EAST LANSING — The Michigan Health Information Network Shared Services and the Michiana Health Information Network have announced transmission of patient immunization records from Indiana health care providers to Michigan’s Care Improvement Registry using Direct secure email through the MiHIN cloud and the Michigan Department of Community Health Data Hub.

This interstate Health Information Exchange capability across state lines is now in full production between Michigan and Indiana after successful piloting and testing in 2012.

After starting with the exchange of immunizations, Indiana and Michigan can begin exchanging more complex electronic records such as Continuity of Care Documents, which are essentially patient histories.

MiHIN has developed the capability to detach any type of attachment from a Direct secure email message and route that attachment to where it should go, whether another HIE, directly to another provider, or to a registry such as Michigan’s immunization registry or a CCD registry.

“Secure, private health information exchange across state lines between Indiana and Michigan is a major milestone,” said Tom Liddell, executive director of MHIN, Indiana’s first health exchange. “Michiana border residents engage in interstate commerce daily because they live near a state line and this interstate commerce includes their regular healthcare; Americans are an increasingly mobile society and we are confident the infrastructure we have co-developed with MiHIN has national ramifications.”

As patients who cross state borders require medical care it is becoming even more important for Health Information Exchanges to interoperate across regional boundaries. Indiana’s MHIN and Michigan’s MiHIN provide by way of example how personal health information can be exchanged nationally.

“Michiana’s MHIN fills information gaps by exchanging health information with our neighboring state for our shared citizens in border areas,” added MiHIN associate director Jeff Livesay. “Using Direct messaging, we will be able to streamline the exchange process across state lines, making it easier for providers in the border cities and towns to provide a high standard of care to patients from other neighboring states.

The Direct Project is a national protocol endorsed by the Office of the National Coordinator for Health Information Technology. Direct is a form of “secure email” that enables use of the Internet to securely transport health information between healthcare participants who have a certified “trust” relationship.

Bob Swanson, director of the Immunization Division at the Michigan Department of Community Health, stated: “The Michigan Care Improvement Registry is recognized nationally for its ability to provide an immunization record to authorized users to assist with clinical decision support and school entry requirements. MCIR continues to improve the process for collecting accurate and timely immunization data electronically from medical providers. The Direct Project allows Indiana providers to have a seamless connection with MCIR to submit immunization data on Michigan residents.”

The relationship between MiHIN and MCIR will allow immunization data coverage to be expanded, including other out of state providers to contribute in the near future.

Michiana’s MHIN is adding to the ever growing message count sent through MiHIN’s Shared Services for Public Health Reporting. MiHIN has successfully and securely exchanged more than 625,000 immunization messages and Admit-Discharge-Transfer messages after entering full production on May 8.

Two Michigan sub-state HIE’s, Grand Rapids-based Michigan Health Connect and Marquette-based Upper Peninsula HIE, entered full production with MiHIN in 2012.  A third Michigan HIE, Jackson Community Medical Records, has completed testing and is preparing to enter production with MiHIN.

MiHIN plans to expand the capability developed with Indiana to all of its border states — Wisconsin, Illinois, and Ohio. Additionally MiHIN is working to establish Direct secure email connections with other states that Michigan residents frequently visit, starting with Florida and then including North Carolina, Alabama, Tennessee and Arizona.

Michigan and Florida have already established “HISP to HISP” connectivity with plans to enter production in the first half of 2013 for Michigan’s “snowbirds.”

Said Florida Health Information Exchange technical and operations director Walt Culbertson: “We are like-minded with Michigan in many areas and have already benefitted from our two-way technical exchange. Florida providers want to be able to communicate electronically with Michigan providers regarding their seasonal treatment of our shared migratory residents.”

Added Livesay: “If you are on vacation in another state and require emergency medical treatment providers should be able to securely and privately request and receive your medical history no matter what state you are from. That is what we are doing. That is what we are building. That is why interstate health information exchange is important. This capability can speed access to important information in addition to improving the quality and decreasing costs for providers and patients at the point and instant of care.”

MiHIN is Michigan’s initiative to improve health care quality, efficiency, and patient safety through the sharing of electronic health information, while reducing costs. MiHIN is the official state designated entity for health information exchange across Michigan and the future integration with the eHealth Exchange. MiHIN is a Michigan nonprofit entity, functioning as a public and private collaboration between the State of Michigan, sub-state Health Information Exchanges, payers, providers, and patients. For more information visit www.mihin.org.


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