
About MiHIN
The Michigan Health Information Network Shared Services (MiHIN) is Michigan’s statewide entity that enables health information data exchange across Michigan. By providing the infrastructure that facilitates data sharing between hospitals, physicians, pharmacies, and public health agencies, MiHIN plays a crucial role in improving care coordination, patient outcomes, and data security.
Since 2019, MiHIN has collaborated with Augusto Digital to develop critical interoperability solutions. Through this partnership, Augusto has helped MiHIN build scalable, innovative technology that addresses the complexities of healthcare data exchange.
The Challenge
Healthcare interoperability remains a significant challenge in the industry. MiHIN needed to create solutions that would:
Facilitate secure and seamless data exchange across healthcare organizations
Comply with evolving federal and state regulations on data access and security
Support healthcare stakeholders in testing, developing, and improving their data-sharing capabilities
MiHIN sought a trusted technology partner who could provide the agility, expertise, and strategic guidance necessary to implement complex digital solutions. That partner was Augusto Digital.
Why MiHIN Chose Augusto
MiHIN selected Augusto for their deep healthcare expertise, strategic approach, and ability to collaborate as an extension of MiHIN’s internal team.
“They have a lot of healthcare experience, and not everybody does. That’s pretty important. And they’ve got some good, repeatable methodologies to jump right in and complete projects,” said Timothy Pletcher, Executive Director of MiHIN.
Augusto’s flexibility allowed MiHIN to structure projects in a way that balanced internal development efforts with external support. This ensured they could scale solutions effectively while maintaining control over key initiatives.
Augusto’s Solutions
Over several years, Augusto partnered with MiHIN on multiple initiatives, including:
Interoperability Land® – Healthcare Data Sandbox
One of the key initiatives Augusto supported was the development of Interoperability Land, a persistent sandbox environment designed to allow healthcare organizations to test and practice data sharing safely.
MiHIN had identified that many organizations wanted to share data, but hesitated due to privacy and security concerns. To bridge this gap, Interoperability Land provided a realistic, synthetic, FHIR-based dataset, allowing stakeholders to experiment with data exchange in a risk-free environment.
“The goal behind Interoperability Land was to create a persistent sandbox that would allow people to kick the tires on all this interaction,” said Tim Pletcher, CEO of MiHIN. “Augusto helped us build the initial prototypes to get this system off the ground.”
IO Station – Developer API Portal
IO Station was another crucial project in which Augusto played a pivotal role. With the introduction of federal regulations by the Centers for Medicare & Medicaid Services (CMS) requiring health plans to provide patient access to data via APIs, MiHIN needed a solution that would allow developers to build and test applications connected to health plan data.
Augusto leveraged its previous work on Interoperability Land to help create IO Station, a developer portal that allows application builders to test their tools in compliance with federal requirements. Today, IO Station is used by major health plans across Michigan and beyond to ensure they meet consumer data access regulations.
“The work that Augusto did helped ensure that our customers, including major Medicaid and private insurers, could stay compliant with federal rules,” said Tim Pletcher. “Millions and millions of patient records are now accessible through this system.”
Active Care Relationship Service ® (ACRS®) 2.0 – Patient-Provider Mapping
One of the biggest challenges in healthcare today is fragmentation— patients see multiple providers, but those providers don’t always have access to the same data. The Active Care Relationship Service (ACRS) was designed to solve this problem by mapping out patient-provider relationships and ensuring that data access is only granted to those with an active relationship with a patient.
Augusto worked with MiHIN to implement ACRS 2.0 using graph database technology (AWS Neptune). This allows MiHIN to efficiently manage and query millions of patient-provider relationships.
“ACRS is really the backbone of everything we do,” said Tim Pletcher. “It enables us to route information to the right places securely and efficiently. Augusto played a big role in helping us build an infrastructure that could scale—going from 8 - 9 million relationships to over 50 million today.”
Agile Transformation – Software Development Coaching
Beyond software product development, MiHIN also engaged Augusto to help shift its project management approach from traditional waterfall to Agile methodologies.
Augusto provided Agile coaching, helped configure JIRA workflows, and trained MiHIN’s teams on best practices for running Agile sprints. Over time, MiHIN transitioned from having a single software development team to operating five Agile development teams, delivering new solutions more efficiently than ever before.
“The guidance from Augusto helped us build out our Agile processes and create a sustainable development model,” said Tim Pletcher. “We’re now well into our 18th or 20th program increment cycle and operating at a much higher level.”
The Results
The partnership between MiHIN and Augusto Digital has driven measurable impact across multiple dimensions:
✔ Global Adoption: Over 1,800 users worldwide have engaged with MELD (formerly Interoperability Land) to test and refine healthcare interoperability solutions.
✔ Regulatory Compliance: IO Station has enabled large health plans in Michigan and other states to meet federal CMS interoperability requirements.
✔ Scalability: The Active Care Relationship Service now tracks 50+ million patient-provider relationships, up from 8 - 9 million previously, improving care coordination across the state.
✔ Agile Efficiency: MiHIN expanded from one software development team to five fully Agile teams, significantly improving project velocity and alignment.
Why Others Should Work with Augusto
MiHIN’s experience with Augusto demonstrates the value of working with a technology partner who truly understands healthcare.
“Augusto doesn’t just build software—they help shape strategy and execution,” said Tim Pletcher. “They understand our long-term vision and work alongside us to make it happen.”
Their deep expertise, repeatable methodologies, and ability to collaborate with internal teams make them ideal partners for organizations tackling complex healthcare interoperability challenges.
As MiHIN continues to lead the way in health information exchange, its partnership with Augusto remains critical to future innovations in data sharing, security, and patient-centered solutions.

"The work that Augusto did helped ensure that our customers, including major Medicaid and private insurers, could stay compliant with federal rules. Millions and millions of patient records are now accessible through this system.”
Tim Pletcher
Chief Operating Officer
Michigan Health Information Network
Healthcare Interoperability is Hard - Let’s Make It Easier. From strategy to scalable systems, Augusto helps healthcare organizations like MiHIN deliver solutions that meet today’s challenges—and tomorrow’s. Let’s talk.

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