The project aims to standardize the referral process to social services

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Six vendors are committed to interoperability of referral messages, leveraging the Michigan Health Information Network.


Social challenges: HIEs across the country are also working on social care data sharing initiatives, says Lisa Bari, CEO of Civitas Networks for Health.

Six social care technology platform companies have launched an effort to work with the Michigan Health Information Exchange to automate the referral process using a standardized approach.

The Michigan Health Information Network recently signed an “Interoperable Reference Commitment” with six companies, including CareAdvisors, Findhelp, PCE Systems, RiverStar, Unite Us and WellSky.

The initiative highlights the need to improve the way social care providers handle referrals for services. Currently, these providers use a wide variety of methods – ranging from phone calls and faxes to web forms and electronic submissions within closed networks – to respond to and manage service requests.


“We need to ensure that social care data can be exchanged between all systems and networks, regardless of the platforms used.”

-Lisa Bari, CEO, Civitas Networks for Health


The Michigan project companies “committed to coming together with MiHIN to form a community of practice where referral message interoperability — and potentially other aspects of cross-industry data sharing — will be prioritized and worked on together,” says Lisa Nicolaou, MiHIN Cross-Sector Data Sharing Program Manager

“The providers have committed to working with MiHIN as the state’s designated HIE to exchange social care data across and within the state,” she says. “Interoperable standards, policies, and a trust framework will guide how members of acute care teams from different agencies and practices can receive and access important information about their clients.”

Although their initial goal was to implement interoperable referral messages, vendors have identified that “interoperability of other aspects of social care data will likely be required in the future as well,” says Nicolaou. “Reference is just the first step.”

Suppliers face challenges

Many social service providers operate with limited technology infrastructure, and they lack the capacity and funding to integrate systems into workflow processes, says Nicolaou.

Several commercial care platform providers “use their funding and partnerships to provide social care organizations with free access to their referral platforms and resource directories,” she notes. “These platforms work well if only one platform works in a specific geographic area, across many care teams. What we see in Michigan is that there are different systems within the same community.

And that’s why the interoperable referral project is so important, she says. Other HIEs across the country are also working on social care data sharing initiatives, says Lisa Bari, CEO of Civitas Networks for Health, a national organization that supports health information exchange.

“Civitas wants to work with its members to develop a model policy and agreements similar to the Michigan agreement that other states can use,” Bari said. “The federal government can support these efforts through its mobilizing and funding powers and its authority to accelerate progress across the country.”

Interoperability is important in all healthcare sectors, Bari points out. “We need to ensure that social care data can be exchanged between all systems and networks, regardless of the platforms used.”

In search of true interoperability

In the Michigan project, Nicolaou explains, participants have committed to working toward truly interoperable cross-references. “This means that all members of the care team, regardless of technology platform, could operate within their own system of record and be able to receive a referral message from any other system and to share the same meaning and context by which this reference was sent. The way this can happen is through data transmission standards.

Vendors have committed to using national standards, including HL7, FHIR (Fast Healthcare Interoperability Resources), and open APIs.

The MiHIN facilitated the convening of the community of practice for the referral project, “and from there the community of practice will guide itself,” said Nicolaou, with the HIE providing the platform for data exchange.

“MiHIN will offer to contribute to the community of practice our expertise, our core functionalities and our basic use cases for data exchange, as well as our artificial / simulated environments where suppliers can test solutions without testing in real situations. [providing a way to] resolve bugs in advance as much as possible.

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