Presenters:Tina R. Scott, MDCHPaul Groll, DTMBCynthia Green-Edwards, MDCH

SOM HIE

Unraveling the Current Information Tangle

Insurance Companies

Physicians

Specialty Providers

Hospitals & Clinics

Patients & Families

Lab tests &XRAYs

Medications

Public Health

2

* One Directional

* Not Real-Time

* Lacks Standards

Desired SolutionHealth Information Exchange

Insurance Companies

Physicians

Specialty Providers

Hospitals & Clinics

Patients & Families

Lab tests &XRAYs

Medications

Public Health

HIE

3Standards govern: Form, Content and Response

SOM HIE

MedicaidDW

MSSS

Doctors &CommunityProviders EHRs

SUB-STATE HIEs

Michigan HIE Model

Routing

Audit Trail

4

State LabsStarLIMS

5

SOM HIE

Doctors EHRs

SUB-STATE HIE

Michigan HIE ModelEarly 2012

SOM HIE Phase I* Implement interim solution for HL7 messages

* Direct Connect to SOM HIE

* Send immunization records to MCIR* Compliance with CDC Grant

* Send hospital reportable labs to MDSS

* Ability to send message acknowledgements

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SOM HIE

Medicaid

Doctors &CommunityProviders EHRs

SUB-STATE HIEs

Michigan HIE ModelCurrent

Doctors &Local PH Dept EHRs

SOM HIE Phase II * Implement production solution

* Establish MiHIN – SOM HIE connection

* Continued Infrastructure Development

* Gather new functional requirements

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MedicaidDW

MSSS

SOM HIE Phase III

* MiHIN – SOM HIE – connection via VPN

* Next SOM Use Cases* MSSS* MCIR forecast/history* State Labs (StarLIMS)

* HPD – Health Provider Directory* Not Limited to Licensed Providers

Michigan HIE ModelPlanning

State LabsStarLIMS

8

MedicaidDW

MSSS

*Match person-level records across data sets

*Link data from multiple data sources for an individual person

*Include data sets beyond HIE

*Phased implementation approach

SOM Master Person Index

State LabsStarLIMS

*

*Affordable Care Act and other healthcare initiatives are driving data sharing

*Comprehensive view of individuals in multiple programs making it possible to*effectively assess and analyze healthcare

program data

*make better and faster decisions

*manage and measure programs

*reduce costs

* improve outcomes

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*

*Phase 1 – Replace Unique Client Identifier (UCI) on Data Warehouse with COTS product (IBM Initiate)

*Phase 2 – Establish real-time MCIR interface

*Future – additional sources, Household identification

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*

*Completed March 2012

*Deployed the Initiate Citizen Hub

*Implemented Initiate Inspector for data resolution

*Replaced Data Warehouse UCI*UCI originally implemented 2001

*Configured single input and output streams combining 17 data sources

* Initial conversion included 38 million records

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12

MPI Phase II

SSHIE - PID

DC -PID

SSO - PID

SSO -DDE

* Establish real-time interface between MCIR and MPI

* Data Warehouse to accept MCIR updates from MPI

* Establish process to add additional MDCH systems

MPI Future Phases* MDSS and StarLIMS

* other SOM systems

* Household identification

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Step 1: Optimizes data for statistical comparisons– Normalizes & compacts data, creates derived data layer,

source data remains intact– Phonetic equivalences, tokenization, nicknames, etc.

Step 2: Finds all the potential matches– Casts a wide net – all matches on current or historical attributes, prevents misses– Partial matches, reversals, anonymous values, etc.

Step 3: Scores accurately via probabilistic statistics– Compares attributes one-by-one and produces

a weighted score (likelihood ratio) – Frequency weights specific to your business– Edit distance, proximity of match– Allows custom deterministic rules

Step 4: Custom threshold settings– Single or dual threshold models– Link, don’t link, don’t know – “learns”

from manual input – Manage cost/quality trade-offs– Manage the linkages, workflow review

Manual ReviewLowest

PossibleScore

HighestPossible

Score

Don’tLink Link

LowestThreshold

UpperThreshold

Should be linkedShould not be linked

*

*14

Alerts data stewards to potential data quality and relationship issues delivering the ability to collaboratively inspect data, visualize relationships and resolve issues

Inspect and resolve data quality issues

Resolve duplicates within same source Manually link records across multiple

systems

Visualize and manage relationships

Centralize and leverage data across the enterprise…with a single tool

IBM® INITIATE® INSPECTORIBM® INITIATE® INSPECTOR

IssueResolution

Hierarchy/RelationshipManagement

CentralData Store

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CONSUMINGSOURCES

DATASOURCES

Source 1 Source 2 Source ‘n’Source 3

System 1 System 2 System 3

Catherine Lamb

763543Dr Kath J. Jones 1:N4456 15/06/1970 9263462232 Sussex St 0415266721

763543Dr Kate Lamb 2:2736 Female 02-9263-4622

763543Mrs. K. Jones 3:S7846 15/06/1970 9263-4622Level 1, 32 Sussex Rd +61415266721

763543n:97662 15/06/2006 Female 92630-6000 0415-266-721

60558

60558

60558

Local ID: EID:Name: DOB: Sex: Home Phone:Address 1: Mobile:Zip Code:

763543Dr Kath J. Jones 15/06/1970 Female 02 9263 4622 0415 266 721Level 1, 32 Sussex St 60558

System ‘n’

*

*

*Administrators*Assign tasks to data stewards

*Resolve tasks* Link records

* Identify target record

* Assign trusted source

*Data Stewards*Review potential linkages

*Resolve data integrity issues

*Ensure source-record quality

*Monitor and maintain data accuracy

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*

*Limited to authorized users (data stewards) and to specific data/levels of information

*Identifier information is not shared

*Data can be linked without being visible

*Oversight by MDCH Security Office

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*

*Collaboration with MiHIN for development of Health Provider Directory

*Leverage development to expand to Provider Index* Include provider/organizations beyond HIE

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19

*

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SOM HIE