HIE – HLN Consulting, LLC

AHRQ Releases Draft Guide for Registry Interoperability: Does Public Health Have a Role?

by Noam Arzton January 29, 2019

On January 11, 2019 the Agency for Healthcare Research and Quality (AHRQ) released a draft Addendum to the Third Edition of Registries for Evaluating Patient Outcomes: A User’s Guide called Tool and Technologies for Registry Interoperability. AHRQ has long written about registries – largely from a research standpoint – and I have been following this from afar for some time. This new guide is focused on helping those who both create and use registries understand the issue surrounding leveraging external data to improve registry completeness, accuracy, and usefulness.

This report covers lots of ground and does a good job of summarizing important subtopics. Each chapter is overflowing with footnotes and sources. In Chapter 1, AHRQ reviews the context for registries today within the notion of a learning health system, and then quickly jumps into a useful discussion of interoperability barriers and problems. Many research-oriented registries are narrowly focused on a specific issue or problem; AHRQ envisions a more interoperable set of registries that can create a more integrated “national research infrastructure.”

HLN to Participate in HIMSS19 Interoperability Showcase

by Noam Arzton January 16, 2019

For the third straight year, HLN Consulting will participate in the Interoperability Showcase at this year’s HIMSS19 Global Conference and Exhibition which is being held in Orlando, FL from February 11-15, 2019. The Showcase itself runs on February 12-14. This year HLN will participate in two use cases:

Immunization Integration & CDS: HLN’s award-winning ICE Immunization Evaluation and Forecasting System will be featured supporting two different EHRs as a sample patient moves through a scenario of lifelong immunizations.

Opioid Crisis, the Person & the Population: HLN’s Reportable Conditions Knowledge Management System (RCKMS) will be featured as the decision support component of electronic case reporting (eCR) in this scenario about drug overdose.

Come see us in Hall F, Booth 9100 at the Orange County Convention Center.

See full press release and the feature article about ICE in Open Health News!

ONC Releases 2018 HITECH Report

by Noam Arzton January 16, 2019

In early January the Office of the National Coordinator for Health Information Technology (ONC) issued its annual report to Congress for 2018 on the adoption of electronic health records (EHR) and interoperability. This report is required under the HITECH Act and is further informed by requirements of the later 21st Century Cures Act.

There was actually very little to comment about in this report, and it felt more like ONC was “going through the motions.” There were a few (actually, very few) updated statistics about technology use, a short discussion about the importance of open Application Programming Interfaces (APIs), and a useful but not terribly new list of initiatives and reports issued by ONC over the past year or two. I spotted one or two things in there that I had not recalled seeing before but nothing terribly important.

One thing that I think is notable was a short discussion about barriers to interoperability that we have heard before. The report identifies three types: technical barriers, financial barriers, and trust barriers. Within trust barriers the report mentions legal incentives to keep data from moving (I guess that would have better been phrased as legal disincentives to sharing), but this misses the point: It is the patchwork of inconsistent and incompatible State and local laws and regulations – not intentional information blocking – that presents a bigger challenge and barrier. These can be laws prohibiting movement of certain health data across state lines, incompatible consent requirements, or restrictions on “downstream” use of data that is shared. Until these legal barriers are addressed separate from trust issues interoperability will be hampered.

HHS Releases Landmark Report: Reforming America’s Healthcare System

by Noam Arzton January 6, 2019

On December 3, 2018, the Department of Health and Human Services (HHS) released an extensive, 120-page report on the administration’s proposals to reform the healthcare system. The report, titled Reforming America’s Healthcare System Through Choice and Competition, is divided into four major sections. The report that government policy of the last few years has suppressed competition, increased prices for healthcare, and limited choices for consumers. Though rich in detail as it tries to prove each of these points, the more than fifty recommendations are often broad and aspirational rather than practical.

Since I am not a health economist, I will leave the market issues to others to discuss (many of the ideas in this report have been vetted and discussed by others previously). But there are two sections of the report which make direct mention of Health IT.

HLN Submits Comments to CMS on IPPS NPRM

by Noam Arzton June 14, 2018

On June 14, 2018 HLN submitted the following comments on the Centers for Medicare and Medicaid Services (CMS) 2019 Inpatient Prospective Payment System Notice of Proposed Rulemaking (NPRM) to Quality Payment Program based on our earlier comments:

HLN Consulting, LLC is pleased to submit the following comments on the recently-released CMS IPPS NPRM, CMS–1694–P. HLN is a leading public health informatics consulting company. With that in mind, we read documents like the NPRM through a public health lens, and confine our comments to that important context.