Connecting Michigan Providers

Dietzman: I mentioned the sharing of laboratory orders—with 121 locations, which could include a community hospital or a physician office, and there are about 8,300 orders being transmitted every month. Another solution involved in the HIE is a scheduled-orders application, primarily focused right now on radiology. And right now, there are 64 offices that have been rolled out, and there are about 610 orders a month being created. And lastly, we’re just getting started with physician referrals, and we’ve got six physician offices live so far.

HCI: What will happen in the next couple of years, as Michigan Health Connect evolves forward?

Dietzman: So far, we’ve talked exclusively about pushing data. Now we’re beginning to talk about the ‘pull’—so if I show up in an emergency room, what do they know about me, Doug? And they could create a query. So sometime in 2011, we’ll have our community master person index started. Each organization is pursuing this in their own way. But we’re not forcing organizations to move in lockstep. One hospital might say, yes, that community viewer is extremely important to us; while another might say it’s not their top development priority. So we’ll have a few of the hospitals up on the viewer, and others will catch up based on their strategic priorities.

HCI: What lessons have been learned so far in this initiative?

Dietzman: I think from an overall standpoint, one of the things we’ve tried to do and that has been a good lesson for us, has been to stay focused on the basics. I think there’s so much swirl in HIE-land, with the bells and whistles and trying to solve world peace and such, that it’s important to focus on the basics. And there’s nothing sexy about providing a basic results interface, but making progress in that area is huge. And focusing on the basics keeps it simple. And when it’s kept simple, and the business model is kept simple, you can avoid some of the problems that some of the other exchanges might have run into.

What’s more, from a momentum standpoint, we’ve hit the right timing. I think health information exchange has always been seen as an incremental, extra expense, to hospitals; and what we’ve been trying to explain to the hospitals is that you have to build this infrastructure to exchange clinical data and to meet the requirements of meaningful use. So you can either take a pile of money, and either spend it in isolation, or collaborate together for results. And as more and more physicians are implementing EMR, and they’re saying, I don’t want to deal with the paper anymore, I want that data electronically in my system. So it’s forcing hospitals to move forward anyway. And we can say to the hospitals, do this in collaboration—it’s cheaper, and you’re reaching out to your community, and participating in HIE activity. We’ve also been very focused at this point on hospitals and health systems. But we’ve been having conversations with health plans. And I would say that in the next year or so, we’ll find some real op
portunities working with health plans and working with public health organizations at the state level. So you’ll see us expanding beyond the core participation we have right now.

HCI: Tell us a bit about the business model for transactions.

Dietzman: It’s a subscription-based model, and right now, the hospitals are paying the costs—so the referrals module, the ordering module, the results module, are all free to the providers.

HCI: Do you have any explicit advice for others as they begin to develop HIEs?

Dietzman: People don’t want to spend money unless there’s value. So we’ve really tried to define very basic and defined value propositions. And also, we’ve been working with our regional health extension center. And we’ve been able to keep our HIE staff relatively small, because we’ve been leveraging our relationships with people in the hospitals. So I’m not putting people all over the state for this. We’re better leveraging our relationships, and in addition, building greater credibility with the participating hospital organizations. So that’s something that I would recommend as well for others.

HCI: Have there been advantages in working with a single core vendor?