Noam Arzt, president of HLN, has published a new article, “Why Cloud-Based Public Health Solutions are a Good Option for Clinical Decision Support” in OpenHealthNews. Cloud computing is one of the most powerful technology deployment strategies in use today. In this article Dr. Arzt examines some of the key reasons to host public health clinical decision support (CDS) solutions in the cloud. The article goes on to explain the difference between cloud computing and traditional computing. It then goes on to define Clinical Decision Support for Immunizations, or CDSi, and HLN’s Open Source Immunization Calculation Engine (ICE) and related tools and utilities. Finally, the article concludes with a discussion of how externally hosted services may provide some distinct advantages for organizations that deploy CDS tools such as these.
A new release (v 184.108.40.206) of the Immunization Calculation Engine (ICE) is now available (download ICE v 220.127.116.11). ICE is a state-of-the-art open-source software system that provides clinical decision support for immunizations (CDSi) for use in Immunization Information Systems (IIS), Electronic Health Record (EHR) and Personal Health Record (PHR) Systems.
The release includes the following changes:
- Added support for Meningococcal B.
- Support for Meningococcal B has been added as a new vaccine group, separate from the existing Meningococcal ACWY vaccine group. Meningococcal ACWY will continue to be returned as its own vaccine group.
- Implementers may need to modify their software to start looking for the new Meningococcal B vaccine group code (835).
- Logic fixes for HPV and Hep B vaccine groups.
- Addition of non-U.S. vaccine DTaP-IPV-Hib (CVX 170)
- Release notes that describe the latest changes in more detail
Please refer to the updated ICE Implementation Guide (v2r17) for information on how to make the appropriate adjustments to your software to be compatible with this release. The guide provides details about the new Meningococcal B vaccine group implementation as well as a few other vaccines and reason codes that have been added. In addition, a “tracked changes version” of this same guide is also available. The tracked changes are intended to make it easier to see what has changed since the prior release (v 18.104.22.168).
You can determine which release of ICE you are using by viewing the README.HISTORY file that is included with each distribution.
Please feel free to e-mail us at firstname.lastname@example.org if you have any questions.
On October 3, 2017 Noam Arzt and Daryl Chertcoff from HLN attended the Patient Centered Clinical Decision Support Learning Network (PCCDS-LN) 2017 Annual Conference in Crystal City, VA. HLN was also a Bronze-level Sponsor of this event, which brought together clincians, informaticists, and health policy advocates to discuss current trends in clinical decision support leveraging information from Patient Centered Outcomes Research (PCOR) findings and patient-specific information. The conference featured national experts in CDS and patient-centered research in the morning, and a participative set of breakout sessions in the afternoon developing an idealized design of the patient-centered CDS process through four different perspectives.
Must of this conference focused on patient-centered CDS. But it seems that this term absorbs a number of somewhat different concepts and is used by different people to mean different things. “Patient centered” to some people means “patient-facing” – that is, it refers to an application (in this case a CDS-enabled application) that is used or accessed by a patient directly. To others, patient-centered is synonymous with “patient-empowered” which implies support for more patient control of his or her care and records. Many uses of CDS support do not directly involve patients in real time while still impacting patients and their care.
For HLN’s work in clinical decision support, this conference presented a number of useful themes and raised a number of important issues. While there was a lot of focus at this conference on user interface, it is important for HLN to maintain its focus on the back-end services we are developing (like our ICE Open Source Immunization Forecaster). But it is equally important that we continue to develop a rich set of application programming interfaces (APIs) to our services, including our traditional SOAP-based Web Services, supplemented by various RESTful services (including FHIR, SMART, and CDS Hooks). And all of this work should support and use accepted standards embraced by the healthcare industry.
In September 2017 GAO released a new report, Public Health Information Technology: HHS Has Made Little Progress toward Implementing Enhanced Situational Awareness Network Capabilities. In particular, GAO pointed out lapses in completing Congressionally-mandated requirements for this area including the definition of minimal data elements required and collaboration with state, local, and tribal public health officials on the development of standards and procedures to ensure proper data collection. In addition, the GAO chided HHS for not following its own information technology project management methodology in the planning and execution of this project.
Situational awareness has been a conspicuous topic ever since the 9/11 attacks and the anthrax scare that followed shortly thereafter. But since the initial flurry of public health preparedness funds in the ensuing several years this topic has not had a high priority at CDC nor the funding necessary to implement it successfully. Perhaps this report will serve as a catalyst for the new administration to provide the funding and leadership to fulfill Congress’ intentions in this area.
HLN has released a product Roadmap for its award winning Immunization Calculation Engine (ICE). ICE is an open source service-oriented, standards-based immunization forecasting software system that evaluates a patient’s immunization history and generates the appropriate immunization recommendations. The Roadmap describes modifications that have already been scheduled for inclusion in new releases of ICE in the near future, in addition to ongoing changes that may be required to maintain compliance with Advisory Committee on Immunization Practices (ACIP) recommendations. Addition of new vaccine schedules, changes to core business logic, and additional functionality are all included on the Roadmap. As additional modifications are scheduled they will be published on the Roadmap as well. HLN hopes this information will help clinical organizations seeking to use ICE in their practices and software vendors seeking to incorporate ICE into their products to plan for new feature availability.
ICE provides state-of-the-art clinical decision support for immunizations (CDSi). ICE can be used in Immunization Information Systems (IIS), Electronic Health Records (EHR), Health Information Exchanges (HIEs), and Personal Health Record (PHR) Systems.
See Press Release