Public Health in a Starring Role: The Michigan Capital Area Regional Health Information Exchange

Communities in Charge

Field of Work: Helping community coalitions design and establish sustainable health care delivery systems.

Problem Synopsis: In 1998, 44.5 million people in America did not have health insurance, according to the federal Health Resources and Services Administration (HRSA). In the absence of comprehensive federal efforts to expand health coverage, the burden of caring for uninsured individuals falls on states and local communities. Often, local health care systems are not organized to promote prevention and early intervention, coordinate care and services or monitor access to and quality of care. When people do not receive the care they need, the costs are borne by providers, local governments and, ultimately, local taxpayers.

Synopsis of the Work: In July 1997, the Board of Directors of the Robert Wood Johnson Foundation (RWJF) authorized $16.8 million to support Communities in Charge: Financing and Delivering Health Care to the Uninsured (CIC). CIC was designed to help broad-based community coalitions design and establish sustainable health care delivery systems. In 2004, a coalition of business and health care stakeholders—the Capital Area Health Alliance—began exploring the feasibility of establishing a health information exchange in a three-county region near Lansing, the capital of Michigan. In January 2005, the alliance's board of directors decided to develop the Capitol Area Regional Health Information Organization (CARHIO).

The alliance recognized the benefits of including public health in CARHIO's design and operations, and the Ingham County Health Department was a key participant. When Ingham County received an InformationLinks grant under CIC from the Robert Wood Johnson Foundation (RWJF) in early 2006, the major stakeholders were ready to explore and define the business case for incorporating public health into CARHIO.

Key Results: the Ingham County Health Department assembled a Public Health Task Force as one of five committees that directed CARHIO's development. The Public Health Task Force met six times between March and September 2006, drawing on guidance from the Public Health Informatics Institute, the technical assistance provider to all of the InformationLinks grantees.