Mississippi Health Information Network (MS-HIN)
The shortfalls of documenting health care services in paper medical records were realized broadly after Hurricane Katrina hit the gulf coast in 2005. Mississippi has since enacted policies to promote electronic health information exchange (HIE). In 2010, the Mississippi Health Information Network (MS-HIN) was authorized by law as the state entity to coordinate a statewide HIE.
MS-HIN is up for reauthorization by state policymakers in 2019. The Center for Mississippi Health Policy has prepared an Issue Brief that outlines the history of MS-HIN, describes its current status, and discusses administrative and policy strategies used in Mississippi and other states to promote the development of a mature statewide HIE.
MS-HIN facilitates the secure exchange of electronic clinical information within its network that enables provider access to patient health records at any location. Participating providers can be informed in real-time if a patient is admitted into an emergency department or another healthcare setting. Participants may also obtain other details not available in an electronic health record, such as prescriptions filled or lab results.
MS-HIN is an independent organization that serves a diverse set of stakeholders. It is governed by an 11-member board of directors who represent public and private healthcare organizations. Administrative support is provided by the State Department of Health.
To date, most of the participating health care providers are hospitals and large health systems. Plans are in place to add reference laboratories, pharmacies, third-party payors, and other providers and organizations that are depicted in the following figure:
Source: MS-HIN. (2018).
While participation has grown over the past decade, MS-HIN has not reached the critical mass necessary to be of enough value to some stakeholders. Broader stakeholder participation is crucial to reaching sustainability.
MS-HIN had a strong start, bolstered by outside funding that enabled the state to launch the effort with a sound structure and growth in initial participation. The Network has established itself as a proof of concept for health information exchange. While MS-HIN has experienced increased funding from participation fees, it is not yet self-sustaining from those fees alone. For the Network to realize its potential, more health care providers need to participate. Provider participation is needed not only to supply revenue but also to expand the volume of medical data available to its participating providers. Lack of seamless integration into provider workflow and incomplete stakeholder participation are barriers to the system’s reaching its full potential value. These barriers prevent the system from achieving a critical mass of statewide participation and threaten its path to financial sustainability.
To reach sustainability, increased participation can be driven through incentives, workflow support, mandates, marketing, or some mixture of these approaches. Multiple states have worked administratively to encourage participation by offering technical assistance, strategically structuring participation fees, and fostering dialogue with providers to build trust. Several states utilized legislative policy to address sustainability barriers. Some states mandated participation while others offered financial incentives such as waiving of certain fees in exchange for network participation. A few states provided grants to areas of need or to entities not otherwise able to afford to join the network. Every state HIN has different requirements and different needs, but state HINs strike a similar chord when implementing administrative and legislative policies to further the goals of creating efficiencies in data exchange and improving patient care.