Clinical Decision Support – HLN Consulting, LLC

HLN releases Version 1.13.1 of its Award Winning Open Source Immunization Forecaster

by Noam Arzton June 18, 2018

A new release (v 1.13.1) of the Immunization Calculation Engine (ICE) is now available (download ICE version 1.13.1). ICE is a state-of-the-art open-source software system that provides clinical decision support (CDS) for immunizations for use in Immunization Information Systems (IIS), Electronic Health Record (EHR) and Personal Health Record (PHR) Systems.

The release includes support Earliest Date and Overdue Date for additional vaccines: Pneumococcal and Hib. 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. With this release, ICE returns the earliest and overdue dates for nine vaccine groups, and the remaining three vaccine groups will be completely supported in a future release of ICE this summer.

In addition, this release includes an adjustment to the Pneumococcal catch-up schedule (see Exception 1B in the Pneumococcal Vaccine Group documentation for details). All changes are documented in the release notes. There were no changes to the ICE Implementation Guide (v2r20) which describes how implementers should update their installation and software to properly read the Earliest, Recommended, and Overdue dates.

Feel free to e-mail us at ice@hln.com if you have any questions.

HLN Signs Letter of Support for AHRQ National Guideline Clearinghouse (NGC)

Clinical Decision Support

by Noam Arzton June 18, 2018

On June 1, 2018 HLN signed a letter of support regarding a recent decision by the Agency for Healthcare Quality Research (AHRQ) to end financial support for the National Guideline Clearinghouse (NGC) and terminate its operations as of July 17, 2018. The purpose of the Clearinghouse is to make clinical guidelines easily accessible for clinicians, patients, and clinical decision support (CDS) rules and application developers. Loss of this site – the only freely-available one of its kind – will impact all these stakeholders and make evidenced-based medicine harder to support.

See the full text of the letter.

Epic and Cerner Connect to HLN’s ICE at FHIR Connectathon

by Noam Arzton May 18, 2018

At the 18th FHIR Connectathon in Cologne, Germany on May 12-13, 2018, HLN successfully integrated its open source Immunization Calculation Engine (ICE) service with test instances of two Electronic Health Record (EHR) products, Epic and Cerner, using the CDS Hooks standard.

CDS Hooks is an emerging specification for invoking third-party Clinical Decision Support (CDS) web services from various points within an EHR workflow, such as whenever a patient is viewed. Registering a CDS service in an EHR is as easy as supplying a service discovery URL.

When invoked, the ICE CDS Hooks service accepts patient demographics and immunization history supplied by the EHR in FHIR format; calls the ICE decision support service; and sends back immunization forecasting alerts to the EHR for display.

The Connectathon was held prior to the May HL7 Working Group Meeting in Cologne. Version 1.0 of the CDS Hooks standard (cds-hooks.org) is being voted on during the May 2018 HL7 ballot cycle.

More information on ICE is available at cdsframework.org.

HLN Adds Additional Support for Earliest/Overdue Date in Latest Release of Open Source Immunization Forecaster

by Noam Arzton April 13, 2018

A new release (v 1.12.1) of the Immunization Calculation Engine (ICE) is now available (download ICE version 1.12.1). ICE is a state-of-the-art open-source software system that provides clinical decision support (CDS) for immunizations for use in Immunization Information Systems (IIS), Electronic Health Record (EHR) and Personal Health Record (PHR) Systems.

The release includes support Earliest Date and Overdue Date for additional vaccines: Hep A, MMR and Zoster. 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. With this release, ICE returns the earliest and overdue dates for seven vaccine groups, and the remaining three vaccine groups will be completely supported in future releases of ICE in Spring 2018.

In addition, this release includes several other changes with are documented in the release notes. The latest ICE Implementation Guide (v2r20) describes how implementers should update their installation and software to properly read the Earliest, Recommended, and Overdue dates.

Feel free to e-mail us at ice@hln.com if you have any questions.

HLN Updates White Paper on IIS/EHR Feature Overlap

by Noam Arzton April 11, 2018

Immunization Information Systems (IIS) have been around for more than twenty years. Their functionality, completeness, and usefulness have all increased over this time. IIS and electronic health record (EHR) systems have always had unique features, as well as some overlapping features, and the deployment of EHRs has enhanced the local immunization capabilities of clinician practices. Several critical clinical features that are considered to be core functions of IIS are beginning to be supported by EHRs.

IIS and EHR Feature Overlap, originally published in 2014, reviews and discusses five such critical features. The paper offers insight into the likelihood and implications of their migration from IIS to EHR, and offers recommendations to both the IIS and EHR communities for how to thoughtfully guide this migration. The proliferation of EHR with funding from the CMS EHR Incentive Programs has in some cases exacerbated the feature overlap. Both IIS and EHR projects should consider wisely investments in these functional areas, considering the potential for overlap as well as the on-hand expertise to develop, support these feature.