The Interface

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MiHIN, TEFCA, and QHINs: Your Questions Answered

As the national framework for health data exchange continues to evolve, MiHIN is taking important steps to ensure our network is well-positioned with TEFCA (Trusted Exchange Framework and Common Agreement). We know that QHIN (Qualified Health Information Network) decisions can feel complex, and we want to provide clarity about MiHIN’s current role, what it means for our participants, and how we are working to minimize any challenges along the way.

Q&A: MiHIN’s QHIN and TEFCA Participation

Does MiHIN plan to connect to TEFCA as a QHIN?
No. MiHIN will not become a QHIN. Instead, MiHIN is participating in TEFCA as a Participant through a connection with eHealth Exchange (eHX), which serves as the QHIN. MiHIN will connect organizations in our network as sub-participants through eHX.

What if my organization plans to use my EMR as our TEFCA QHIN?
This situation creates some technical and policy challenges. It is important to note that sub-participants have the discretion to choose which use cases they engage in with their QHIN; not all use cases are required to route through the QHIN. Currently, MiHIN does not have an EMR or organizational “flag” in our environment to distinguish data received from one EMR or another. MiHIN is working to create this flag to support filtering of TEFCA queries, allowing for the exclusion of sub-participant data for those who have chosen to use their EMR’s QHIN for each use case.

What risks exist if we use our EMR for TEFCA and MiHIN for other HIE services?

• Partial Data Visibility: Organizations that do not query MiHIN’s QHIN (eHX) or MiHIN directly may miss data that MiHIN aggregates from across the state.
• Patient-Matching Discrepancies: Divergent patient-matching logic between QHINs can lead to incomplete or inaccurate record pulls, impacting clinical decisions.
• Workflow Conflicts: Staff may encounter friction or confusion when navigating data from multiple QHIN sources.
• Loss of Local Context: Clinical staff will need education on what data will be coming from MiHIN and what will be coming from their QHIN.

What documentation is needed to avoid unintended overlap?
MiHIN will ask participating organizations to confirm their understanding of MiHIN’s TEFCA role, acknowledge the risks associated with participating in a separate QHIN, and accept responsibility for any potential overlap or data sharing conflicts until a technical solution is available. In some cases, this may require updates to agreements with MiHIN.

Looking Ahead
MiHIN is actively developing solutions to help distinguish participants and reduce the possibility of overlap between QHIN connections. We are also raising these issues directly with the State of Michigan to ensure alignment at the state level. Our focus remains on supporting our network, maintaining reliable and seamless data exchange, and ensuring that patients and providers benefit from the strongest possible access to health information.

If you have questions about MiHIN’s TEFCA and QHIN participation or how this may impact your organization, please reach out to MiHIN’s Chief Operating Officer, Jaki Porter, at jaki.porter@mihin.org.

August 2025 Highlights

 MiHIN Attending MI HIMSS

MiHIN is proud to attend the HIMSS Michigan Chapter 2025 Fall Conference from September 8-9 in Novi, MI.

At a time when interoperability and innovation are shaping the future of care, MiHIN is excited to connect with healthcare professionals, thought leaders, and innovators at this year’s MI HIMSS conference. Our team is looking forward to exchanging ideas and exploring how information and technology are reshaping care delivery across Michigan and beyond.

Join MiHIN's Isabell Pacheco on September 8th from 1:00PM-4:00PM while she speaks at the Physician Organization Learning Session, and September 9th at 11:15AM at the Connected for Michigan: Building the State's Health Data Future Together session to learn more about MiHIN's recent activities!

Coming Soon: ACRS® CareLink in MIGateway®

MiHIN is excited to introduce ACRS CareLink, a new enhancement to MIGateway’s Patient Viewer module. With this update, users will be able to search for patients across MiHIN’s Master Patient Index—not just within their own ACRS populations— and quickly establish provider-patient relationships to access longitudinal records. This enhancement will be live in production soon, so please watch for upcoming MiHIN communications with more details.

Faster Resolutions Start Here: Help Desk Update

To improve response times, MiHIN has updated the automated message sent when externals submit a Help Desk ticket. The new message now prompts submitters to include key details—such as their name, email, organization, and a clear description of the issue—right from the start. By providing this information upfront, our Customer Service team can resolve tickets more quickly, reduce back-and-forth communication, and deliver faster support.

MiHIN Responds to CMS Health Tech Ecosystem Initiative with Strategic Optimism and Renewed Commitment to Community-Based Interoperability

The Centers for Medicare & Medicaid Services (CMS) announced a bold new vision for a more connected and patient-centered healthcare system. The Health Tech Ecosystem and Interoperability Framework has already gained support from national health data networks, major technology companies, and interoperability platforms.

MiHIN welcomes this vision as both a validation of our work and a challenge to step forward with even greater clarity and will continue to evaluate opportunities and value-added partnerships to align with the CMS initiative as implementation details emerge.

Conferences the MiHIN Team Will Be At