If you remember the CHIN (Community Health Information Network) attempts in the 1990s or the next incarnation in the mid-2000s referred to as RHIOs (Regional Health Information Exchange), you know we’ve been on this interoperability journey in health care a very long time. And it’s not over.
Creating sustainable Health Information Exchanges (HIE), not to be confused with a Health Insurance Exchange, is what we are all focused on now. The Office of the National Coordinator for Health IT (ONC) published “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap” for public comments earlier this year. There has been progress over the years but we still have a long ways to go.
The ability to easily access and share data with other health care providers in Michigan is critical for UMHS – we are the only provider in the state that serves patients from every county. But HIEs are important for all providers regardless of their reach. For example, when a patient shows up at an emergency room away from their primary hospital and physician, basic information should be readily available. This includes a patient’s current problem summary list, allergies, chronic conditions, and medications. Having this kind of information can make a qualitative difference in their care. And knowing that a certain test or procedure has recently been done along with the results can avoid duplication, saving both time and money.
Yet, unlike other industries where basic information is easily accessible and shared, health care lags far behind.
I have invested significant time in efforts to move interoperability forward for UMHS, Michigan and nationally. With my team, we’ve developed an HIE strategy in support of our UMHS network strategy providing a range of options for information exchange. I’m on the board for our HIE, Great Lakes Health Connect (GLHC), and represent GLHC at the Michigan Health Information Network (MiHIN). I am a member of the College of Healthcare Information Management Executives (CHIME) Policy Steering Committee where we help shape national policy through our review and comments on proposed legislation.
UMHS is fairly advanced in the area of interoperability as is our state. At UMHS, we have a range of options for interoperability depending on the relationship with other provider organizations and the systems they have in place. Our focus is getting the right data to the right people with the right access. We exchange information directly with other provider organizations on Epic using the Care Everywhere product. As of April, UMHS has exchanged information with 182 organizations in 46 states. We provide access to referring physicians outside of UMHS through our physician portal using EpicCare Link. We share data with many Michigan provider organizations and physician practices on various EHR platforms through GLHC as our HIE.
Within Michigan, GLHC is the result of the merger one year ago of Michigan Health Connect (MHC) and Great Lakes Health Information Exchange (GLHIE). As a sub-state HIE, GLHC is by far the largest covering over 80% of the beds in the state. Its mission is to “create and operate a digital information system to promote the secure access to health information for the advancement of the patient care delivery, coordination, and value of healthcare across the communities it serves.” MiHIN, created in 2010, is a public and private nonprofit collaboration “dedicated to improving the healthcare experience, improving quality and decreasing cost for Michigan’s people by supporting the statewide exchange of health information and making valuable data available at the point of care.” MiHIN serves as a statewide hub for the substate HIEs in Michigan.
Unfortunately, many states and regions are still struggling with their HIEs. For many it is a matter of creating a sustainable business model. The lack of standards overall and the complexity of legal issues as well as politics are often barriers. It is not usually about the technology itself.
Our collective interoperability journey continues to be an important topic within the health care industry. Raising awareness is part of the journey. People need to understand the challenges of interoperability as well as the importance to our patients, which we all are at some point. There are two such opportunities coming up next week in Ann Arbor.
Monday, June 29th from 4:00-6:00 PM – Public screening of the documentary “No Matter Where” at the Michigan Theater including a Q&A with the filmmaker, Dr. Kevin Johnson, Chief Informatics Officer at Vanderbilt University Medical Center. The film brings alive the concept of HIEs and its importance to safe and effective health care.- Tuesday, June 30th from 9:30-11:00 AM – Panel discussion on “The Promise and Practicalities of Health Information Exchange” with Dr. Johnson and four UMHS faculty. Palmer Commons, Floor 4, Forum Hall.
Demonstrating the collective nature of this journey, sponsors of these events include a number of UMHS departments and programs, as well as GLHC and MiHIN.
Resources:
June 29 screening of “No Matter Where”
June 30 panel discussion on HIE
ONC website on Interoperability