In October the Centers for Disease Control and Prevention (CDC) issued a Request for Information (RFI) for a Natural Test Collaborative (NTC). Through a series of questions, the RFI seeks opinions and information about “The development of a national testbed (notionally called the National Test Collaborative (NTC)) for real-world testing of health information technology (IT)” and “Approaches for creating a sustainable infrastructure” to achieve it. The scope of the questions is somewhat confusing and quite broad, starting with Clinical Decision Support (CDS) and electronic Clinical Quality Measures (eCQMs) but quickly expanding to Electronic Health Records (EHR) and interoperability (not precisely defined).
Biological and other disaster threats – whether accidental, driven by forces of nature, or intentional – pose fairly grave risks to the United States and the world. Situational awareness has been a conspicuous topic ever since the 9/11 attacks and the anthrax scare that followed shortly thereafter. Since then we have experienced numerous disasters: health impacts of major weather events such as hurricanes and earthquakes, new virus outbreaks like Ebola in Africa, raging wildfires on the West Coast (I live in California), and the ever-present threat of pandemic flu which a hundred ago infected some 500 million people across the globe and killed an estimated 50 million people worldwide, according to the Center for Disease Control and Preparedness (CDC).
But since the initial flurry of public health preparedness funds in the ensuing several years after the 9/11 attacks, this topic has not had a high priority at CDC nor the funding necessary to implement it successfully.
On August 14-16, 2018 the American Immunization Registry Association (AIRA) held its 2018 National Meeting. This meeting brought together more than 350 informatics professionals, public health officials, EHR vendors, and other stakeholders who all care passionately about Immunization Information Systems (IIS) and their role in the healthcare community. IIS projects leverage interoperability with EHRs, PHRs, and other systems to promote clinical practice at the point of care; enable public health surveillance; and reduce cost by assisting in preventing both under and over immunization.Read More
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!
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.