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MiHIN Overview - Health Information Exchange Meet and Greet v7 10 22-14

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1. MiHIN Overview HIE Meet and Greet October 2014 2. MiHIN is a network for sharing health information statewide for Michigan Copyright 2014 - Michigan Health Information…
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  • 1. MiHIN Overview HIE Meet and Greet October 2014
  • 2. MiHIN is a network for sharing health information statewide for Michigan Copyright 2014 - Michigan Health Information Network Shared Services 2
  • 3. Statewide Coordination 3 Health Plans Physicians Specialty Providers Patients & Families Lab tests & XRAYs Hospitals & Clinics Medications Public Health Duplication of effort, waste, & expense (N x N-1 connections) Insurance Companies Physicians Specialty Providers Patients & Families Lab tests & XRAYs Hospitals & Clinics Medications Public Health Shared Services (N connections) Copyright 2014 - Michigan Health Information Network Shared Services
  • 4. “One and Done”- Easier, Simplified, Predictable Data Sharing 1. Sign once • Common legal framework across the state • Transparent data usage for each use case 2. Connect once • MiHIN network includes all of health care: HIEs, HISPs, health plans, the state and the federal agencies 3. Publish once • Patient and provider delivery preferences easily registered and centrally managed 4. Report once • Messages can be routed to multiple destinations – no duplicate interfaces or repeat reports 5. Log-on once • Single sign-on across patient/member and provider portals Copyright 2014 - Michigan Health Information Network Shared Services 4
  • 5. State-wide Shared Services MDCH Data Hub Medicaid MSSS State LABS Network of Networks: HIE QOs (Qualified sub-state HIEs) Doctors & Community Providers Data Warehouse 5 Health Plan QOs (more coming) Single point of entry/exit for state Virtual QOs Pharmacies (more coming) Copyright 2014 - Michigan Health Information Network Shared Services Immunizations Mi Syndromic Surveillance System Mi Disease Surveillance System Consumer QOs (more coming) Federal
  • 6. MiHIN FAST FACTS Network of Networks (not an HIE) Shared network of multiple qualified organizations (QOs) for sharing data Transparency via Governor’s HIT Commission Strong state and health plan representation Statewide Approach Driven by Use Cases Leverages public health code & Meaningful Use Public-private model vs. complete state control Accomplishments (established 2010) From zero to 100M+ production messages since inception 22 *O connections: 8 HIEs, 6 payers, 4 pharmacies, state, 3 others Health Provider Directory, certified eHealth Exchange node, EHNAC-DTAAP Direct Copyright 2014 - Michigan Health Information Network Shared Services 6
  • 7. MiHIN Stakeholders HIE QO (HQO) • Meets the QO requirements • Plans to participate in at least 2/3 of Use Cases • Voice in the MiHIN Advisory Committee (MOAC) Plan/Payor QO (PQO) • Health Plan licensed in the state of Michigan • Blue Cross, Michigan Association of Health Plans, & Priority Health have Board eligibility Government QO (GQO) • Government Qualified Organization (i.e. Michigan Department of Community Health) • Federal Agency (i.e. Social Security Administration, CMS, Veterans Affairs, DoD, CDC, etc.) • Tribal Nations in Michigan Consumer QO (CQO) • Participate in consumer-focused Use Cases (i.e. MiWay Statewide Consumer Directory) • Supported & authorized consumer facing services (i.e. Patient Health Record, Patient Portal) - an example is advance directives stored in Peace of Mind Registry Copyright 2014 - Michigan Health Information Network Shared Services 7
  • 8. What is a USE CASE? • Data sharing scenario with specific: • purpose • type of data exchanged • description of interactions between people/ systems • Each Use Case may have different: • access restrictions • rules for using the data • cost recovery fees or charges • technical requirements 8 Use Case Factory™ Copyright 2014 - Michigan Health Information Network Shared Services
  • 9. Use Case Components 9 Use Case Summary explains purpose and value proposition for sharing data Use Case Agreement is a legal document that covers expected rules of engagement (all Qualified Organizations sign the agreements) Implementation Guide is a technical specification that outlines standard format details for data transmission & content Copyright 2014 - Michigan Health Information Network Shared Services
  • 10. Use Case Factory Idea with Champion Idea with Sponsor Plan & Develop Pilot & Refine Technical Planning Conceptual Use Case Summary Contains The B asic I deas L aid Out in an E asy to R ead Document for the B oard to A pprove Define Evaluation Purpose Implement Production Status Metrics Continuous Improvement Adoption Critical Mass Mass Marketing & Outreach MiHIN Board Successful Adoption Functional Data-Sharing Widget http://mihin.org/about-mihin/resources/use-case-submission-form/ Copyright 2014 - Michigan Health Information Network Shared Services 10
  • 11. Use Case Assembly Lines 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 •41 new use cases identified 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 •Clinical decision support alerts Quality & Administrative Reporting •Registry Updates •Physician Quality Reporting measures •Meaningful Use reporting •Electronic verification •Patient satisfaction •Eligibility •Authorization •Claims audit Patient/Consumer Engagement •Instructions •Health risk appraisals •Medication Compliance •Therapy Compliance •Patient activation and self determination •Health literacy & numeracy •Consumer Preferences and Consents 11 Copyright 2014 - Michigan Health Information Network Shared Services
  • 12. Infrastructure Services Master Person Index (Common Key Service) Federated Identity Management (FiDM) Gateway Services (e.g. XCA) Secure Transport Layer Services and Digital Credentials Active Care Relationship Service Patient Opt-In Preferences Identity Management Health Provider Directory Copyright 2014 - Michigan Health Information Network Shared Services 12
  • 13. Accelerating Use Cases 13 Policy & Regulatory Levers Clinical Endorsement & Evidence Financial Incentives or Disincentives Copyright 2014 - Michigan Health Information Network Shared Services
  • 14. Use Case Pipeline Example Copyright 2014 - Michigan Health Information Network Shared Services 14
  • 15. Benefits of Use Case Approach 15 • Manageable chunks so competitive or confidentiality Reduces Complexity concerns can be addressed without “boiling the ocean” • Standardized mechanism for scoping purpose, technical Consistent Pattern requirements, costs, and limits on how data is used • Use Cases can be combined to create higher and higher Modular (like Lego blocks) levels of functionality • Incentives, regulations or policies can target specific Use Aligns Priorities Case to foster or accelerate adoption • Constituents can understand expected use of their data and Transparent follow the common chain of trust across organizations • Aids focused monitoring and measurement of progress Measureable • Reduces variability and enables scalability Faster & Cost Effective Copyright 2014 - Michigan Health Information Network Shared Services
  • 16. Monitoring Public Health Use Cases 4,000,000 3,500,000 3,000,000 2,500,000 2,000,000 1,500,000 1,000,000 500,000 16 - Syndromic Surveillance (SS) Clinical Quality Measures (CQM) Reportable Labs (ELR) Immunizations (VXU) Copyright 2014 - Michigan Health Information Network Shared Services
  • 17. 16000000 14000000 12000000 10000000 8000000 6000000 4000000 2000000 17 Monitoring Transitions of Care 0 Admit-Discharge-Transfer (ADT) Outbound (ADT) Copyright 2014 - Michigan Health Information Network Shared Services
  • 18. Statewide ADT Use Case Example 18 Active Care Relationship Service (ACRS) Statewide Health Provider Directory (HPD) + + Copyright 2014 - Michigan Health Information Network Shared Services
  • 19. Statewide Health Provider Directory 19 • Contains Electronic Service Information (ESI) used to route information to providers • Flexibility to maintain multiple distribution points for single provider or single distribution for organization • Manages organizations, providers and the multiple relationships between them Copyright 2014 - Michigan Health Information Network Shared Services
  • 20. ACRS™ Update – Version 2.0 Additional patient information to minimize false positives 20 Patient Information Source Patient ID First Name Middle Initial Last Name Suffix Date of Birth Gender SSN – Last 4 digits Address 1 & Address 2 City, State, Zip Home & Mobile Phones Physician Information NPI First Name Last Name Practice Unit ID Practice Unit Name Physician Organization ID Physician Org Name Physician DIRECT Address DIRECT Preferences Copyright 2014 - Michigan Health Information Network Shared Services
  • 21. Important Horizontal View 21 Eligible Hospitals Eligible Providers & PCMH Care Coordinators Specialty Providers Behavioral Health Specialists Critical Access Hospitals Patients & Families Copyright 2014 - Michigan Health Information Network Shared Services
  • 22. Statewide ADT Notification Qualified Organization Qualified Organization Active Care Relationship HPD Delivery Preference Lookup 1) Patient goes to the hospital, hospital sends a registration message 2) Check Active Care Relationships and identify three providers 3) Using the HPD, identify delivery preference for each provider 4) Notification is routed to providers based on preferences Care Coordinator Primary Care Specialist 22 Animation Copyright 2014 - Michigan Health Information Network Shared Services
  • 23. Other “Lego” Combinations 23 + + Active Care Directory Relationships State-wide Health Provider + + Active Care Directory Relationships State-wide Health Provider MED REC Care Plan Copyright 2014 - Michigan Health Information Network Shared Services
  • 24. Some 2015 Use Cases Ready Now! • Query for immunizations • Newborn screening • Social Security eligibility determination • Medication Reconciliation-discharge push of Med Rec • Trusted identities • Provider single-sign-on • Patient single-sign-on • Statewide HPD query-direct client integration module • Medication Information Direct Gateway (MiDiGateTM) • Common Key Service– patient matching service • ACRS Services-expose to beneficiaries • Advance Directives - send to Peace of Mind registry • Health Risk Assessment (HRA) • Integrated Care Bridge Record (ICBR) - care plan 24 Copyright 2014 - Michigan Health Information Network Shared Services
  • 25. MSSS 25 MDCH Data Hub HIE QO/VQO Medical Information Direct GatewayTM MiDiGateTM for HIE QOs and VQOs MiDiGate CQM Data Mart Medicaid ADT Repository MCIR MDSS SOM Data Warehouse Inbound Outbound QRDA Cat III QRDA CAT III MU Credit Meaningful Use Database QRDA Labs Patients Hospitals Physicians HIEs Correctional Facility Any provider organization EDRS MCDR MiHIN HIE Repository Other States Direct Email Convention Examples Using MiDiGate & Health Provider Directory Inbox labs@direct.hieqo.org deaths@direct.hieqo.org immunizations@direct.hieqo.org usecasename@direct.hieqo.org birthdefects@direct.hieqo.org cqms@direct.hieqo.org adts@direct.hieqo.org fostercarehealth@direct.hieqo.org ccdas@direct.hieqo.org Destination(s) . Reportable Labs to MDSS Electronic Death Registry System Michigan Care Improvement Registry Registry for that use case Chronic Condition Registry SOM Data Warehouse Vital Statistics Foster Kids Registry Chronic Disease Registry Description Lab Results Death Notices Immunizations Use Case Specific Birth Defect Notices Clinical Quality Measures Admit, Discharge, Transfer Foster Kids Care Summaries Consolidated Clinical Document Architecture Copyright 2014 - Michigan Health Information Network Shared Services
  • 26. Maximize SOM Resources 26 State of Michigan Internal MDCH Data Hub MiHIN & the Qualified Data Sharing Organizations STATEWIDE External SHARED SERVICES Transparency via HIT Commission Monitoring Shared Governance via MiHIN Board Copyright 2014 - Michigan Health Information Network Shared Services
  • 27. 27 MiHIN Governance MiHIN Board of Directors MiHIN Management & Core Staff Executes the Operations Plan MiHIN Operations Advisory Committee (MOAC) oversees working groups that advise MiHIN Health Information Technology Commission Copyright 2014 - Michigan Health Information Network Shared Services
  • 28. 28 MiHIN Board of Directors MiHIN Executive Management Executes the operations plan Tim Pletcher, Executive Director Jeff Livesay, Associate Director MiHIN Operations Advisory Committee (MOAC) Provides monthly MiHIN status report Health Information Technology Commission (HITC) The Commission's mission is to facilitate and promote the design, implementation, operation, and maintenance of an interoperable health care information infrastructure in Michigan. Michael G. Chrissos, M.D. Representing Consumers Gregory Forzley, M.D.- Chair Representing Doctors of Medicine Robert Milewski Representing Nonprofit Healthcare Corporations Pat Rinvelt Representing Purchasers or Employers Mark Notman, Ph.D. Representing Schools of Medicine Nick Lyon Representing MDCH Nick Smith Representing Health Plans or Third Party Payers Rod Davenport Representing State of Michigan CTO Jill Castiglione Representing Pharmacists Orest Sowirka, D.O. Representing Doctors of Osteopathic Medicine Jim Lee Representing Hospitals MiHIN Board of Directors Michigan Public Health Jim Collins Southeast Michigan HIE (SEMHIE) Helen Hill Michigan Pharmacist Association Larry Wagenknecht, Chair Michigan Medicaid Cynthia Green Edwards Ex Officio Tim Pletcher Priority Health Krischa Winwright Blue Cross Blue Shield of MI (BCBSM) Dr. Thomas Simmer Jackson Community Medical Record (JCMR) Rick Warren, Vice Chair Great Lakes Health Connect Vacant Ingenium John Vismara, President Upper Peninsula Health Information Exchange (UPHIE) Dennis Smith S e t P o l i c i e s A c t o n t h e P o l i c i e s Vacant Representing Pharmaceutical Manufacturers Irita B. Matthews Represents Health Information Technology Meridian Health Plan Thomas Lauzon HIT Commissioner Nick Lyon Copyright 2014 - Michigan Health Information Network Shared Services
  • 29. MiHIN Operations Advisory Committee (MOAC) 29 Information Exchange (UPHIE) MOAC Working Groups Operations/ Production Support MDCH/DTMB/SOM Doug Wi tten – Co-Chair, Tina Scott, Alan Darl ing, Lar ry Ruble, Kevin Garnett, Therese Hoyle, Bea Salada, Dave Wil lhite, Brenda Coleman, Paul Groll, Ed Hartwick, Jeff Shaw, Doug Saylor, Craig Weaver, Mike Potter, Soma Duppi, Brendan O’Brien, Jaya Tamrakar MiHIN Shared Services Brian Seggie, Rod Mach, Steve Arnst, Aldan Beaubien Great Lakes Health Connect Adam Gee Mike Ayers Upper Peninsula Health Information Exchange (UPHIE) Paula Hedlund, Dan Boyle Jackson Community Medical Record (JCMR) Jeanne Wymer Ingenium John Vismara, E.D., Rusty Mandle Great Lakes Health Connect Doug Dietzman Upper Peninsula Health Paula Hedlund Dan Boyle (alt.) Integration and Architecture MDCH/DTMB/SOM Doug Wi tten – Co-Chair, Tina Scott, Alan Darl ing, Lar ry Ruble, Kevin Garnett, Therese Hoyle, Bea Salada, Dave Willhite, Brenda Coleman, Paul Groll, Ed Hartwick, Jeff Shaw, Doug Saylor, Craig Weaver, Mike Potter, Soma Duppi, Brendan O’Brien, Jaya Tamrakar MiHIN Shared Services Brian Seggie, Co-Chair, Steve Arnst, Rod Mach, Aldan Beaubien Security MDCH Data Hub/DTMB Paul Groll, Phil Kurdunowicz, Tairus Taylor MiHIN Shared Services Brian Seggie – Co-Chair Jeff Livesay, Frank Cass Great Lakes Health Connect Adam Gee, Rich Fi sh Upper Peninsula Health Information Exchange (UPHIE) Paula Hedlund Jackson Community Medical Record (JCMR) Jeanne Wymer Issue Remediation MDCH Cynthia Green-Edwards – Co-Chair, Meghan Vanderstelt MiHIN Shared Services Dr. Tim Pletcher – Co-Chair Health Alliance Plan of Use Case MDCH/DTMB Tina Scott– Co-Chair, Paul Groll, Alan Darl ing, Rick Mathews, Doug Witten, Bob Swanson, Tairus Taylor, Phil Kurdunowicz, Patty Clark, Therese Hoyle, Jeff Haskell, Jim Collins, Brendan O’Brien, Jaya Tamrakar MiHIN Shared Services Rick Wilkening – Co-Chair Michael Taylor SEMHIE Mick Tal ley Great Lakes Health Connect Heidi Newton, Mike Ayers Great Lakes Health Connect Carol Parker, Douglas Dietzman Upper Peninsula Health Information Exchange (UPHIE) Paula Hedlund, Dan Boyle Jackson Community Medical Record (JCMR) Aaron Wootton Rick Warren (alt.) Ingenium John Vismara Wendy Linkimer (alt.) MDCH/MDCH Data Hub Tina Scott, Co-Chair Cynthia Edwards MiHIN Shared Services Jeff Livesay, Co-Chair Dr. Tim Pletcher Southeast Michigan HIE (SEMHIE) Helen Hill Blue Cross Blue Shield of MI (BCBSM) Wanda Brideau Michigan (HAP) Jane Harper Jackson Community Medical Record (JCMR) Jeanne Wymer Ingenium John Vismara, Rusty Mandle SEMHIE Vacant Blue Cross Blue Shield of MI (BCBSM) Vacant Health Al liance Plan of Michigan (HAP) Vacant SEMHIE Vacant Blue Cross Blue Shield of MI (BCBSM) Vacant Health Al liance Plan of Michigan (HAP) Vacant Blue Cross Blue Shield of MI (BCBSM) Vacant Health Al liance Plan of Michigan (HAP) Jane Harper, Robert Keefer Upper Peninsula Health Information Exchange (UPHIE) Paula Hedlund Jackson Community Medical Record (JCMR) Aaron Wootton Ingenium John Vismara SEMHIE Helen Hill Blue Cross Blue Shield of MI (BCBSM) John Bialowicz Health Al liance Plan of Michigan (HAP) Vacant Upper Peninsula Health Information Exchange (UPHIE) Paula Hedlund, Dan Boyle Jackson Community Medical Record (JCMR) Aaron Wootton, Jeanne Wymer, Rick War ren Ingenium Diane Slon, Wendy Linkimer SEMHIE Helen Hill, Mick Tal ley Blue Cross Blue Shield of MI (BCBSM) John Bialowicz Health Al liance Plan of Michigan (HAP) Deborah Spencer Ingenium Rusty Mandle Ken O’Brien Privacy MDCH/DTMB Leslie Asman, John Donovan-Co-Chair, Phil Kurdunowicz- Co-Chair MiHIN Shared Service Jeff Livesay Brandi Briones Great Lakes Health Connect Rich Fi sh Upper Peninsula Health Information Exchange (UPHIE) Paula Hedlund Jackson Community Medical Record (JCMR) Jeanne Wymer Ingenium Rusty Mandle Ken O’Brien SEMHIE Mick Tal ley Blue Cross Blue Shield of MI (BCBSM) Vacant Health Al liance Plan of Michigan (HAP) Vacant Priority Health Lee VanWagner Priority Health Vacant Priority Health Vacant Priority Health Vacant Priority Health Vacant Priority Health Vacant Priority Health Vacant Meridian Health Plan Tony Randolph Thomas Lauzon Meridian Health Plan Vacant Meridian Health Plan Vacant Meridian Health Plan Vacant Meridian Health Plan Vacant Meridian Health Plan Vacant Meridian Health Plan Vacant Great Lakes Health Connect Adam Gee Mike Ayers Copyright 2014 - Michigan Health Information Network Shared Services
  • 30. Challenges • Communicate effectively • Maintain stability in the rapidly growing ecosystem • Understand how to better support our stakeholders Copyright 2014 - Michigan Health Information Network Shared Services 30
  • 31. Questions? Dr. Tim Pletcher Executive Director pletcher@mihin.org Jeff Livesay Associate Director livesay@mihin.org Shelley Mannino Senior Project Manager mannino@mihin.org Copyright 2014 - Michigan Health Information Network Shared Services 31
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