Indigenous tribe becomes first in Michigan to tap state HIE for data sharing between tribal, non-tribal providers

An indigenous tribe joined the Michigan Health Information Network Shared Services (MiHIN) last week, becoming the first in the state to unlock bidirectional data sharing with tribal and non-tribal facilities. 

The Nottawaseppi Huron Band of the Potawatomi (NHBP), with 1,900 members, can now see how patients move through the healthcare ecosystem by tapping into the Active Care Relationship Service (ACRS), a centralized MiHIN solution for data sharing across organizations. 

"NHBP’s decision to join MiHIN reflects its commitment to improving healthcare outcomes and providing patient-centered medical care for our members," Rosalind Johnston, health and human services director for NHBP, said in an announcement (PDF). "We are excited to partner with MIHIN and leverage their state-of-the-art solutions to access accurate and timely health information that will allow us to improve outcomes, reduce costs and enhance the overall quality of care.”

The tribe was also onboarded with several other MiHIN tools to help streamline referrals and send immunization records.

Ensuring access to good health data for indigenous communities is critical, Lorna Elliott-Egan, director of tribal government services and policy with the state’s health department, said in a press release.

“By actively participating in the health information exchange, they will be able to coordinate and provide better patient care and improve health equity in a way that ensures patient health information is protected from unauthorized access and is used in a culturally sensitive and appropriate way,” Elliott-Egan said.

"Increasing tribal representation in healthcare data will ultimately lead to improved health equity, outcomes and patient satisfaction for tribal patients,” echoed Tim Pletcher, executive director of the state network, in the announcement. The latest effort will help advance interoperability across the state, he added. 

Of the 12 federally recognized tribes in the state, nine have signed on to join MiHIN. But NHBP is the first to access the ACRS solution, explained Krystal Schramm, senior technical business analyst at the network. Doing so involved sending MiHIN a roster of NHBP’s patients and providers, which will allow for real-time clinical data sharing. 

There are several reasons most tribes who have onboarded with MiHIN cannot yet tap into the ACRS service. “The tribal data infrastructure has been siloed for years, and there are technical infrastructure challenges to bringing tribes on board,” Schramm told Fierce Healthcare. 

For one, the electronic health record software most tribes use does not aggregate data well, making it difficult to integrate across systems. “This makes it much more challenging to create that level of health information exchange needed to compile and submit a list of patients/providers to share with the network,” Schramm said. In addition, a concept like ACRS is relatively new to the tribes and requires a special skill set to be able to collaborate with MiHIN in a meaningful way.  

The latest announcement can serve as a road map for other states looking to do similar work. “We have actually had several other states reach out to us to find out how we are doing what we are doing and have asked us for feedback on how they can work to get more tribes engaged,” Schramm said.