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MiHIN Overview
April 2015
What Does HIE (verb) Do?
2
Adapted from Hripcsak et al. (2007)
Benefits
· Avoiding repeat diagnostic tests
· Enables a clinician to add or
remove a differential diagnosis
in a timely fashion
· Optimal choice of tests and
therapy
· More rapid response to a
contraindication or any
necessary refinements to a
given therapy
· Care coordination: helps ensure
that the next clinician involved
in the patient’s care will see the
relevant information about the
patient!
Prevent future or
fill known and unknown
knowledge
deficits
Copyright 2014 - Michigan Health Information Network
Shared Services
Statewide Coordination
3
Health
Plans
Physicians
Specialty
Providers
Hospitals & Clinics
Patients
& Families
Lab tests &
XRAYs
Medications
Public Health
Insurance
Companies
Physicians
Specialty
Providers
Hospitals & Clinics
Patients
& Families
Lab tests &
XRAYs
Medications
Public Health
Duplication of effort, waste, & expense
(N x N-1 connections)
Shared Services
(N connections)
Copyright 2014 Michigan Health Information Network
MiHIN is a
network for sharing health
information statewide
for Michigan
4Copyright 2014 Michigan Health Information Network
“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
5Copyright 2014 Michigan Health Information Network
State-wide
Shared Services
MDCH Data Hub
Medicaid
MSSS
State
LABS
Doctors & Community
Providers
HIE QOs
(Qualified sub-state HIEs)
Network of Networks:
Data
Warehouse
6
Health Plan QOs
(more coming)
Single point of
entry/exit for state
Virtual QOs
Copyright 2014 Michigan Health Information Network
Pharmacies
(more coming)
Immunizations
Mi Syndromic
Surveillance System
Mi Disease
Surveillance System
Consumer QOs
(more coming)
Federal
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
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
8Copyright 2014 Michigan Health Information Network
Maximize SOM Resources
9
StateofMichigan
Internal
ExternalSTATEWIDE
SHARED SERVICES
MDCH Data Hub MiHIN & the Qualified
Data Sharing Organizations
Transparency
via HIT
Commission
Monitoring
Shared
Governance via
MiHIN Board
Copyright 2014 Michigan Health Information Network
10
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
MiHIN Operations Advisory Committee
(MOAC)
MiHIN Executive Management
Executes the operations plan
Tim Pletcher, Executive Director
Jeff Livesay, Associate Director
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 infrastructurein Michigan.
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
Jill Castiglione
Representing Pharmacists
Gregory Forzley, M.D.- Chair
Representing Doctors ofMedicine
Michael G. Chrissos, M.D.
Representing Consumers
Robert Milewski
Representing Nonprofit HealthcareCorporations
Rod Davenport
Representing State of Michigan CTO
Orest Sowirka, D.O.
Representing Doctors ofOsteopathic Medicine
Jim Lee
Representing Hospitals
MiHIN Board of Directors
Michigan PublicHealth
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 CrossBlueShield
of MI (BCBSM)
Dr. Thomas Simmer
Jackson Community
Medical Record (JCMR)
Rick Warren, Vice Chair
Great LakesHealth Connect
Vacant
Ingenium
John Vismara, President
Upper PeninsulaHealth
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
MiHIN Governance
Vacant
Representing PharmaceuticalManufacturers
Irita B. Matthews
Represents Health Information Technology
2014Copyright 2011 - Michigan Health Information Network Shared Services
Meridian Health Plan
Thomas Lauzon
HITCommissioner
Nick Lyon
Copyright 2014 - Michigan Health Information Network 11
MiHIN Governance
Copyright 2014 - Michigan Health Information Network 12
MOAC Working Groups
Operations/
Production Support
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
MDCH/DTMB/SOM
Doug Witten – Co-Chair,
Tina Scott, Alan Darling, Larry
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, Rod Mach, Steve
Arnst, Aldan Beaubien
Integration and
Architecture
MDCH/DTMB/SOM
Doug Witten – Co-Chair,
Tina Scott, Alan Darling, Larry
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
Great Lakes Health Connect
Adam Gee, Rich Fish
Upper Peninsula Health
Information Exchange (UPHIE)
Paula Hedlund
Jackson Community
Medical Record (JCMR)
Jeanne Wymer
MDCH Data Hub/DTMB
Paul Groll,
Phil Kurdunowicz, Tairus Taylor
MiHIN Shared Services
Brian Seggie – Co-Chair
Jeff Livesay, Frank Cass
Issue Remediation
MDCH
Cynthia Green-Edwards –
Co-Chair,
Meghan Vanderstelt
MiHIN Shared Services
Dr. Tim Pletcher – Co-Chair
Use Case
MDCH/DTMB
Tina Scott– Co-Chair,
Paul Groll, Alan Darling, 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 Talley
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
2014Copyright Michigan Health Information Network Shared Services
Great LakesHealth Connect
Doug Dietzman
Upper PeninsulaHealth
Information Exchange (UPHIE)
Paula Hedlund
Dan Boyle (alt.)
Jackson Community
Medical Record (JCMR)
Aaron Wootton
Rick Warren (alt.)
Ingenium
John Vismara
Wendy Linkimer (alt.)
MDCH/MDCH DataHub
Tina Scott, Co-Chair
Cynthia Edwards
MiHIN Shared Services
Jeff Livesay, Co-Chair
Dr. Tim Pletcher
Southeast Michigan HIE
(SEMHIE)
Helen Hill
Blue CrossBlueShield
of MI (BCBSM)
Wanda Brideau
Health AlliancePlan of
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 Alliance Plan of
Michigan (HAP)
Vacant
SEMHIE
Vacant
Blue Cross Blue Shield
of MI (BCBSM)
Vacant
Health Alliance Plan of
Michigan (HAP)
Vacant
Blue Cross Blue Shield
ofMI (BCBSM)
Vacant
Health Alliance 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 Alliance 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 Warren
Ingenium
Diane Slon, Wendy Linkimer
SEMHIE
Helen Hill, Mick Talley
Blue Cross Blue Shield
of MI (BCBSM)
John Bialowicz
Health Alliance Plan of
Michigan (HAP)
Deborah Spencer
Ingenium
Rusty Mandle
Ken O’Brien
Privacy
Upper Peninsula Health
Information Exchange (UPHIE)
Paula Hedlund
Jackson Community
Medical Record (JCMR)
Jeanne Wymer
MDCH/DTMB
Leslie Asman,
John Donovan-Co-Chair, Phil
Kurdunowicz- Co-Chair
MiHIN Shared Service
Jeff Livesay
Brandi Briones
SEMHIE
Mick Talley
Blue Cross Blue Shield
of MI (BCBSM)
Vacant
Health Alliance Plan of
Michigan (HAP)
Vacant
Ingenium
Rusty Mandle
Ken O’Brien
Great Lakes Health Connect
Rich Fish
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
MiHIN Operations Advisory Committee (MOAC)
Great Lakes Health Connect
Adam Gee
Mike Ayers
MiHIN Operations Advisory Committee (MOAC)
Data Sharing Agreement
Use Case
#1
Use Case
#2
Use Case
#3
Legal Infrastructure for Data Sharing
13Copyright 2014 - Michigan Health Information Network
ORGANIZATION AGREEMENT
(QDSOA,VQDSOA, CQDSOA, SSOA,
SSSOA, PIHP QDSOA, other “OA”)
Basic Connection Terms
Basic BAA Terms
Minimal Operational SLA
Contracting & Payment
Definitions
Termination
Cyber Liability Insurance
Qualified
Sub-state HIE
or VQO
Qualified
Sub-state HIE
or VQO
Clear Chain of Trust
Copyright 2014 - Michigan Health Information Network
Shared Services 14
Covered
Entity
Business
Associate
Business
Associate
Business
Associate
Covered
Entity
Covered
Entity
Constituent Transparency
Copyright 2014 - Michigan Health Information Network
Shared Services 15
Use Case
Health
Plans
Physicians
Specialty
Providers
Hospitals & Clinics
Patients
& Families
Laboratories &
Diagnostic centers
Pharmacies
Public Health & CMS
Policy Makers
Communities
Employers
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
16
Use Case Factory™
Copyright 2014 Michigan Health Information Network
Use Case Components
17
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
http://mihin.org/about-mihin/resources/use-case-submission-form/
Use Case Factory
Idea with
Champion
Idea with
Sponsor
Plan & Develop
Pilot &
Refine
Technical
Planning
Conceptual
EvaluationDefine
Purpose
U seCaseSummary
ContainsTheB asicI deas
L aidOutinanE asyto
R eadDocumentforthe
B oardtoA pprove
Implement
Production
Status
Metrics
Adoption
Critical
Mass
Mass
Marketing &
Outreach
MiHIN Board
Successful
Adoption
Continuous
Improvement
Functional
Data-Sharing
Widget
18Copyright 2014 Michigan Health Information Network
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
19
Copyright 2014 Michigan Health Information Network
Infrastructure Use Cases
Secure Transport Layer Services and
Digital Credentials
Master Person Index
(Common Key Service)
Active Care
Relationship
Service
Patient Opt-In
Preferences
Identity
Management
Federated
Identity
Management
(FiDM)
Health
Provider
Directory
Gateway
Services (e.g.
XCA)
20Copyright 2014 Michigan Health Information Network
Accelerating Use Cases
21
Policy &
Regulatory
Levers
Clinical
Endorsement &
Evidence
Financial
Incentives or
Disincentives
Copyright 2014 Michigan Health Information Network
Use Case Pipeline Example
22Copyright 2014 Michigan Health Information Network
Statewide Use Case Evolution
Planning & DevelopmentConceptual
Implementation
(Operational Adoption)
Mature Production
(> 65% Utilization)
Statewide ADT-IN
Submit Syndromics
Request Immunization
History/Forecast Submit Immunizations
Submit Data to Active
Care Relationship Service
(ACRS)
Death Registry
Advanced Directives
Health Provider Directory
Basic Query
Submit Data to Health
Provider Directory
Medication Reconciliation
Chronic Disease Registry
Health Provider Directory
Advanced Query
MiHealth Link(ICBR)
Provider Submission
Birth Registry
Convert Syndromics
Submit Newborn Screening-
CCHD
Health Provider Directory
Search Service
Single Sign On
Federated Identity
Management
Common Key Service
Health Risk Assessment
(HRA)
Submit Clinical Quality
Measures
Send/Receive Lab Results/
Orders
Submit Birth Defect
Notifications
eHealth Exchange Patient
Query
Cross-QO Patient Query
Submit Reportable Labs
VA Patient Query
CMS Electronic Submission of
Medical Documentation
SSA Disability Determination
Patient Look Up(Cross
Community Access XCA)
Benefits of Use Case Approach
23
• Manageable chunks so competitive or confidentiality
concerns can be addressed without “boiling the ocean”Reduces Complexity
• Standardized mechanism for scoping purpose, technical
requirements, costs, and limits on how data is usedConsistent Pattern
• Use Cases can be combined to create higher and higher
levels of functionalityModular (like Lego blocks)
• Incentives, regulations or policies can target specific Use
Case to foster or accelerate adoptionAligns Priorities
• Constituents can understand expected use of their data and
follow the common chain of trust across organizationsTransparent
• Aids focused monitoring and measurement of progress
Measureable
• Reduces variability and enables scalability
Faster & Cost Effective
Copyright 2014 Michigan Health Information Network
-
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
14,000,000
MONTHLY MESSAGE COUNT
Admit-Discharge-Transfer (ADT)
Outbound (ADT)
Copyright 2014 Michigan Health Information Network
Copyright 2014 Michigan Health Information Network
-
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
MONTHLY MESSAGE COUNT
Syndromic Surveillance (SS)
Clinical Quality Measures (CQM)
Reportable Labs (ELR)
Immunizations (VXU)
Copyright 2014 Michigan Health Information Network
25
26
Monitoring Transitions of Care
0
2000000
4000000
6000000
8000000
10000000
12000000
14000000
16000000
Admit-Discharge-Transfer (ADT)
Outbound (ADT)
Copyright 2014 Michigan Health Information Network
Statewide ADT Use Case Example
27
Active Care
Relationship Service
(ACRS)
Statewide
Health Provider
Directory (HPD)+ +
Copyright 2014 Michigan Health Information Network
Admit Discharge & Transfer (ADT)
Use Case
28
Copyright 2014 - Michigan Health Information Network
Statewide Health Provider Directory
29
• 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
ACRS™ Update – Version 2.0
Additional patient information to minimize false positives
30
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
Important Horizontal View
31
Eligible
Hospitals
Eligible
Providers &
PCMH
Care
Coordinators
Specialty
Providers
Behavioral
Health Specialists
Critical Access
Hospitals
Patients & Families
Copyright 2014 Michigan Health Information Network
Trusted Data
Sharing
Organization
Trusted Data
Sharing
Organization
Statewide ADT Notification
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
Primary Care
Specialist
Care
Coordinator
32
Animation
Copyright 2014 Michigan Health Information Network
Other “Lego” Combinations
33
Active Care
Relationships
State-wide
Health Provider
Directory+ +
Active Care
Relationships
State-wide
Health Provider
Directory+ +
MED
REC
Care
Plan
Copyright 2014 Michigan Health Information Network
Some 2015 Use Cases
• 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 (MIDIGATE®)
• 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
34
Ready Now!
Copyright 2014 Michigan Health Information Network
The Direct Project
• Simple, secure, scalable, standards-based
way to send encrypted information “directly” to
known, authenticated, trusted recipients
• Messages sent securely between end-points:
• person to person
• person to system
• system to system
• system to person
Copyright 2014 - Michigan Health Information Network
35
Dr. Jones
Dr. Smith
Provider to Provider Email
Definitions
HISP – Health Information Service Provider
HISP
HISP
Federally-bridged digital
security certificate as
trust anchor
Copyright 2014 - Michigan Health Information Network
36
From:
results@direct.lab.com
To:
someClinic_lab_results@direct.mihin.org
System-to-system messaging
Definitions
HISP – Health Information Service Provider
HISP
HISP
Federally-bridged digital
security certificate as
trust anchor
Copyright 2014 - Michigan Health Information Network
37
The Role of DIRECT & EHRs
Copyright 2014 - Michigan Health Information Network
38
DirectTrust Members
39
39Copyright 2014 - Michigan Health Information Network
Current DTAAP Accreditation Roster
January 15, 2014
• CareAccord
• Cerner Corporation
• DigiCert
• Infomedtrix
• ICA
• Inpriva
• MaxMD
• Surescripts
• MedAllies
• DataMotion
• Applied Research Works, Inc.
• Athenahealth
• Covisint
• EMR Direct
• GlobalSign, Inc.
• HIXNy
• Health Companion
• Health Connection CNY
• Health Info EXchange of NY
• iMedicor
• IOD Inc.
• Medicity
• NYeC
• RelayHealth
• Rochester RHIO
• Secure Exchange Solutions
• Simplicity Health Systems
• Truven Health Analytics
• Updox
• Utah Health Information Network
• Vitalz, Inc.
• West Virginia HIN
Fully Accredited and Audited Candidate Status
Copyright 2014 - Michigan Health Information Network
4040
MIDIGATE® Purpose
• Simplified & low cost data capture based
on DIRECT Secure Messaging protocols
• Fully secure for handling PHI
• Bridges the gap or “mitigates” transport
challenges, e.g. DIRECT to HL7 LLP
• Designed to support MiHIN Use Cases,
broad quality reporting requirements, and
custom data capture needs
Copyright 2014 - Michigan Health Information Network
41
Key Components
• Configuration of the base service that feeds data into the
existing virtual private network used to send data
• Captures attachments to published DIRECT addresses
• “Peels” off structured data and routes appropriately
• Establishment of one or more “catcher” modules
• Examples of common catcher modules:
• ADT’s
• Electronic clinical quality measures
• HEDIS reports
• Care Plan Updates
• Authorizations
• Etc.
Copyright 2014 - Michigan Health Information Network
42
“Catcher” Modules
Copyright 2014 - Michigan Health Information Network
43
HISP
Doctor offices &
Community
Hospitals
ADT
Catcher
Module
MiDIGATE
Handler ‘peels” off
attachments
Base Gateway
Service
Normal ADT Flow
Copyright 2014 - Michigan Health Information Network
44
MiHIN
TOC
Router
ADT
HIE QOs
(Qualified sub-state
HIEs)
Trusted Data
Sharing
Organization
Active Care
Relationships
HPD Delivery
Preference
Lookup
With ADT “Catcher” Module
Copyright 2014 - Michigan Health Information Network
45
MiHIN
TOC
Router
Trusted Data
Sharing
Organization
Active Care
Relationships
HPD Delivery
Preference
Lookup
adt@direct.mihin.org
HISP
MiDIGATE
Base Service
Handler
Lots of Potential “catchers”
Copyright 2014 - Michigan Health Information Network
46
adt@direct.mihin.org
labs@direct.mihin.org
meds@direct.mihin.org
immunizations@direct.mihin.org
47
MDCH
Data Hub
HIE
QO/VQO
MiDiGate
Medical Information Direct GatewayTM
MiDiGateTM
for HIE QOs and VQOs
CQMData
Mart
Medicaid ADT
Repository
MCIR
MDSS
MSSS
SOM Data Warehouse
OutboundInbound
QRDA Cat III
QRDA
CAT III
MU Credit
Meaningful
Use
Database
QRDA
Any provider
organization
Physicians
Labs
Hospitals
HIEs
Correctional
Facility
Patients
EDRS
MCDR
MiHIN
Repository
HIE
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
Questions?
Dr. Tim Pletcher
Executive Director
pletcher@mihin.org
Jeff Livesay
Associate Director
livesay@mihin.org
Shelley Mannino
Director
mannino@mihin.org
48Copyright 2014 - Michigan Health Information Network Shared Services

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MiHIN 101 Overview v4 04-08-15

  • 2. What Does HIE (verb) Do? 2 Adapted from Hripcsak et al. (2007) Benefits · Avoiding repeat diagnostic tests · Enables a clinician to add or remove a differential diagnosis in a timely fashion · Optimal choice of tests and therapy · More rapid response to a contraindication or any necessary refinements to a given therapy · Care coordination: helps ensure that the next clinician involved in the patient’s care will see the relevant information about the patient! Prevent future or fill known and unknown knowledge deficits Copyright 2014 - Michigan Health Information Network Shared Services
  • 3. Statewide Coordination 3 Health Plans Physicians Specialty Providers Hospitals & Clinics Patients & Families Lab tests & XRAYs Medications Public Health Insurance Companies Physicians Specialty Providers Hospitals & Clinics Patients & Families Lab tests & XRAYs Medications Public Health Duplication of effort, waste, & expense (N x N-1 connections) Shared Services (N connections) Copyright 2014 Michigan Health Information Network
  • 4. MiHIN is a network for sharing health information statewide for Michigan 4Copyright 2014 Michigan Health Information Network
  • 5. “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 5Copyright 2014 Michigan Health Information Network
  • 6. State-wide Shared Services MDCH Data Hub Medicaid MSSS State LABS Doctors & Community Providers HIE QOs (Qualified sub-state HIEs) Network of Networks: Data Warehouse 6 Health Plan QOs (more coming) Single point of entry/exit for state Virtual QOs Copyright 2014 Michigan Health Information Network Pharmacies (more coming) Immunizations Mi Syndromic Surveillance System Mi Disease Surveillance System Consumer QOs (more coming) Federal
  • 7. 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 7
  • 8. 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 8Copyright 2014 Michigan Health Information Network
  • 9. Maximize SOM Resources 9 StateofMichigan Internal ExternalSTATEWIDE SHARED SERVICES MDCH Data Hub MiHIN & the Qualified Data Sharing Organizations Transparency via HIT Commission Monitoring Shared Governance via MiHIN Board Copyright 2014 Michigan Health Information Network
  • 10. 10 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
  • 11. MiHIN Operations Advisory Committee (MOAC) MiHIN Executive Management Executes the operations plan Tim Pletcher, Executive Director Jeff Livesay, Associate Director 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 infrastructurein Michigan. 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 Jill Castiglione Representing Pharmacists Gregory Forzley, M.D.- Chair Representing Doctors ofMedicine Michael G. Chrissos, M.D. Representing Consumers Robert Milewski Representing Nonprofit HealthcareCorporations Rod Davenport Representing State of Michigan CTO Orest Sowirka, D.O. Representing Doctors ofOsteopathic Medicine Jim Lee Representing Hospitals MiHIN Board of Directors Michigan PublicHealth 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 CrossBlueShield of MI (BCBSM) Dr. Thomas Simmer Jackson Community Medical Record (JCMR) Rick Warren, Vice Chair Great LakesHealth Connect Vacant Ingenium John Vismara, President Upper PeninsulaHealth 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 MiHIN Governance Vacant Representing PharmaceuticalManufacturers Irita B. Matthews Represents Health Information Technology 2014Copyright 2011 - Michigan Health Information Network Shared Services Meridian Health Plan Thomas Lauzon HITCommissioner Nick Lyon Copyright 2014 - Michigan Health Information Network 11 MiHIN Governance
  • 12. Copyright 2014 - Michigan Health Information Network 12 MOAC Working Groups Operations/ Production Support 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 MDCH/DTMB/SOM Doug Witten – Co-Chair, Tina Scott, Alan Darling, Larry 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, Rod Mach, Steve Arnst, Aldan Beaubien Integration and Architecture MDCH/DTMB/SOM Doug Witten – Co-Chair, Tina Scott, Alan Darling, Larry 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 Great Lakes Health Connect Adam Gee, Rich Fish Upper Peninsula Health Information Exchange (UPHIE) Paula Hedlund Jackson Community Medical Record (JCMR) Jeanne Wymer MDCH Data Hub/DTMB Paul Groll, Phil Kurdunowicz, Tairus Taylor MiHIN Shared Services Brian Seggie – Co-Chair Jeff Livesay, Frank Cass Issue Remediation MDCH Cynthia Green-Edwards – Co-Chair, Meghan Vanderstelt MiHIN Shared Services Dr. Tim Pletcher – Co-Chair Use Case MDCH/DTMB Tina Scott– Co-Chair, Paul Groll, Alan Darling, 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 Talley 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 2014Copyright Michigan Health Information Network Shared Services Great LakesHealth Connect Doug Dietzman Upper PeninsulaHealth Information Exchange (UPHIE) Paula Hedlund Dan Boyle (alt.) Jackson Community Medical Record (JCMR) Aaron Wootton Rick Warren (alt.) Ingenium John Vismara Wendy Linkimer (alt.) MDCH/MDCH DataHub Tina Scott, Co-Chair Cynthia Edwards MiHIN Shared Services Jeff Livesay, Co-Chair Dr. Tim Pletcher Southeast Michigan HIE (SEMHIE) Helen Hill Blue CrossBlueShield of MI (BCBSM) Wanda Brideau Health AlliancePlan of 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 Alliance Plan of Michigan (HAP) Vacant SEMHIE Vacant Blue Cross Blue Shield of MI (BCBSM) Vacant Health Alliance Plan of Michigan (HAP) Vacant Blue Cross Blue Shield ofMI (BCBSM) Vacant Health Alliance 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 Alliance 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 Warren Ingenium Diane Slon, Wendy Linkimer SEMHIE Helen Hill, Mick Talley Blue Cross Blue Shield of MI (BCBSM) John Bialowicz Health Alliance Plan of Michigan (HAP) Deborah Spencer Ingenium Rusty Mandle Ken O’Brien Privacy Upper Peninsula Health Information Exchange (UPHIE) Paula Hedlund Jackson Community Medical Record (JCMR) Jeanne Wymer MDCH/DTMB Leslie Asman, John Donovan-Co-Chair, Phil Kurdunowicz- Co-Chair MiHIN Shared Service Jeff Livesay Brandi Briones SEMHIE Mick Talley Blue Cross Blue Shield of MI (BCBSM) Vacant Health Alliance Plan of Michigan (HAP) Vacant Ingenium Rusty Mandle Ken O’Brien Great Lakes Health Connect Rich Fish 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 MiHIN Operations Advisory Committee (MOAC) Great Lakes Health Connect Adam Gee Mike Ayers MiHIN Operations Advisory Committee (MOAC)
  • 13. Data Sharing Agreement Use Case #1 Use Case #2 Use Case #3 Legal Infrastructure for Data Sharing 13Copyright 2014 - Michigan Health Information Network ORGANIZATION AGREEMENT (QDSOA,VQDSOA, CQDSOA, SSOA, SSSOA, PIHP QDSOA, other “OA”) Basic Connection Terms Basic BAA Terms Minimal Operational SLA Contracting & Payment Definitions Termination Cyber Liability Insurance
  • 14. Qualified Sub-state HIE or VQO Qualified Sub-state HIE or VQO Clear Chain of Trust Copyright 2014 - Michigan Health Information Network Shared Services 14 Covered Entity Business Associate Business Associate Business Associate Covered Entity Covered Entity
  • 15. Constituent Transparency Copyright 2014 - Michigan Health Information Network Shared Services 15 Use Case Health Plans Physicians Specialty Providers Hospitals & Clinics Patients & Families Laboratories & Diagnostic centers Pharmacies Public Health & CMS Policy Makers Communities Employers
  • 16. 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 16 Use Case Factory™ Copyright 2014 Michigan Health Information Network
  • 17. Use Case Components 17 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
  • 18. http://mihin.org/about-mihin/resources/use-case-submission-form/ Use Case Factory Idea with Champion Idea with Sponsor Plan & Develop Pilot & Refine Technical Planning Conceptual EvaluationDefine Purpose U seCaseSummary ContainsTheB asicI deas L aidOutinanE asyto R eadDocumentforthe B oardtoA pprove Implement Production Status Metrics Adoption Critical Mass Mass Marketing & Outreach MiHIN Board Successful Adoption Continuous Improvement Functional Data-Sharing Widget 18Copyright 2014 Michigan Health Information Network
  • 19. 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 19 Copyright 2014 Michigan Health Information Network
  • 20. Infrastructure Use Cases Secure Transport Layer Services and Digital Credentials Master Person Index (Common Key Service) Active Care Relationship Service Patient Opt-In Preferences Identity Management Federated Identity Management (FiDM) Health Provider Directory Gateway Services (e.g. XCA) 20Copyright 2014 Michigan Health Information Network
  • 21. Accelerating Use Cases 21 Policy & Regulatory Levers Clinical Endorsement & Evidence Financial Incentives or Disincentives Copyright 2014 Michigan Health Information Network
  • 22. Use Case Pipeline Example 22Copyright 2014 Michigan Health Information Network Statewide Use Case Evolution Planning & DevelopmentConceptual Implementation (Operational Adoption) Mature Production (> 65% Utilization) Statewide ADT-IN Submit Syndromics Request Immunization History/Forecast Submit Immunizations Submit Data to Active Care Relationship Service (ACRS) Death Registry Advanced Directives Health Provider Directory Basic Query Submit Data to Health Provider Directory Medication Reconciliation Chronic Disease Registry Health Provider Directory Advanced Query MiHealth Link(ICBR) Provider Submission Birth Registry Convert Syndromics Submit Newborn Screening- CCHD Health Provider Directory Search Service Single Sign On Federated Identity Management Common Key Service Health Risk Assessment (HRA) Submit Clinical Quality Measures Send/Receive Lab Results/ Orders Submit Birth Defect Notifications eHealth Exchange Patient Query Cross-QO Patient Query Submit Reportable Labs VA Patient Query CMS Electronic Submission of Medical Documentation SSA Disability Determination Patient Look Up(Cross Community Access XCA)
  • 23. Benefits of Use Case Approach 23 • Manageable chunks so competitive or confidentiality concerns can be addressed without “boiling the ocean”Reduces Complexity • Standardized mechanism for scoping purpose, technical requirements, costs, and limits on how data is usedConsistent Pattern • Use Cases can be combined to create higher and higher levels of functionalityModular (like Lego blocks) • Incentives, regulations or policies can target specific Use Case to foster or accelerate adoptionAligns Priorities • Constituents can understand expected use of their data and follow the common chain of trust across organizationsTransparent • Aids focused monitoring and measurement of progress Measureable • Reduces variability and enables scalability Faster & Cost Effective Copyright 2014 Michigan Health Information Network
  • 25. Copyright 2014 Michigan Health Information Network - 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 3,500,000 4,000,000 MONTHLY MESSAGE COUNT Syndromic Surveillance (SS) Clinical Quality Measures (CQM) Reportable Labs (ELR) Immunizations (VXU) Copyright 2014 Michigan Health Information Network 25
  • 26. 26 Monitoring Transitions of Care 0 2000000 4000000 6000000 8000000 10000000 12000000 14000000 16000000 Admit-Discharge-Transfer (ADT) Outbound (ADT) Copyright 2014 Michigan Health Information Network
  • 27. Statewide ADT Use Case Example 27 Active Care Relationship Service (ACRS) Statewide Health Provider Directory (HPD)+ + Copyright 2014 Michigan Health Information Network
  • 28. Admit Discharge & Transfer (ADT) Use Case 28 Copyright 2014 - Michigan Health Information Network
  • 29. Statewide Health Provider Directory 29 • 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
  • 30. ACRS™ Update – Version 2.0 Additional patient information to minimize false positives 30 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
  • 31. Important Horizontal View 31 Eligible Hospitals Eligible Providers & PCMH Care Coordinators Specialty Providers Behavioral Health Specialists Critical Access Hospitals Patients & Families Copyright 2014 Michigan Health Information Network
  • 32. Trusted Data Sharing Organization Trusted Data Sharing Organization Statewide ADT Notification 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 Primary Care Specialist Care Coordinator 32 Animation Copyright 2014 Michigan Health Information Network
  • 33. Other “Lego” Combinations 33 Active Care Relationships State-wide Health Provider Directory+ + Active Care Relationships State-wide Health Provider Directory+ + MED REC Care Plan Copyright 2014 Michigan Health Information Network
  • 34. Some 2015 Use Cases • 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 (MIDIGATE®) • 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 34 Ready Now! Copyright 2014 Michigan Health Information Network
  • 35. The Direct Project • Simple, secure, scalable, standards-based way to send encrypted information “directly” to known, authenticated, trusted recipients • Messages sent securely between end-points: • person to person • person to system • system to system • system to person Copyright 2014 - Michigan Health Information Network 35
  • 36. Dr. Jones Dr. Smith Provider to Provider Email Definitions HISP – Health Information Service Provider HISP HISP Federally-bridged digital security certificate as trust anchor Copyright 2014 - Michigan Health Information Network 36
  • 37. From: results@direct.lab.com To: someClinic_lab_results@direct.mihin.org System-to-system messaging Definitions HISP – Health Information Service Provider HISP HISP Federally-bridged digital security certificate as trust anchor Copyright 2014 - Michigan Health Information Network 37
  • 38. The Role of DIRECT & EHRs Copyright 2014 - Michigan Health Information Network 38
  • 39. DirectTrust Members 39 39Copyright 2014 - Michigan Health Information Network
  • 40. Current DTAAP Accreditation Roster January 15, 2014 • CareAccord • Cerner Corporation • DigiCert • Infomedtrix • ICA • Inpriva • MaxMD • Surescripts • MedAllies • DataMotion • Applied Research Works, Inc. • Athenahealth • Covisint • EMR Direct • GlobalSign, Inc. • HIXNy • Health Companion • Health Connection CNY • Health Info EXchange of NY • iMedicor • IOD Inc. • Medicity • NYeC • RelayHealth • Rochester RHIO • Secure Exchange Solutions • Simplicity Health Systems • Truven Health Analytics • Updox • Utah Health Information Network • Vitalz, Inc. • West Virginia HIN Fully Accredited and Audited Candidate Status Copyright 2014 - Michigan Health Information Network 4040
  • 41. MIDIGATE® Purpose • Simplified & low cost data capture based on DIRECT Secure Messaging protocols • Fully secure for handling PHI • Bridges the gap or “mitigates” transport challenges, e.g. DIRECT to HL7 LLP • Designed to support MiHIN Use Cases, broad quality reporting requirements, and custom data capture needs Copyright 2014 - Michigan Health Information Network 41
  • 42. Key Components • Configuration of the base service that feeds data into the existing virtual private network used to send data • Captures attachments to published DIRECT addresses • “Peels” off structured data and routes appropriately • Establishment of one or more “catcher” modules • Examples of common catcher modules: • ADT’s • Electronic clinical quality measures • HEDIS reports • Care Plan Updates • Authorizations • Etc. Copyright 2014 - Michigan Health Information Network 42
  • 43. “Catcher” Modules Copyright 2014 - Michigan Health Information Network 43 HISP Doctor offices & Community Hospitals ADT Catcher Module MiDIGATE Handler ‘peels” off attachments Base Gateway Service
  • 44. Normal ADT Flow Copyright 2014 - Michigan Health Information Network 44 MiHIN TOC Router ADT HIE QOs (Qualified sub-state HIEs) Trusted Data Sharing Organization Active Care Relationships HPD Delivery Preference Lookup
  • 45. With ADT “Catcher” Module Copyright 2014 - Michigan Health Information Network 45 MiHIN TOC Router Trusted Data Sharing Organization Active Care Relationships HPD Delivery Preference Lookup adt@direct.mihin.org HISP MiDIGATE Base Service Handler
  • 46. Lots of Potential “catchers” Copyright 2014 - Michigan Health Information Network 46 adt@direct.mihin.org labs@direct.mihin.org meds@direct.mihin.org immunizations@direct.mihin.org
  • 47. 47 MDCH Data Hub HIE QO/VQO MiDiGate Medical Information Direct GatewayTM MiDiGateTM for HIE QOs and VQOs CQMData Mart Medicaid ADT Repository MCIR MDSS MSSS SOM Data Warehouse OutboundInbound QRDA Cat III QRDA CAT III MU Credit Meaningful Use Database QRDA Any provider organization Physicians Labs Hospitals HIEs Correctional Facility Patients EDRS MCDR MiHIN Repository HIE 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
  • 48. Questions? Dr. Tim Pletcher Executive Director pletcher@mihin.org Jeff Livesay Associate Director livesay@mihin.org Shelley Mannino Director mannino@mihin.org 48Copyright 2014 - Michigan Health Information Network Shared Services

Editor's Notes

  1. Updated
  2. Includes Sept. Data
  3. Includes Sept. Data
  4. <click to animate>