Heath Information Technology Commission Report - Fy2010 Appropriation Bill - Michigan Department Of Community Health Page 86
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876.3 Alternative Technology Approaches Considered
The MiHIN is being designed with sub-state HIEs which provide “last mile” connectivity to
providers and State of Michigan systems that are connected to the shared services bus for
cross community interoperability and NHIN connectivity. This design is not the least expensive
nor is it the most technologically advanced but we believe it represents the best, most viable
short term architecture with the most sustainable long term benefits.
We reviewed the following architectural models and recommendations were reviewed and not
pursued for the reasons noted below:
Single HIE
1. This model has one HIE for the entire state and all provider organizations plug into this
HIE
2. Used successfully in small states (Vermont, Delaware, etc)
3. Not recommended for Michigan due to the number and scope of providers and because
there are already HIEs in progress
Single HIE Vendor for all State HIEs
1. Single HIE vendor that provides HIEs for regions and then provides a custom gateway
between HIEs
2. Not the primary model in any state and only one vendor is doing this
3. Could be less costly but not recommended due to the proprietary nature of the gateway
and long term interoperability
HIEs playing the role of both HIE and Shared Services Bus
1. Each HIE builds the infrastructure for connecting organizations as well as the cross-HIE
capabilities as a shared services bus
2. This is the model being developed in New York and possibly California
3. Creates a highly interoperable and flexible network
4. Not recommended due to cost and complexity
Shared Services Bus with Stakeholder Organizations plugged in directly
1. This is a Shared Services Bus with only standards compliant EHRs and other clinical
systems allowed to connect
2. This is the Minnesota model
3. Depends on vendor EHR systems becoming fully standards compliant or organizations
standing up the middleware (akin to our Private HIE)
4. Can be cost effective but vendors have made very slow progress towards being
standards compliant
5. We are recommending this as part of our approach
Shared Services Bus with multiple HIEs
1. The HIE connects organizations and the Shared Services Bus connects HIEs
2. The closest model is in Virginia but many states considering
3. Creates a highly interoperable network but requires a middle layer to be developed for
shared services bus connectivity
4. Keeps standards at the core and pushes non-standards to the edges
MiHIN Strategic Plan
Page 80
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