“Start small. Think big. Target strategically.”
That was advice that Lynda M. Zeller, Senior Program Officer, Behavioral Health, Michigan Health Endowment Fund gave to health and human service executives trying to work through the many issues involved in making health information exchange work on a broad scale during her keynote address, Harnessing The Power Of Analytics To Create Innovative Solutions For Complex Consumers, at The 2019 OPEN MINDS Strategy & Innovation Institute. Michigan’s statewide health data sharing backbone, Michigan Health Information Network Shared Services (MiHIN) was a key initiative when Ms. Zeller worked for the State of Michigan and an impressive example of how health information exchanges can work.
MiHIN is a “network of networks”, essentially data from state of Michigan databases, pharmacies, consumer-facing organizations, health plans, and federal sources all feed into a central system to share health information. It simplifies what was once a duplication of effort across different organizations. For example, MiHIN can alert care teams of an individual’s admission, discharge, and transfer notifications.
Ms. Zeller also highlighted another Michigan initiative which started small and targeted, but has grown strategically to improve coordination across behavioral health and social support systems. Care Connect 360, a care management web portal used by relevant stakeholders for consumers in specific state programs such as Medicaid, foster care, and juvenile justice. This platform provides a client-specific summary – diagnoses and chronic conditions, emergency room use, discharges, medications, and care plans. The platform also facilitates a population view of specific conditions and where they are most prevalent in the state.
In order to implement the project, Michigan started smaller, thought big, and targeted strategically.
- Start Small – To address challenges with integration of behavioral and physical health care, MDHHS decided to build its own tool leveraging data that already existed through Michigan’s Enterprise Data Warehouse. Ms. Zeller explained that provider organizations implementing data projects should also start small. Organizations should start by targeting, sharing, and analyzing the data they already have rather than trying to begin the process with the collection of new data.
- Think Big – Although Michigan started with a small tool that leveraged existing data, it was built with the idea that it could be expanded and scaled in the future to include additional sources of data and different groups of users. Provider organizations should also think about how the tool they use can be expanded in the future to better improve the types of analytics and data that is used to inform care.
- Target Strategically – When starting to analyze data to provide care management and population health, it’s important to start strategically where you know there are easy wins rather than targeting the totality of your population. For example, Michigan started with identifying the homeless population with high emergency department use and inpatient costs. They then determined whether this population was actually more expensive than the general population and tried to understand how other safety-net programs were used. From there, they targeted housing resources based on the health needs of this population and shared data across the housing and health care sector. Provider organizations can do this on a smaller scale, identifying high-utilizers of specific services and targeting these individuals for intervention.
Ms. Zeller explained that at times implementing the Care Connect 360 system was painful, yet it has provided incredible value. MDHHS is continually working to scale and improve information sharing and analysis, maximizing use of the MiHIN Infrastructure, as well as use of targeted tools like Care Connect 360. For example, MiHIN is in the process of developing an electronic consent system for sharing protected health information between provider organizations with active consumer-consent only, and immediately stopping the sharing if consent is revoked. Electronic Consent will improve both consumer ability to manage and protect their behavioral health information and allow for greater data-sharing between organizations to improve care coordination. MiHIN, MDHHS, and the Governor’s HIT Commission are working together to strategically streamline tools and strengthen infrastructure so providers can see exactly what they need and not be overwhelmed with superfluous data.
For even more on this topic, join us at The 2019 Management Best Practices Institute in Long Beach, California on August 13 for the plenary address “Taking Your EHR From Data To Strategic Information: Real-World Cases Of EHRs Supporting Value-Based Care” featuring Monica E. Oss, Chief Executive Officer, OPEN MINDS.