Michigan Care Improvement Registry Child Health Integration The Michigan Experience Michigan Care Improvement Registry

Michigan Fun Facts Grand Rapids was the first city in the U.S to put fluoride in their water. The first state police radio system in the world was established in 1929 by Michigan State Police. The first people in the nation to receive assigned phone numbers lived in Detroit in 1879. The first soda pop made in the U.S., Vernor’s Ginger Ale, was created by accident in 1866 in Detroit Mackinac Bridge is the world’s longest suspension bridge. ( 5 miles long)

Benefits Connections Project (PHII) provided Michigan with lessons learned from other states in implementing integrated child health systems. Alternative funding revenue for the IIS program. Providers appreciate the online access to public health data….no more faxes. Demonstrates the value for Health Information Exchange!

Emerging Synergies Surveillance

MCIR Activity 6.5 million records Over 72 million immunizations 25,000 registered users

Current Integration Vital Records Lead Program EPSDT WIC Medicaid Newborn Hearing Newborn Screening

Lead Provides clinical decision support online and with a printable PDF. Displays the following fields: Specimen date Specimen ID Date reported Sample type Venous Capillary

Newborn Screening MCIR displays a link to the Newborn Screening Mailer MCIR displays the Kit number and Accession number Matching NBS Patient ID with MCIR records requires a semi-manual process of linking Patient ID’s from the NBS database and the Vital Records ID.

Newborn Hearing MCIR Displays Initial Screening Results Date Screened, Test Method, Left Ear and Right Ear Results MCIR Displays Diagnostic Results Date Diagnosed,

The Early Periodic Screening, Diagnosis and Treatment (EPSDT)

Body Mass Index The first child health integration project that required data entry into MCIR. MCIR administrative rules change to require reporting height and weight into MCIR annually for children ages 2 – 20 years that visit their clinician in the calendar year.

BMI Planning Process Healthy Kids Healthy Michigan Pediatric BMI Surveillance was selected as 1 of 6 policy priorities to address childhood obesity in schools and communities. Tasked with adding obesity measures to the MCIR to monitor, evaluate and prioritize childhood obesity prevention efforts. Altarum Institute Involvement Childhood obesity is one of three mission projects supported by Altarum internal funds. A component of the Childhood Obesity Mission Project is to provide technical assistance to the MDCH and HKHM in adding BMI surveillance to MCIR. MCIR BMI Team Work closely with MCIR development team, MDCH epidemiology, and cardiovascular health and immunization staff to develop functional specifications and impact design.

BMI Screens Added Height and Weight data entry fields Added Counseling Activity fields Added Clinical Decision Support Documentation

Lessons Learned Be patient it always takes more time to complete the linkages. IIS staff have the health informatics experience to facilitate child health integration projects at the State, Regional, County or City level.

Future Child Health Integration Plans Perinatal Hepatitis B case management /follow-up module Sickle Cell case reporting/follow-up module Forecasting vaccines by a child’s weight Forecasting vaccines specific for sickle cell patients Michigan Health Information Network

Why do we put all this effort into integration?

Questions? Therese Hoyle, MCIR Contractor Hoylet@michigan.gov 269-330-9393 Bea Salada, State MCIR Coordinator SaladaB@michigan.gov 517-335-9340