HLN Consulting, LLC – Software and Services for Public Health

HLN Releases Roadmap for Open Source ICE Immunization Forecaster

by Noam Arzton September 18, 2017

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

Two New Reports on Interoperability

by Noam Arzton September 14, 2017

Two new reports have been released on interoperability in September 2017 with potential impact on public health. The Office of the National Coordinator for Health Information Technology (ONC) released a commissioned study, Connecting Public Health Information Systems and Health Information Exchange Organizations: Lessons from the Field. This study of former ONC Health Information Exchange (HIE) grantees focuses on their experience, best practices, and lessons learned promoting the use of HIEs for public health reporting. The report covered a number of areas, including leadership issues, technical considerations, financial issues, privacy and security, and legal and policy issues. Generally the report provides useful information and insight, though it is not clear how many actual public health agencies were interviewed (as opposed to the HIEs alone). There is also an over-emphasis on clinical documents when much of public health reporting is still leveraging HL7 v2 messages. And the discussion of CMS 90/10 funding requires a more nuanced understanding to be used effectively.

HIEs can certainly be effective partners for public health reporting and data exchange. We have studied this in the past – see the HLN White Paper, I IS and HIE: Is there a Future Together? (November 2013). This report stresses the collaborative nature of public health-HIE collaboration, which we also emphasized in our White Paper.

The National Quality Forum (NQF) recently issued A Measurement Framework to Assess Nationwide Progress Related to Interoperable Health Information Exchange to Support the National Quality Strategy: Final Report. This report is the culmination of an NQF project to understand the barriers to interoperability and develop a measurement framework to monitor its effectiveness. While there is only passing reference to public health in this final report, there is some useful insights and strategies toward measuring interoperability.

HLN Attends August ONC 2017 Technical Interoperability Forum

by Noam Arzton August 21, 2017

Last week I attended with my colleague Mike Berry the ONC 2017 Technical Interoperability Forum. This meeting was convened under the 21^st Century Cures Act passed by Congress in late 2016. Several hundred attended a series of panel presentations and discussions over one and a half days covering a variety of topics related to interoperability, including discussion of the business case for interoperability, semantics, national networks, and application programming interfaces (APIs). In many ways the speakers were “the usual suspects” involved in national networks, standards development, and HIE planning and implementation.

Nearly two years ago I wrote an essay, The Interoperability of Things, based on the collection of comments received by ONC on the draft Nationwide Interoperability Roadmap. Though I asked the new National Coordinator for Health Information Technology, Dr. Don Rucker, in a previous meeting if the Roadmap was still relevant and he said it was, there was absolutely no mention of this document at the Forum and it did not seem like the Roadmap was the operative guide for ONC activities or thinking. My own essay drew out a number of themes in interoperability I perceived at the time, including: lack of consensus on definition and scope; ambiguity over the role of HIEs, especially at the state level; disagreement over whether the pace of change was too fast or too slow, too general or too specific; and the complex state of consent and privacy laws across the country that really put a crimp in cross-state data sharing.

HLN Attends 2017 Netsmart Public Health Summit

by Noam Arzton August 3, 2017

Dr. Noam Arzt, President of HLN, attended the second annual Netsmart Public Health Summit. This meeting brought together representatives from local public health agencies who primarily use NetSmart’s public health electronic health records software. Dr. Arzt was invited to attend and he delivered a presentation on Clinical Decision Support Tools for Public Health.

New Version of HLN’s Award Winning Open Source Immunization Forecaster Released

by Noam Arzton August 1, 2017

A new release (v1.8.1.0) of the Immunization Calculation Engine (ICE) is now available. (Download ICE v arzt1.8.2.0). 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:

Updates to the Polio Vaccine Group and the Meningococcal ACWY Vaccine Group to better reflect latest guidelines, and addition of Influenza vaccine (CVX 185 and 186) to the Influenza Vaccine Group.
Combines PCV and PPSV vaccine groups into one, new vaccine group for Pneumococcal. This change was made to better account for shots administered across the patient’s lifetime. (To support this new Pneumococcal vaccine group, implementers may need to make adjustments to stop looking for the old PCV and PPSV vaccine group codes (700 and 720), and start looking for the new vaccine group code (750). Child and adult pneumococcal vaccinations are now evaluated and forecast under this new vaccine group. The PCV and PPSV vaccine groups are no longer supported.)
Release notes which describe the above changes to the vaccine group logic in more detail.

Implementers should refer to the new ICE Implementation Guide (v2r15) when making adjustments to be compatible with this latest release, including the new Pneumococcal vaccine group as well as a few other vaccine and evaluation reason codes that have been added. (A “track changes” version of the guide is also available to make it easy to see what has changed since the last release.)

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 ice@hln.com if you have any questions.

See press release.