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TEFCA: A Public Health Perspective (final)

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TEFCA: A Public Health Perspective (final)

In January 2018 the Office of the National Coordinator for Health Information Technology (ONC) issued a draft Trusted Exchange Framework and Common Agreement (TEFCA), and related s ...

In January 2018 the Office of the National Coordinator for Health Information Technology (ONC) issued a draft Trusted Exchange Framework and Common Agreement (TEFCA), and related supporting documents, in response to a requirement imposed by Congress in the 21st Century Cures Act. The Act says that the TEF may include a common method for authenticating users, a common set of rules, enabling policies, and a process for managing non-compliance. Nowhere does the Act instruct ONC to determine an actual technical architecture in this process, though such a step is not precluded either.

The primary document is in two parts: Part 1 is a set of principles that set the foundation for Part 2 which is a set if minimum terms and conditions for trusted exchange. While the principles seem overall quite reasonable, the terms and conditions have many, many technical specifications and standards embedded within them and lay the groundwork for a very specific nationwide implementation. Though the phrase “network of networks” appears nowhere in these documents, Part 2 seems to describe a technical implementation not too unlike the original NwHIN/eHealth Exchange model that was implemented with limited success a number of years ago. It does not appear that this model fits all that well with any of the major market-based strategies that have emerged in the past several years, notably the Commonwell Health Alliance, Carequality, or the Strategic Health Information Exchange Collaborative (SHIEC).

HLN Participates in PCORS CDS Learning Network National Webinar

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HLN Participates in PCORS CDS Learning Network National Webinar

HLN organized and participated in a national webinar titled CDS for Immunizations (CDSi): A Community and Standards-based Approach on January 18, 2018. Speakers included: Dr. ...

HLN organized and participated in a national webinar titled CDS for Immunizations (CDSi): A Community and Standards-based Approach on January 18, 2018. Speakers included:

  • Dr. Noam Arzt, President of HLN, who spoke about the business case for clinical decision support for immunizations, and about HLN’s Open Source ICE vaccine evaluation and forecasting product
  • Stuart Myerburg from CDC who spoke about the CDC CDSi project
  • Angel Aponte from the NYC Department of Health and Mental Hygiene who spoke about real-work implementations in the Citywide Immunization Registry (CIR)

Over 50 individuals participated in the webinar which was sponsored by the Patient-Centered Clinical Decision Support (CDS) Learning Network (PCORCDS).

Approaches for IIS-HIE Collaboration

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Approaches for IIS-HIE Collaboration

We have written in a previous policy white paper about collaboration between Immunization Information System (IIS) projects and Health Information Exchange (HIE) networks, and a se ...

We have written in a previous policy white paper about collaboration between Immunization Information System (IIS) projects and Health Information Exchange (HIE) networks, and a second more technical white paper about options for interoperability between IIS and electronic health record (EHR) systems. We described a range of interoperability options for EHR users and IIS and the strengths and challenges of each alternative:

HIE: The New Landscape

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HIE: The New Landscape

In the past several years we have seen a real shift in leadership over Health Information Exchange (HIE) in the US. The phase out of the ONC State HIE Cooperative Agreement Program ...

In the past several years we have seen a real shift in leadership over Health Information Exchange (HIE) in the US. The phase out of the ONC State HIE Cooperative Agreement Program in 2014 marked a real turning point in HIE planning and implementation as ONCs leadership has waned and other more market-driven forces have ascended. Some activities have continued with funding from CMS under the Medicaid Electronic Health Record Incentive Program Health Information Technology (HIT) 90 percent Federal Financial Participation (FFP) program, and to a lesser degree under the Medicaid Management Information System FFP program. State-level HIEs have continued to flourish in some states (including Delaware, New York, Michigan, and others) while they have floundered in others.

HLN Attends CDC Early Hearing Detection and Intervention (EHDI) Grantee Meeting

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HLN Attends CDC Early Hearing Detection and Intervention (EHDI) Grantee Meeting

On November 14-15, 2017, Mike Berry from HLN, with the Rhode Island Department of Health, attended the CDC Early Hearing Detection and Intervention (EHDI) Grantee Meeting in Atlant ...

On November 14-15, 2017, Mike Berry from HLN, with the Rhode Island Department of Health, attended the CDC Early Hearing Detection and Intervention (EHDI) Grantee Meeting in Atlanta. The meeting featured EHDI programs from
states and territories across the U.S., along with national experts in areas of hearing screening and diagnostic audiology as well as epidemiology, public health informatics, health outcomes and program evaluation.

Much of the meeting focused on the purpose and strategies of the current cooperative agreement between CDC and state EHDI programs. Similar to the Immunization Information System (IIS) Functional Standards in our IIS work, EHDI has its own set of EHDI Information System (EHDI-IS) Functional Standards; and the cooperative agreement is assisting grantees to meet those standards, as well as to evaluate their progress towards those and other program goals. There were also technical sessions on data linkage, tracking and surveillance; and group activities in which states shared their strategies on topics such as data exchange, stakeholder outreach, and program evaluation. Rhode Island is unique in that its EHDI-IS is part of KIDSNET, the state’s integrated child health information system; and at the meeting, we shared our recent experience deploying EHDI reports in KIDSNET to a wide variety of EHDI-related providers; as well as our current initiative to establish data exchange with audiologists’ Electronic Health Record Systems (EHR-S) for diagnostic audiology encounters.