2008
• Second round of HIE grant Request for Proposals
  released May 1
• 1st Annual MiHIN Conference
• Fall 2008
• 1st round of regional HIE Grants end,
  deliverables due

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The MiHIN Model

• MiHIN guiding principles
• Consumer privacy, security and confidentiality
  are paramount
• Multi-stakeholder collaboration is needed to
  implement achievable and measurable initiatives
  in order to show early progress and value
• The delivery of health care is local therefore,
  health information initiatives at the regional
  level are critical.
• RHIOs must have a self-sustaining business model.
  Their basis of support should be derived from
  the demonstrable value that they offer to a
  number of stakeholders
• National standards and policies will be followed
  where possible

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The MiHIN Model

• 9 Medical Trading Areas (MTA)
• Each MTA to form a RHIO consistent with the MiHIN
  Conduit to Care Report
• State of Michigan HIE grant program provides
  RHIOs with planning implementation funding
• RHIOs must develop a sustainable business plan
  for HIE operations

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The MiHIN Model
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The future
Nine regional RHIOs that cover all Michigan
counties with successful HIE implementation
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The future
The ability for all regional HIEs to exchange
necessary information for treating patients at
the point of care
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The future
Michigan connects with other states
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The future
A National Health Information Network is
operational
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Groundwork

• State of Michigan
• Leadership of Governor Granholm
• Partnership with MI Legislature
• MDCH and MDIT partnership
• Operating a HIE planning and implementation grant
  program
• Funding a statewide Resource Center
• Leveraging state systems for HIE value
• Participating as employer and insurer in HIE
  operations
• Providing input to national forums and
  standard-setting bodies

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Groundwork

• HIT Commission Deliberations
• Implementing HIE
• Defining HIE
• Adopting national standards
• Privacy issues
• Consent to exchange patient data
• Sanctions for breaches
• Handling of special classes of data
• Technical issues
• Master Patient Index Record Locator Service
  design

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Groundwork

• MiHIN Resource Center
• Distributing information
• Defining Value Propositions
• Leveraging statewide resources
• Securing grant foundation funding
• Watching national trends
• Learning lessons once, statewide

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Groundwork

• Regional HIEs
• Building community partnerships
• Following MiHIN Roadmap
• Working with Resource Center
• Developing locally-relevant business plans
• Focusing on a Medical Trading Area geography
• Keeping an eye on long-term goals

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It doesn't work to leap a twenty-foot chasm in
two ten-foot jumps.