Project aims to standardize social care referral process

Six vendors pledge to achieve interoperability for referral messages, leveraging the Michigan Health Information Network.


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

Six social care technology platform companies have launched an effort to work with Michigan’s health information exchange to automate the referral process using a standardized approach.

The Michigan Health Information Network recently signed an “interoperable referrals pledge” with six firms – these include CareAdvisors, Findhelp, PCE Systems, RiverStar, Unite Us and WellSky.

The initiative underscores the need to improve how social care providers manage 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 – in responding to and managing referrals for services.


“We need to ensure that social care data can be exchanged across all systems and networks, regardless of which platforms are being used.”

-Lisa Bari, CEO, Civitas Networks for Health


Companies in the Michigan project “are committed to coming together with MiHIN to form a community of practice where the interoperability of referral messages – and potentially other aspects of cross-sector data sharing – will be prioritized and worked through together,” says Lisa Nicolaou, director of MiHIN’s cross-sector data sharing program

“The vendors have committed to working with MiHIN as the state-designated HIE to exchange social care data across and within the state,” she says. “Interoperable standards, policies and a trust framework will guide how individuals on active care teams across different agencies and practices can receive and access important information about their clients.”

Although their initial focus is on implementing interoperable referral messages, the vendors have identified that “interoperability of other aspects of social care data is likely to be needed in the future as well,” Nicolaou says. “The referral is just the first step.”

Providers face challenges

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

Several commercial care platform vendors “use their funding and partnerships to provide social care organizations free access to their referral platforms and resource directories,” she notes. “These platforms work well if only one platform is working within a specific geography, across many care teams. What we’re seeing in Michigan is that there are various systems within any one community.”

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

“Civitas is interested in working with its members to develop model policy and agreements similar to the agreement reached in Michigan that other states can use,” Bari says. “The federal government can support these efforts with its convening and funding powers and authority to speed progress across the country.”

Interoperability is important in all sectors of healthcare, Bari stresses. “We need to ensure that social care data can be exchanged across all systems and networks, regardless of which platforms are being used.”

Striving for true interoperability

In the Michigan project, Nicolaou explains, participants have pledged to work toward achieving truly interoperable referrals. “That means that all care team members, regardless of technology platform, could operate in their own system of record and be able to intake a referral message from any other system and share the same meaning and context by which that referral was sent. The way this can occur is through data transmission standards.”

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

MiHIN facilitated the convening of the community of practice for the referral project, “and from here, the community of practice will guide itself,” Nicolaou says, 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 base uses cases for data exchange, along with our artificial/simulated environments where vendors can test out solutions without testing in real-life situations [providing a way to] work out the bugs in advance as much as possible.”

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