On April 17, 2019 the Office of the National Coordinator for Health Information Technology (ONC) released the second draft of its Trusted Exchange Framework and Common Agreement (TEFCA) for comment. The initial version was released more than a year ago in January 2018 (see my original blog). As before, this is in response to a requirement imposed by Congress in the 21st Century Cures Act. After a somewhat lengthy (but well written) introduction, the document contains three parts (compared to just two parts the first time around):
HLN participated in the 2019 California Immunization Coalition Summit held on April 8-9. 2019 in Riverside, CA. For over twelve years, the CIC Summit has brought together partners and colleagues from throughout California and beyond to share ideas, highlight successes, and identify partnerships.
This year HLN’s president, Dr. Noam Arzt, delivered two talks during breakout sessions at the summit:
- A Brief History of Immunization Information Systems in the US and California
- IIS Interoperability in the New HIE World
Several hundred stakeholders from around California attended this important event.
HLN joined more than eighty organizations, institutions and companies in imploring Congress to fund public health surveillance systems. The appropriations request letters – one to the House and one to the Senate – is seeking $1 billion over ten years (and $100 million in FY 2020) for the Centers for Disease Control and Prevention (CDC) to allow CDC, state, local, tribal, and territorial health departments to move from sluggish, manual, paper-based data collection to seamless, automated, interoperable IT systems and to recruit and retain skilled data scientists to use them.
HLN has been at the forefront of systems development in public health, and has long advocated for the modernization of public health registries and other systems. This initiative is focused on public health surveillance systems, and HLN’s work on the Reportable Condition Knowledge Management System (RCKMS) supports the electronic case reporting (eCR) initiative described in a flyer describing the details of this initiative published by a set of leading public health organizations.
HLN encourages everyone to advocate for these needed funds at every opportunity.
On March 7, 2019, HLN released a new version (v1.16.1) 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.
This version includes:
- DTP Vaccine Group: Added an update to the “Six by Seven” rule to explicitly state that duplicate shots on the same day do not count towards this rule. The intention of this change is to prevent potentially “bad data” that may be passed into the ICE service from affecting the forecast result.
- Hib Vaccine Group: Improved handling of duplicate shots administered on the same day. For details, please refer to the Two Shots, Same Vaccine Group, Same Day Exception Rules page.
- Minor logic changes to the Meningococcal B, Polio, Rotavirus and Pneumococcal vaccine groups.
HLN recently demonstrated ICE integrated into two EHRs at the HIMSS19 Interoperability Showcase starting in February in Orlando, FL.
The full software release is available for download at https://cdsframework.atlassian.net/wiki/display/ICE/Downloads. A revised ICE Implementation Guide is also available.
See the feature article about ICE in Open Health News.
On February 11, 2019 the Office of the National Coordinator for Health Information Technology (ONC) released its latest Notice of Proposed Rulemaking (NPRM) to Improve the Interoperability of Health Information. Referred to by some people as the “Information Blocking NPRM,” since this was the primary topic anticipated, the document actually covers a host of other topics related to interoperability driven primarily by requirements of the 21st Century Cures Act. Besides the initial text of the NPRM, ONC also released a set of summary slides and fact sheets to help explain the document.
Given the relatively minimal mention of core public health reporting certification criteria in this NPRM, there is still a fairly large potential impact on public health. Topics, descriptions, issues, impacts, and potential opportunities discussed in this article and associated documents are based on our careful read of the NPRM and related material. But please note that this information is voluminous and at times confusing. Ongoing discussion and review will attempt to clarify (and if necessary correct) initial ideas presented here.
In order to help focus the reader, I have prepared a detailed table of Public Health Issues, Impacts, and Opportunities (currently at Version 15) which will be updated periodically, as well as a separate detailed response to the ONC Patient Matching RFI and CMS Patient Matching RFI.