1. “Reducing the Cost for Data Sharing”
Connecting Michigan for Health 2017
Tim Pletcher, DHA
Executive Director
Michigan Health Information Network Shared Services
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2. Infrastructure
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3. Basic Model Receive Data From MiHIN Via ACRS & HD
Send Data for Use Case to MiHIN
Receive Data From MiHIN Via ACRS & HD
Common Key Service A
Active Care
Relationship
Service
Declare linkages
Provider
Info
Health Directory
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4. Reducing Provider Burdens
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5. MiHIN Use Case Factory: Operational Governance
A modular, highly standardized legal framework
Implementation guides and conformance
Synthetic data, personas and simulation tools
A four-phase stage gate process to prioritize and incentivize use case adoption
Cost recovery and sustainability linked to mature use cases & value
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6. Use Case Financial Incentives
Health plan pays incentives
$$$$
Use
Case
MiHIN
Statewide
Shared Services
Provider agrees to use case terms and sends
data to MiHIN based on use case requirements
MiHIN shares conformance report
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7. Copyright Michigan Health Information Network Shared Services Proprietary – Confidential – Do not copy or redistribute

8. IT’S ABOUT A PROCESS TO CLEAN UP THE DATA
The Model Works
Now more than 13 million Active Care Relationships/mo
Near 100% of the State’s Admission, Discharge, Transfers (6.1 million each week) received and over 3.6 million sent back out to appropriate care team members
Similar level of adoption occurring for Care Summaries (CCDs)
But it’s not all about adoption
IT’S ABOUT A PROCESS TO CLEAN UP THE DATA
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9. Conformance to ADT standard
ADT data quality: April 2015
ADT data quality: December 2015
Fields populated
Fields mapped
Enhanced fields
Fields populated
Fields mapped
Enhanced fields
Hospital Systems
December 2015 snapshot shows one health system by individual hospitals resulting in additional rows
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10. Active Care Relationships
Provider
Linkage
Patient
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11. ~ 13 Million Active Care Relationships
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12. View Active Care Relationships
Health Plans
Primary Care Provider
Specialist
Physician Organizations & ACOs
Hospital or SNF
Pharmacist
Community Based Services
Patient
Foster Care Program
Care Coordinator
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13. Data for the Common Key Service
Patient Demographics
Used by Common Key Service
Patient
Primary Care Provider
First Name
Last Name
Date of Birth
Last 4
SS#
Local
MRN#
Gender
Linkage
(plus other demographic data)
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14. Common Key Service (CKS)
What:
An additional common identifier to include in patient demographics when sharing or merging data
Built upon:
Active Care Relationship Service
MiHIN legal trust framework
Leverages the State of Michigan MPI
Goal:
Improve match rates when linking patient records
Link individuals across multiple organizations, applications and services
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15. Core Data Flow Model Common Key Service Data clean-up services
Patient Matching Accelerator (very high performance MPI)
Active Care
Relationship
Service
Common Key Service
Declare linkages
Data clean-up services
Patient Demographics
+ Common Key
Common key returned with
cleaned demographics
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16. Provider & Affiliation Data for HD
Patient
Practice
Physician Group
Practice
Unit
Primary Care Provider
Direct Address or
ESI
Used for the Health
Directory
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17. Confirm and Enforce Conformance
Push Data
Push Data To MiHIN
Confirm and Enforce Conformance
Admission, Discharge, & Transfer Use Case
Care Summary (CDA CCD) Use Case
Lab Results Use Case
Quality Measure (QRDA) Use Case
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18. Quality Control & Routing
Specialist HD
Primary Care
Physician
ACRS
STANDARDIZED
Data to MiHIN
CKS
Care
Coordinator
Hospital & SNF
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19. An Iterative Approach ACRS ADT’s Care Summaries Specialist HPD CKS
STANDARDIZED
CKS
Care Summaries
Care
Coordinator
CCD
Problems
Allergies
MEDs
Hospital & SNF
CCD
+Care Plan
“pain plan”
CCD
Diagnostics
CCD
+Advance Directives
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20. Promote the CCD HL7 C-CDA Lowest Cost!! Direct Small Provider CCD
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21. Disease, Health Risk or Exposure Registry
New Types of ACRS
Linkage
Disease, Health Risk or Exposure Registry
Patient
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22. Supports Provider Awareness
Trusted Data Sharing Organization
(TDSO)
Trusted Data Sharing Organization
(TDSO)
Specialist
Active Care Relationships
Health Provider Directory
Primary Care
Patient Added to Registry
Care
Coordinator
1) When patient added to registry a public health ADT alert sent to MiHIN
2) MiHIN checks Active Care Relationship Service and identifies providers
3) MiHIN retrieves contact and delivery preference for each provider from HPD
4) Notifications routed to providers based on electronic addresses and preferences
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23. Alert & Query ACRS Prescription Drug Monitoring Program Report
delivered to multi-purpose inbox
MiHIN attaches
report to
message
MiHIN queries Prescription Drug Monitoring Program
ADT (A01) Message from ED
ACRS
Prescription Monitoring Indicator (person active in system)
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24. ACRS Informed Query Active Care Relationship Service Specialist
Primary Care
Physician
Hospital & SNF
Health Plan
Pharmacist
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25. What About The EHR Vendors?
Push
Everyone Else
ACRS
CKS
CORPORATE CONFIDENTIAL MIHIN 2017

26. Tim Pletcher Executive Director pletcher@mihin.org
Thank you!
Tim Pletcher Executive Director
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