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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.

HLN Presents at AMIA 2017 on RCKMS

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HLN Presents at AMIA 2017 on RCKMS

On November 8, 2017 Dr. Noam Arzt, President of HLN, participated in a panel discussion titled, "Advancing Electronic Case Reporting (eCR) to Enable Public Health Disease Control a ...

On November 8, 2017 Dr. Noam Arzt, President of HLN, participated in a panel discussion titled, “Advancing Electronic Case Reporting (eCR) to Enable Public Health Disease Control and Emergency Response: Getting Into the Technical Weeds.” Along with his colleagues from the University of Utah, the Association of Public Health Laboratories (APHL), and CGI Federal, this session discussed details of the current national implementation of electronic case reporting (eCR) including its sponsorship by the Digital Bridge project. Specifically, Dr. Arzt presented on various models of deployment for the clinical decision support (CDS) component of eCR, referred to as the Reportable Condition Knowledge Management System (RCKMS).

Dr. Arzt suggested in this talk that while there are strong reasons why a centralized decision support service is recommended at this time (and is in fact being deployed), other more decentralized CDS options are possible, including replication of the centrally-deployed software at a local site or incorporation of the national CDS rules themselves into a local CDS product (for instance, by using CQL). Given the diversity of systems in the US and the varying timetables for implementation, likely all these strategies will be enabled over time. The most important thing is for all these deployment strategies to rely on a single, consistent set of rules developed by public health and compliant with state and local jurisdiction law and policy.

New GAO Report Chides HHS About Situation Awareness System

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New GAO Report Chides HHS About Situation Awareness System

In September 2017 GAO released a new report, Public Health Information Technology: HHS Has Made Little Progress toward Implementing Enhanced Situational Awareness Network Capabilit ...

In September 2017 GAO released a new report, Public Health Information Technology: HHS Has Made Little Progress toward Implementing Enhanced Situational Awareness Network Capabilities. In particular, GAO pointed out lapses in completing Congressionally-mandated requirements for this area including the definition of minimal data elements required and collaboration with state, local, and tribal public health officials on the development of standards and procedures to ensure proper data collection. In addition, the GAO chided HHS for not following its own information technology project management methodology in the planning and execution of this project.

Situational awareness has been a conspicuous topic ever since the 9/11 attacks and the anthrax scare that followed shortly thereafter. But since the initial flurry of public health preparedness funds in the ensuing several years this topic has not had a high priority at CDC nor the funding necessary to implement it successfully. Perhaps this report will serve as a catalyst for the new administration to provide the funding and leadership to fulfill Congress’ intentions in this area.

Two New Reports on Interoperability

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Two New Reports on Interoperability

Two new reports have been released on interoperability in September 2017 with potential impact on public health. The Office of the National Coordinator for Health Information Techn ...

Two new reports have been released on interoperability in September 2017 with potential impact on public health. The Office of the National Coordinator for Health Information Technology (ONC) released a commissioned study, Connecting Public Health Information Systems and Health Information Exchange Organizations: Lessons from the Field. This study of former ONC Health Information Exchange (HIE) grantees focuses on their experience, best practices, and lessons learned promoting the use of HIEs for public health reporting. The report covered a number of areas, including leadership issues, technical considerations, financial issues, privacy and security, and legal and policy issues. Generally the report provides useful information and insight, though it is not clear how many actual public health agencies were interviewed (as opposed to the HIEs alone). There is also an over-emphasis on clinical documents when much of public health reporting is still leveraging HL7 v2 messages. And the discussion of CMS 90/10 funding requires a more nuanced understanding to be used effectively.

HIEs can certainly be effective partners for public health reporting and data exchange. We have studied this in the past – see the HLN White Paper, IIS and HIE: Is there a Future Together? (November 2013). This report stresses the collaborative nature of public health-HIE collaboration, which we also emphasized in our White Paper.

The National Quality Forum (NQF) recently issued A Measurement Framework to Assess Nationwide Progress Related to Interoperable Health Information Exchange to Support the National Quality Strategy: Final Report. This report is the culmination of an NQF project to understand the barriers to interoperability and develop a measurement framework to monitor its effectiveness. While there is only passing reference to public health in this final report, there is some useful insights and strategies toward measuring interoperability.

HLN Attends August ONC 2017 Technical Interoperability Forum

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HLN Attends August ONC 2017 Technical Interoperability Forum

Last week I attended with my colleague Mike Berry the ONC 2017 Technical Interoperability Forum. This meeting was convened under the 21st Century Cures Act passed by Congress in la ...

Last week I attended with my colleague Mike Berry the ONC 2017 Technical Interoperability Forum. This meeting was convened under the 21st Century Cures Act passed by Congress in late 2016. Several hundred attended a series of panel presentations and discussions over one and a half days covering a variety of topics related to interoperability, including discussion of the business case for interoperability, semantics, national networks, and application programming interfaces (APIs). In many ways the speakers were “the usual suspects” involved in national networks, standards development, and HIE planning and implementation.

Nearly two years ago I wrote an essay, The Interoperability of Things, based on the collection of comments received by ONC on the draft Nationwide Interoperability Roadmap. Though I asked the new National Coordinator for Health Information Technology, Dr. Don Rucker, in a previous meeting if the Roadmap was still relevant and he said it was, there was absolutely no mention of this document at the Forum and it did not seem like the Roadmap was the operative guide for ONC activities or thinking. My own essay drew out a number of themes in interoperability I perceived at the time, including: lack of consensus on definition and scope; ambiguity over the role of HIEs, especially at the state level; disagreement over whether the pace of change was too fast or too slow, too general or too specific; and the complex state of consent and privacy laws across the country that really put a crimp in cross-state data sharing.