A pair of bills introduced in the Michigan Legislature in late October would create a state-designated health data utility (HDU) to combine, enhance and exchange electronic health data for various purposes, including treatment, care coordination, quality improvement and public health.
State Rep. Julie Rogers (D-Kalamazoo), chair of the House Health Policy Committee, introduced House Bill 5823 alongside Minority Vice Chair state Rep. Curt VanderWall’s (R-Ludington) HB 5824. The legislators said the bills would move beyond the health information exchange model currently operated by the Michigan Health Information Network (MiHIN) Shared Services. Implementing an HDU provides the opportunity to modernize Michigan’s public health data collection and ensure nearly instant and secure medical record sharing with healthcare providers.
The health data utility model is catching on in several states. As Healthcare Innovation reported in July 2023, the State of Maryland has designated CRISP as the state’s health data utility. State law requires CRISP to provide data in real-time to individuals and organizations involved in the treatment and care coordination of patients and to public health agencies. The legislation also required the Maryland Department of Health, nursing homes, electronic health networks, and prescription drug dispensers to provide data to the state-designated HIE. The story noted that similar efforts are underway in Missouri and Michigan, while California is working on its own version of a requisite data-sharing framework.
Tim Pletcher, MiHIN’s executive director, told Healthcare Innovation that the conversations he has with legislators in Michigan have changed dramatically over the last few years and there is a greater openness to the importance of a health data utility model. “I think COVID made certain things easier,” he said. “COVID was basically a 9/11 equivalent for social services and equity and a lot of what we do in public health. There was a lack of infrastructure and a lack of coordination. The folks who were not used to working with their HIE duplicated resources and wasted a lot of time. I think that the health data utility is very much going to be a model for economies of scale.”
Pletcher adds that looking across siloed legacy systems, most state and county social services programs can’t tell you if they are dealing with the same person. “We HIEs have been struggling with patient matching for years and we've gotten pretty good at it. Some of us have even progressed to doing consent and other hard problems. It's going to take you a decade to do that if you don't build on this infrastructure. We want to build on these core utility type services to do more and more.”
Once you start to look at things like SNAP, children's services, and doing a better job preventing people from getting sick, that's much broader than just the social determinants of health, Pletcher said. “It's full cross-sector infrastructure. Suddenly, we realize we need a utility.”
Pletcher added that transparency is a key issue as health data utilities reach out to stakeholders beyond traditional health system partners. “As we expand to these other cross-sector areas, it can't be dominated by the health plans or the big hospitals. The governance, particularly the operational governance of things, has to evolve. I think that's going to come with more public-sector funding. The trick will be to do that in a way where the politics don't screw up the ability to execute.”
“Most of us have experienced a family member or found ourselves in situations where our medical team is flying blindly without a full picture of our medical history, including what medications we are on, allergies we may have and surgical procedures in our history. Often, medical decisions are made based on limited information that can have literally life-and-death consequences,” Rogers said in a statement. “These bills strengthen the existing framework that has already been established in Michigan under MiHIN and are a significant step forward in ensuring comprehensive health data is shared seamlessly, no matter the health care setting, so that the whole person can be evaluated and treated in a comprehensive, individualized manner.”
The bills have been referred to the House Health Policy Committee.
