C4BH Meeting 2/23 -Lessons Learned from MiHIN

Tim Pletcher and Angie Bass of the Michigan Health Information Network Shared Services (MiHIN) joined the February 23 Connecting for Better Health (C4BH) Coalition meeting to share an overview of MiHIN, key takeaways, and lessons learned from their decade of experience. 

Michigan’s statewide health information network, MiHIN, was founded in 2010 as a collaboration of public and private entities united to improve state-wide data exchange and the health outcomes of Michigan’s people. 

Pletcher explained that infrastructure, a key component of any health information network, is more than just the ability to exchange information. It encompasses standard operating procedures, rules of engagement, and mechanisms to ensure equity, quality, reliability, and access. 

Historically, data has been difficult to access, but Pletcher stressed that we are now up against a new phenomenon: an abundance of data. We must adapt to identify high quality data and embed it into health and social service workflows. 

He emphasized MiHIN’s focus on use cases and the importance of policy levers and financial incentives to encourage people. Not only does this drive adoption, but it also improves data usability, as providers change their business processes to correct the data in accordance with  incentives. 

Pletcher stated that although a provider directory, master person index, and a social care resource directory are all valuable resources, organizing the system around the patient has been most vital to MiHIN’s success. 

MiHIN developed the Active Care Relationship Services (ACRS), which utilizes mechanisms such as real-time fees to build a map around the following three categories:

  1. Who the individual is connected to or receiving services from, including social services
  2. What the person’s preferences are, including consent
  3. Patient attributes and where to find more information 

Built upon the ACRS, the MiHIN legal trust framework and their master patient index is the Common Key Service, which issues an additional vendor-neutral common identifier that MiHIN participants have the option to  include in patient demographics when sharing or merging data. This system greatly improves match rates and links individuals across multiple organizations and applications. 

These mechanisms flow into the Care Mapping Service, which allows MiHIN to broker context about what the individual cares about, how they fit into the health and social services universe, and which of their attributes should be noted. 

The Michigan experience provides many useful lessons for other states as they develop their health information networks.


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