MIHIN’s ‘trailblazing’ Interoperable Referral Pledge promises future work to create a unified network ecosystem


Patrick Jones


The Michigan Health Information Network (MIHIN) recently facilitated a “trailblazing” Interoperable Referrals Pledge (the Pledge) among 6 of the state’s prominent social care companies to figure out how to create a system of interoperable referrals. Lisa Nicolaou, Cross Sector Data Sharing for Social Needs Program Director at MIHIN, said though this is a very early first step, it is a step in the right direction to build towards an equitable, interoperable infrastructure for the social determinants of health (SDOH). 

The 6 companies who signed the pledge—CareAdvisors, findhelp, PCE Systems, RiverStar, Unite Us, and WellSky—have agreed to 5 core principles to “equally commit to eliminating information silos,” MIHIN’s press release said. 


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Nicolaou said vendors in this sector encourage providers to use their siloed platforms. These siloed networks do not communicate with each other, which greatly affects providers’ ability to make and receive referrals for their patients. It also does not allow for electronic health records (EHRs) to be transferred and viewed by other providers, hospitals, or clinics that might be on a different network. These silos prevent cross-sector, agency, and community coordination. 

“The referral is just one step in bridging health and social care,” said Joanne Jarvi, Senior Director of Outreach and Market Communications at MIHIN. “It’s also the beginning step in learning what data is necessary. There are other pieces of the data puzzle to come which may include the social care snapshot, the assessment, the diagnosis, and interventions. This is a needed first step, and we are so encouraged that these large vendors who care enough about Michigan really do want to be here.”

The long-term goal of this Pledge is to establish trust among vendors to allow providers to use their health information system of choice, while being able to work in conjunction with the overall data ecosystem in the state of Michigan. This will aim to simplify data exchange in the future to allow for providers, clinics, specialists, hospitals, etc., to access importation information about a patient’s SDOH and address all of their needs. 

“Organizations should be allowed to choose a system of record that meets their internal needs, and necessary data should flow interoperably between those systems,” Nicolaou said. “Having access to information about not just the medical treatment but the realities of a person’s day to day creates appropriate care plans that meet the individual’s needs. Why would you prescribe someone insulin if you know they can’t afford it?”

The 5 core principles outlined in the Pledge are:

  1. Service providers should be able to work within their chosen system of record
  2. Consumers should have access to their own data with full transparency into who will have access to their data if they consent to a service; and service providers commit to not block electronic health information
  3. Service providers commit to the use of national standards and open APIs
  4. Service providers recognize the need for data aggregations from multiple systems to quantify demand and utilization for services to inform policy makers and ensure service quality
  5. Service providers support the state designated entity, statewide HIE, or health data utility to serve as the trusted health state exchange broker to ensure an interoperable ecosystem among the medical, public health, and social care communities 

Though a small step, MIHIN thinks the Pledge will pave the way for Michigan to better-address SDOH. 

“I feel like this community of practices stands a chance of actually moving the mark to that elusive goal of equitably addressing and funding the support of health and wellness outside the walls of traditional health care,” Nicolaou said. “But, we have to open our eyes enough to pay attention to it.”