We recently sat down with Interop Hero, Krystal Schramm, Senior Technical Business Analyst at Michigan Health Information Network (MiHIN) Shared Services. During the conversation, we were thrilled to hear about her work with local native communities, and how she and her team are working to close gaps in tribal healthcare.

MiHIN is Michigan’s statewide Health Information Network that securely connects care teams, hospitals, pharmacies, health insurance providers, and public health organizations to support local communities. Krystal works closely with organizations to make sure they are giving MiHIN the correct data. Specifically, she focuses on tribal health, where she partners with tribal clinics and native communities to improve processes and patient care.

As a native herself, this initiative is especially important to Krystal. Soon after she started working at MiHIN, she noticed a gap in the tribal clinic data. Michigan hospitals were not receiving patient information from the local tribal community members who attend tribal clinics.

She began reaching out to tribes as a way to establish trust and build relationships, and because Krystal shares their heritage, she was able to do so right away. There was a mutual understanding that Krystal wanted to help improve their relationship with the healthcare system. In her meetings with tribal stakeholders, Krystal explained health improvement opportunities, starting with immunizations, and then focusing on referrals, and admission, discharge, and transfer notifications.

We were curious how Social Determinants of Health (SDoH) affect Krystal’s work. After all, it’s clear that this population was being underserved and underrepresented in healthcare. Three of the biggest factors affecting their SDoH include the rural environment, the community’s increased risk for diabetes, and the shorter life expectancy for native people, in comparison to other populations. The SDoH impacting tribal communities make solving data disparities even more important.

Krystal moved on to tell us the key lessons she learned from her body of work. First, that every tribe is different. There are more than 500 individual tribes in the United States, and each have their own unique needs, so, no solution can be a one-size-fits-all. She contacts each tribe with the goal of understanding their approach to healthcare: what is working and what is not. From there, she and the stakeholders come up with a plan together. She learned that tribal clinics often lack resources, staffing, and technical knowledge, which makes it difficult to work on and improve health IT capabilities.

Krystal credits the program’s success to her empathetic approach. She says it has been crucial to create relationships, bridge gaps, and get the native population up to speed from a healthcare and health IT perspective.

She shared that one especially exciting milestone was when MiHIN started working closely with the Michigan Tribal Health Board. Tribal Health Directors from each of the 12 Michigan clinics hold quarterly sessions to discuss healthcare-related topics. Krystal and her team recently presented at one of those sessions, and they’re planning to present on a regular basis. MiHIN has helped these tribal representatives recognize that they deserve a seat at the table. Starting the conversation is just the first step, Krystal shared, but often times the most significant.

Krystal has already experienced success in her tribal outreach, and we are excited to hear what she has planned for the future. She says she would like to take what they are doing in the state of Michigan and expand the efforts regionally — and eventually nationally. She recognizes it isn’t something that will happen overnight, but she’s determined to see this program flourish into more areas.

To close, Krystal shared her overarching words of wisdom: She encourages the health IT community to think how they can help the greater good. Specifically, how to bring population health, SDoH, and all the other components of the healthcare system together in a way that moves interoperability forward.

“How can we bring the different pieces together…to where we’re just constantly moving forward? And even if we take a step back, that’s okay. Learn from that, look at what we did well, and continue to move forward.”

It’s through this lens that Krystal believes we’ll build a successful approach to interoperability that benefits everyone.

Thank you to Krystal Schramm of MiHIN for sharing your experience and perspective with us!

Learn more about the Interoperability Hero Initiative and check out our Q3 2022 class of Interop Heroes!

This post was contributed by Alyssa Foggia-Hamm.