HIE Implementation in Michigan for Improved Health As approved by the Michigan Health Information Technology Commission on March 4, 2009

The Big Picture Goals Utilizing technology to improve healthcare outcomes and clinical workflow –Improving quality and safety –Increasing fiscal responsibility –Increasing clinical and administrative efficiency Empowering citizens with access to information –About their own health in partnership with clinicians –About their community’s healthcare choices

Framework for Successful HIE Implementation in Michigan Leverage the regional collaboration and successes Refine statewide services that support statewide Health Information Exchange (a statewide “backbone”) Position Michigan for resources from the economic stimulus package

Benefits of a Statewide Backbone Aligns with the American Reinvestment and Recovery Act HIE infrastructure requirement for State funding Allows for earlier adopters to populate the record locator service increasing HIE value and reducing the “empty” EHR syndrome. Unifies privacy and consent management policies, governance and data sharing agreements avoiding confusion for clinicians practicing cross-regions and consumers seeking treatment across regions Unifies the coordination of community outreach and support avoiding mixed messages on Michigan’s health information exchange initiative Allows Michigan’s earlier adopters of HIE/interoperability to connect with each other and state applications (i.e., MCIR) Allows HIT/HIE experts across regions to unite and advance Michigan’s HIT/HIE initiative

Help Desk / Call Center Enrollment Process Community Outreach Funding/ Revenue Training and Support Governance Business Plan Vendor selection Vendor procurement Business Plan & Operational Policies Privacy & Security Centralized Regionalized Together Proposed Roles & Responsibilities Develop and maintain a statewide business plan for operations Collect funding, administer revenue Standards promulgation & enforcement A fair, transparent purchasing process Community outreach to providers promoting and assisting with enrollment and signing the Data Sharing Agreement Provide 24/7 Service and Support Data Sharing Agreements Develop a standard agreement Provide training and user support locally to providers Market and Educate regarding health information exchange Funding

CentralizedRegionalized Together Proposed Technology Master Patient Index Record Locator Service Messaging Gateway(s) Privacy & Security Disaster Recovery Opt-out Management Master Patient Index Technology purchased & administered Data resolved and managed Technology purchased & administered Messaging Gateway(s) Technology purchased & administered Federated regionally Regional Added Services Technology purchased & administered Disaster Recovery Technology purchased & administered Federated regionally Adhere to Mutually Agreed Upon Standards

Regionalized Service and Support  Provides resources within communities to resolve and troubleshoot issues with identity management, the RLS and gateways Security  Provides authentication, authorization, auditing and logging on all connection and disconnections to the MiHIN Messaging Gateway (s)  Transports the requests for and responses (messages) regarding the location of health information Master Patient Index  Uniquely identifies an individual within the Michigan Health Information Network  Locates where the disparate pieces of health information exists on an individual Record Locator Service Michigan’s HIE Backbone

Record Locator Service (RLS) Master Patient Index (MPI) Messaging Gateway Messaging Gateway Service & Support Health System Hospital Clinic Hospital State of MI Applications Public Health Health Plans Clinic Lab Hospital Hospital Nationwide Health Information Network Long Term Care Lab Hospital Physician Group Physician with interoperable EMR Messaging Gateway Service & Support Messaging Gateway Service & Support Messaging Gateway Service & Support Physician with interoperable EMR Hospital Security Payers