Featured March 3, 2013 | cioinsight.com | Tony Kontzer, CIO Insight

Critical data-integration technology is helping health care providers in Michigan get patient information to doctors when and where they need it.

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. These improvements should be made in all hospitals across the country, not just in Michigan, as this will allow for a better quality of health care for its patients. Sometimes people decide to visit the hospital that is guaranteed to provide better treatment, instead of the one that is closest to them. For example, San Francisco residents may decide to check out these San Francisco hospital rankings before making that decision. If all hospitals had a similar routine to the ones that MiHIN is introducing, then it won’t matter which hospital you attend as you are likely to receive the same care as you would at any other hospital. MiHIN’s plans don’t stop here though.

But there’s even more to it. Pletcher notes that as health care providers have bought systems for managing electronic health records, they continue to receive paper faxes that were previously added to the end of a patient’s chart, but now have to be manually entered for the fax’s data to be digitally usable.

If the faxed data can be delivered electronically at the time and in the format that makes it most useful, it also becomes much more valuable. “If it came through as discrete data that was computable,” says Pletcher, “it would automatically be embedded in the database and would be able to be accessible to any decision support or reporting tools that might generate an alert on a patient.”

APIs are used to accomplish a lot of things—from tapping external data and functionality to sharing said data and functionality among multiple applications—but it’s not often that any technology can literally be called a lifesaver. In the case of the Michigan Health Information Network, that’s exactly what APIs have become.

Tony Kontzer has written about technology and business for nearly 20 years and currently freelances from his home in the San Francisco Bay Area. Having spent the dot-com boom and bust years in Silicon Valley, he’s had a front-row seat for the evolution of the technologies that have been the foundation of IT-powered business. He has been a regular contributor to CIO Insight and Baseline Magazine since 2007. You can follow him on Twitter as @tkontzer.