michigan’s statewide health information network · skilled nursing facilities/ltpacs, home health...
TRANSCRIPT
11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 1
Michigan’s Statewide Health
Information NetworkNovember 9, 2017
Marty Woodruff
Associate Director
This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
Today’s Agenda
• Introduction to MiHIN
• Data-Sharing Use Cases
• Shared Services Working Together
• Active Care Relationship Service™
• Health Directory Service
• Admission, Discharge, Transfer Notifications
2This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 2
What We’re Doing at MiHIN
• Enabling statewide exchange of health information
• Making valuable data available at the point of care
• Improving quality
• Decreasing cost
• Improving healthcare experience for patients and
providers
…for the people of Michigan
3This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
MiHIN
Statewide
Shared ServicesMDHHS Data Hub
Medicaid
MSSS
State
Labs
Providers
&
Health
Systems
Health Information
Exchanges (HIEs)
Network of Networks
Data
Warehouse
Health Plans
Single point of
entry/exit for state
Pharmacies
Immunizations
MI
Syndromic
Surveillance
System
MI Disease
Surveillance
System
Consumer-facing Organizations
PIHPs (10)
Other Data Sharing Orgs
MyHealthPortal
MyHealthButton
Chronic
Diseases
State
Innovation
Models (SIM)
---
43 Provider
Organizations
Federal
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11/7/2017
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Statewide Network Requires Efficiency
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 and expense
(N x N-1 connections)
Shared Services
(N connections)
5This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
MiHIN created statewide network to:
• Manage statewide legal trust framework
• Connect state and healthcare organizations in Michigan:• Health systems, physician organizations, health plans, HIEs, pharmacies,
skilled nursing facilities/LTPACs, home health agencies, federally qualified
health centers, appropriate federal government agencies, human services,
and 211 services
• Align incentives and/or regulations to fairly share data and
promote data standardization via use cases
• Maintain statewide master data sharing infrastructure
• Convene stakeholder groups to identify data sharing barriers,
reduce provider burdens, engage consumers, and enable
population health
6This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 4
“One and Done”
• Sign once for legal Interoperability• Common legal framework across the state
• Transparent data usage for each use case
• Connect once for technical integration• MiHIN network includes all of healthcare: HIEs, HISPs, health plans,
state and federal agencies
• Publish once for authoritative sources• Patient/provider delivery preferences easily registered, centrally
managed
• Report once for reuse and reduction of duplicated efforts• Messages can be routed to multiple destinations – no duplicate
interfaces or repeat reports
7
Easier, Simplified, Predictable Data Sharing
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Copyright 2017 Michigan Health Information Network Shared Services
Trusted Data
Sharing
Organization
Trusted Data
Sharing
Organization
Chain of Trust to Reduce Risk
8
Covered
Entity
Business
AssociateBusiness
Associate
Business
Associate
Covered
Entity
Covered
Entity
This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 5
ORGANIZATION AGREEMENT
(QDSOA or SSOA)
Basic Connection Terms
Basic BAA Terms
Minimal Operational SLA
Contracting & Payment
Definitions
Termination
Cyber Liability Insurance
Master Use
Case Agreement
Use Case
Exhibit #1
Use Case
Exhibit #2Use Case
Exhibit #3
Legal Infrastructure Among Trusted
Organizations Linked to “Use Cases”
Use Case
Exhibit #n
9This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
Data-Sharing “Use Cases”
• Use case: One or more scenarios to share specific
information
• Each use case has its own:
• Purpose
• Type of information exchanged
• Description of interactions
between people/systems
• Examples of use cases:
• Immunizations
• Admission, Discharge, Transfer (ADT) Notifications
Use Case Factory®
10This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 6
Idea with Champion
Idea with Sponsor
Plan & Develop
Pilot &
RefineTechnical
Planning
Conceptual
EvaluationDefine Purpose
Use Case Summary Contains The Basic Ideas
Laid Out in an Easy to Read Document for the
Board to Approve
Implement
Production
StatusMetrics
Adoption
Critical Mass
Mass Marketing &
Outreach
MiHIN Board
SuccessfulAdoption
ContinuousImprovement
Functional Data-Sharing
Widget
Stage 2
Stage 3
Stage 4
Stage 1
Use Case Factory Process
11This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
Public Health Reporting
• Immunizations
•Chronic disease registries
•Disease surveillance
•Syndromic surveillance
•Birth & death notifications
Use Case “Assembly Lines”
Results Delivery
•Lab results
•Diagnostic imaging
•Other tests
•Hospital discharge summaries
Care Coordination & Patient Safety
•Referrals
•Care summaries for treatment history & allergies
•Notification of transitions of care (Admission, 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
12This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 7
Shared Services Working Together
to Enable Use Cases
13This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
Patient-Provider Attribution
14
Provider
Linkage
Patient
• Active Care Relationship Service™ (ACRS™) enables providers to
declare active care relationships with patients.
• This attributes to a patient the providers who are active members
of their care team.
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11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 8
Active Care Relationships
Primary Care
Provider
Patient
Specialist
Hospital or SNF
Pharmacist
Care Coordinator
Health Plans
Physician
Organizations &
ACOs
Community
Based Services
Foster Care
Program
15Copyright 2017 Michigan Health Information Network Shared Services
ACRS Benefits• Accurately routes information (e.g. ADT Notifications, medication
reconciliations, continuity of care documents, etc.)
• Enables alerts to providers in active care relationships with
patients
• Coordinates entire care team with changes to patient status in
real time
• Allows searches by authorized persons or organizations:• Health systems and provider/physician organizations
• Care coordinators
• Health plans
• Consumers (who soon will be able to dispute asserted relationships)
16Copyright 2017 Michigan Health Information Network Shared Services
11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 9
ACRS – Attribution Record
Patient InformationUnique Patient ID
First Name
Middle Initial
Last Name
Name Suffix
Date of Birth
Gender
SSN – Last 4 digits
Address 1 & Address 2
City, State, Zip
Home & Mobile Phones
Patient common key
Attributed Physician InfoNPI
First Name
Last Name
Practice Unit ID
Practice Unit Name
Managing Organization ID
Managing Org Name
Service Delivery Preferences
17Copyright 2017 Michigan Health Information Network Shared Services
ACRS – Delivery Record
Provider InformationNPI
First Name
Middle Initial
Last Name
Provider Type
Specialty
DIRECT Address
Practice OID
Practice NPI
Practice Name
Practice Address (City, ST, Zip)
Practice Phone
Practice DIRECT Address
Managing Org InfoOrganization OID
Organization Type
Organization Name
Org Address (City, State, Zip)
Organization Phone
DIRECT Address
Program Eligibility(SIM, MACRA, CPC+, etc.)
Delivery Pref. by use case
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11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 10
• Up-to-date listing of healthcare providers, their
demographic/contact information and affiliations
• Helps manage organizations, providers and multiple, complex
relationships between them
• Contains electronic addresses used to route information to
providers and organizations
Health Directory
Health Directory Service
Master record includes:
• Name
• Specialty
• Practice Unit
• Managing Organization
• Related Organizations
• Electronic Addresses
• …additional attributes
19This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
Why the Health Directory matters
• Helps coordinate care by making it easier to:
• Look up healthcare providers and organizations
• Determine best way to contact a provider or organization
• Find details (e.g. practicing locations, hours of operation, etc.)
• Tracks program participation information
• e.g. CQMR participation, Patient-Centered Medical Homes,
Meaningful Use, etc.
20This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 11
Why the Health Directory matters
• Identifies most accurate data for each provider/organization
• Supports “report once” capability to ease provider burdens
• Aligns with national standards
21
Every organization using the Health Directory
Service contributes to Michigan’s goal for
statewide interoperability
This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
Trusted Data
Sharing
Organization
(TDSO)
Trusted Data
Sharing
Organization
(TDSO)
Example: ADT Notifications
Active Care
Relationship Service
Health
Directory
(HD)
1) Patient goes to hospital which sends message to TDSO then to MiHIN
2) MiHIN checks patient-provider attribution and identifies recipients
3) MiHIN retrieves contact and delivery preference for each recipient from HD
4) Notifications routed to recipients based on electronic address and preferences
Primary Care
Specialist
Care
Coordinator
Patient
Health
Plan
22This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
11/7/2017
Copyright 2015-2017 Michigan Health Information Network Shared Services 12
Other “LEGO®” Combinations
Active Care
Relationships
Statewide
Health
Directory+ +
Active Care
Relationships
Statewide
Health
Directory+ +
MED
REC
Care
Plan
23This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services
Thank You!
Marty Woodruff
Associate Director
24This work made possible by funding from Michigan Department of Health and Human Services
Copyright 2017 Michigan Health Information Network Shared Services