Electronic Health Records

Integration & Interoperability News

Michigan, Indiana build interstate HIE using Direct messaging

By Jennifer Bresnick

- Michigan and Indiana are now able to transmit patient data across state lines using Direct secure messaging, according to a recent press release.  The two-state connection follows a similar Midwestern initiative in establishing an interstate HIE, starting with the exchange of patient immunization data and planning to expand from there.  Interstate HIEs are just beginning to emerge as smaller networks grow and reach out to other local projects.

“Secure, private health information exchange across state lines between Indiana and Michigan is a major milestone.  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,” said Tom Liddell, Executive Director of MHIN, Indiana’s first health exchange.

Direct secure messaging, which sends encrypted emails and attachments between participating providers, saves the time and effort of faxing documents back and forth, contributing to better coordinated care for patients.  It was launched in 2010 by the Office of the National Coordinator in order to provide a basic exchange system without the need for an EHR or any IT infrastructure other than an internet connection. While it is not the most sophisticated form of HIE, lacking the query-and-response capability of a database system, it is seen as a first step towards achieving the goals of health information exchange, and is one of the initial steps towards transferring patient data across state systems with different regulations and levels of EHR adoption.

“Michiana’s MHIN fills information gaps by exchanging health information with our neighboring state for our shared citizens in border areas. 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,” added Jeff Livesay, MiHIN Associate Director.

Michigan’s MiHIN project has successfully send more than 625,000 immunization records and Admit-Discharge-Transfer (ADT) messages since May of 2012, and plans to add Continuity of Care Documents (CCDs) and other vital patient information in the coming months.   “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,” Livesay noted. “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.”

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