HLN Consulting, LLC – Innovators in Public Health Informatics

CMS IPPS Final Rule: A Public Health Perspective

by Noam Arzton August 17, 2018

On August 2, 2018 the Centers for Medicare and Medicaid Services (CMS) released the 2019 Inpatient Prospective Payment System Final Rule to Quality Payment Program. We earlier released thoughts on the Proposed Rule as well as our formal comments.

The Final Rule affirmed most of CMS’ proposed changes, with some notable exceptions:

Required public health measures were reduced from three (Stage 3 requirement) to just two, but Syndromic Surveillance will not be a requirement for hospitals covered under the rule.
While CMS continued to be unclear about its plans for the removal of public health measures altogether for CY2022 and beyond, they did express some openness to consider continuing public health measures and to study the issue over the next few years.

It is clear from the comments discussed in the final rule that comments submitted supporting public health requirements were received, noted, and had a positive impact on the final rule. Kudos to public health advocates for their strong voice!

Noam Arzt awarded AIRA 2018 Volunteer Service Award

by Noam Arzton August 17, 2018

On August 15, 2018 Dr. Noam Arzt, President of HLN, was awarded the 2018 Volunteer Service Award by the American Immunization Registry Association (AIRA).

In her presentation, Rebecca Coyle, Executive Director of AIRA, said that, “Noam Arzt has been nominated and selected for this award for his service as an AIRA volunteer in the IIS community. Since AIRA’s founding in 2012, he has served on 14 committees or workgroups, including the Technical committee, the Urban/Cities Committee, and the Data Exchange Steering Committee and currently serves o the SISC, ESC, and JDI Advisory Workgroup. Noam’s passion and commitment to the IIS community and to public health are also reflected in the open source release of Immunization Calculation Engine (ICE) and a data quality tool developed by HLN.”

HLN releases Version 1.14.1 of its Award Winning Open Source Immunization Forecaster

by Noam Arzton August 12, 2018

On August 10, 2018, HLN released a new version (v1.14.1) of the Immunization Calculation Engine (ICE). ICE is a state-of-the-art open-source software system that provides clinical decision support for immunizations for use in Immunization Information Systems (IIS), Electronic Health Record (EHR) and Personal Health Record (PHR) Systems.

The release completes support for Earliest Date and Overdue Date for all vaccine series in ICE’s default schedule. If enabled, ICE will output two additional forecast dates along with the Recommendation Date: the Earliest Date and Overdue Date. The Earliest Date is the soonest date that the vaccine can be given and still be considered valid. The Overdue Date is the date after which an immunization administered would be considered late. Completing support for Earliest Date/Overdue Date is an important milestone for ICE. HLN will be presenting this new version this week at the annual meeting of the American Immunization Registry Association (AIRA) and week of August 20 at the CDC Public Health Informatics Conference.

The latest ICE Implementation Guide (v2r20) describes how implementers should update their installation and software to properly read the Earliest, Recommended, and Overdue dates. The relevant information starts on page 43. Note that a “track changes” version of this same guide is also available. The tracked changes are intended to make it easier for the reader to see what has changed in the Guide since the prior release of the ICE Implementation Guide (v2r18).

The full software release is available for download at https://cdsframework.atlassian.net/wiki/display/ICE/Downloads.

Preliminary Thoughts on CMS MIPS IP NPRM: A Public Health Perspective

by Noam Arzton July 31, 2018

Well, here we go again.

The Centers for Medicare and Medicaid Services (CMS) has now released a new Notice of Proposed Rulemaking (NPRM), titled Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program. The purpose of this NPRM is to address proposed changes for Year 3 of MIPS, the provider (as opposed to hospital) side of the Quality Payment Program. The part that is most relevant to public health is the Medicaid Promoting Interoperability (IP) Program for Eligible Professionals (EP)” (the EHR Incentive Programs have been renamed). A major goal of this NPRM is to synchronize as much as possible the EP program with the hospital-based program that was addressed in a previous NPRM just a few months ago.

HLN Presenting at Upcoming Healthcare Meetings

by Noam Arzton July 16, 2018

Over the next several months HLN will be attending a number of important healthcare and public health meetings and events and presenting our work and perspectives. Events and presentations include:

2018 OSEHRA Open Source Summit (July 18-20): HLN will be joining colleagues on the Immunization Working Group for an update of the groups activities, including an update about HLN’s ICE Open Source Immunization Evaluation and Forecasting System (7/18, Afternoon Session II, 2:30pm ET).

American Immunization Registry Association (AIRA) 2018 National Meeting (August 14-16): As a gold sponsor of the meeting, HLN shows its strong commitment to the Immunization Information System (IIS) community. We will deliver several presentations during this conference, including:

Strategies for Evaluating and Integrating SmartyStreets [with RI] (Session 1B, 8/14, 1pm MT)
IIS Platform or Module Migration – Is Your Program Prepared? [with CDC, AIRA & PHII] (Session 2B, 8/14, 2:30pm MT)
CAIR2 Patient Matching: Solving the 25 Million Piece Puzzle [with CA] Sessin 3A, 8/15, 9:15am MT)
IIS Past, Present, and Future: A Conversation and a Discussion [with PHII] (Session 4E, 8/15, 11am MT)
Comparative Analysis of AFIX-IIS Tools [with CA] (Session 5D, 8/15, 1pm MT)
Cloud-Based Solutions: A Good Option for Hosting CDS for Immunizations (Session 5D, 8/15, 1pm MT)
Vaccines For Children (VFC)-IIS Integration Strategy [with CA] (Session 6E, 8/15, 2pm MT)
ICE: An Open Source Option for Immunization Forecasting (Session 7D, 8/16, 11am MT)
Hearing from Everyone: Diverse Perspectives to Improve Oregon School Immunization Reporting [with OR] (Session 8C, 8/16, 9:45am MT)

HLN will also have an exhibitor booth at the meeting.

2018 Public Health Informatics (PHI) Conference (August 19-23): HLN will have an even greater presence at this bi-annual CDC-sponsored conference including delivery of the following presentations:

Case Study for Cloud Computing Solutions in Public Health: Clinical Decision Support (Session E03, 8/21, 4:15pm ET)
Reportable Conditions Knowledge Management System (RCKMS): Developing Quality Decision Support in the Data Supply Chain for Public Health Surveillance [with CSTE] Session B01, 8/21, 10:30am ET)
A Collaborative Approach to Supporting Information System Migration Projects [with CDC, AIRA, & PHII] (Session G01, 8/22, 1:30pm ET)
Clinical Decision Support for Immunizations as a Community-drive, Standards-based Activity [with CDC & NYC] (Session H04, 8/22, 3pm ET)
Developing a Data Integration and Management System: Improving New York City’s Population Health Research and Surveillance [with NYC] (Session H07, 8/22, 3pm ET)
The Changing Face of Interoperability and its Impact on Public Health (Session K11, 8/23, 9:15am ET)

In addition to being an exhibitor at the conference, HLN will demonstrate some of its Open Source software as part of a HIMSS Interoperability Showcase that accompanies this event:

Immunization Use Case – ICE Immunization Evaluation and Forecasting System
Electronic Case Reporting Use Case – Reportable Conditions Knowledge Management System (RCKMS)

Health Level 7 (HL7) 32^nd Annual Plenary and Working Group Meeting (9/29-10/5): HLN will attend this important gathering, including demonstrating our Open Source products at the FHIR Connectathon that takes place in conjunction with the meeting.