Critical data-integration technology is helping health care providers in Michigan get patient information to doctors when and where they need it.
By Tony Kontzer
One of the major obstacles to the effective electronic exchange of patient data is that most doctors are moving targets. They are affiliated with numerous organizations and practice in a lot of different settings. In other words, good luck getting a message to them in the right place at the right time.
"You can't just deliver information to them in one spot," says Tim Pletcher, executive director of the Michigan Health Information Network (MiHIN). "You have to understand the medical context and deliver to them where needed."
It was with that conundrum in mind that the state of Michigan joined forces with insurance companies and nascent platforms for exchanging health information to create the MiHIN in late 2010. The idea was to put together a team of medically inclined technical folks and have them solve the disconnect in getting critical patient information to doctors where they need it.
As it turned out, the problem—the need to tie together the disparate components of a doctor's communication channels so that other providers can effectively route data to them—is ideally solved by those increasingly critical IT building blocks known as application programming interfaces, or APIs.
What Pletcher and his team figured out was that all the information on how to get data to doctors is there, but it's scattered about—in Medicare files, state files, physicians' organizations and so on—and electronic health record systems need to know how to route messages and patient data to doctors where they most need the information.
"If a local hospital wants to know how to tell a doctor that her patient went to the ER over the weekend with an asthma attack, it has to have a way to tell the doctor that the patient was discharged but needs to be seen," says Pletcher. "Today there's not an existing big list you can use to know how to send info to the doctor."
It turns out this is an important medical problem. Pletcher says more than 100,000 people die in the U.S. each year because of mistakes made in the health care system, and often times these mistakes can be traced back to disparate systems and the resulting lack of communication or, in some instances, erroneous communication.
To help address this, Pletcher's staff first set out to assemble all of the potential contact data associated with a physician into a health provider directory. Pletcher describes it as a sort of Lightweight Directory Access Protocol for getting at physicians' directory data.
Next, MiHIN stored the mashed-up physicians’ data set on a cloud platform; in this case, Salesforce.com's Force.com. Using Force.com, MiHIN has been feverishly building APIs that let electronic health record systems expose the group's health provider directory service, thus delivering messages and data to doctors more effectively, and decreasing delays in the treatment process by enabling doctors to make quicker decisions.