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Michigan HIE Targets Data Exchange Silos in Emergency Care

Analysis  |  By Eric Wicklund  
   August 22, 2024

A pilot project coordinated by the Michigan Health Information Network aims to help hospitals share critical patient data with EMS providers and ambulances.

Hospitals often face difficulties accessing data on patients coming into their Emergency Departments. A new health information exchange project in Michigan could help.

The Michigan Health Information Network (MIHIN) recently conducted a pilot with Hillsdale Hospital, Reading Emergency Unit, and Beyond Lucid Technologies to create a secure pathway for information exchange between the EMS provider and the hospital, using MIHIN’s secure network and Beyond Lucid’s technology platform.

During the pilot, an REU ambulance transporting a patient to Hillsdale Hospital was able to send an electronic patient care record containing the patient’s vital signs and other clinical information, including medical history and social determinants of health, to Beyond Lucid’s tech platform. That platform converted the data to a Continuity of Care Document (CCD), which was securely transmitted over the MIHIN network to the hospital, enabling care providers to get an accurate assessment of the patient prior to arrival in the ED.

Secure data exchange in emergency care is a complex pain point for health systems and hospitals, many of which don’t have a secure or reliable pathway to exchange information with EMS providers, ambulances, police and fire departments and other mobile responders. With the advent of digital health technology and health information exchange networks, the push is on to create those pathways so that hospitals can coordinate care for ED patients.

“Ambulance and fire services are often the first point of contact for patients suffering a medical emergency,” Tim Pletcher, MIHIN’s executive director, said in a recent press release on the pilot project. “In these time-sensitive situations, expedient access to accurate patient health information is critical for making informed decisions and providing effective care. The partnership between MIHIN, Reading, Hillsdale Hospital and Beyond Lucid Technologies offers a promising solution for improving access to patient data in pre-hospital settings by providing a more complete picture of a patient's health during critical moments and minimizes the risk of errors associated with incomplete or inaccurate information.”

In a 2023 interview with HealthLeaders, Jonathon Feit, MBA, MA, Beyond Lucid’s co-founder and chief executive, said the healthcare industry has been slow to embrace the idea of a common framework for data sharing in emergencies. He noted that in 2020 the Cleveland Clinic, Essentia and Sanford Health were all unable to integrate EMS-based data into their Epic EHR even though Epic had published the data import specifications on its website.

Secure data exchange in emergency and urgent care is crucial for a number of reasons, not just ED transports.

“Consider prescription medications and substance use challenges," Feit said. "Substance use challenges [can] fester into overdoses due to a lack of visibility into patients’ encounters with care settings across jurisdictional lines. If a patient in Ohio sees a doctor in West Virginia, Kentucky, or Indiana, there is presently no mechanism for the Ohio-based fire or ambulance crews, or hospitals, to know what medications the patient should have been taking, which makes it much harder to surmise what she or he likely took."

Feit said the MIHIN project is an important step forward for interoperability.

“Michigan is a complex prehospital and post-hospital medical transportation ecosystem, and the partners to this project sought to create an onramp for any mobile medical agency to enjoy the benefits of true interoperability across the state,” he said in the MIHIN press release. “It also proves something that deserves to be shouted from the rooftops: This isn’t about fire or EMS or public or private services. It is about continuity of patient care, and getting everyone on the same page so that responders can deliver the most informed care possible.”

While the first phase of the project demonstrated the ability to share date between the EMS provider and the hospital, a second phase targets a familiar idea: A portable patient record that goes with the patient and can be accessed by EMS providers and others.

According to MIHIN, the organization “will create a real-time active care relationship between the patient and the mobile medical agency, enabling it to receive future discharge medication reconciliation reports from participating hospitals, improving medication management for patients.” MIHIN would then be able to share that ambulatory CCD with the patient’s care team.

In addition, MIHIN plans to expand the project to include fire and rescue services in two nearby communities.

Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.


KEY TAKEAWAYS

Very few hospitals can access information on patients being transported to their Emergency Departments.

A pilot project in Michigan has created a framework by which an EMS provider can transmit patient vitals and other data to the hospital through a health information exchange network.

The model could eventually help hospitals assess critical patients before they arrive in the ED, improving care management and outcomes.


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