Matching – HLN Consulting, LLC

ONC Releases New NPRM on Interoperability: How Might it Affect Public Health? [Updated]

by Noam Arzton February 27, 2019

See our final comments on the ONC NPRM and the CMS NPRM Patient Matching RFI

On February 11, 2019 the Office of the National Coordinator for Health Information Technology (ONC) released its latest Notice of Proposed Rulemaking (NPRM) to Improve the Interoperability of Health Information. Referred to by some people as the “Information Blocking NPRM,” since this was the primary topic anticipated, the document actually covers a host of other topics related to interoperability driven primarily by requirements of the 21st Century Cures Act. Besides the initial text of the NPRM, ONC also released a set of summary slides and fact sheets to help explain the document.

Given the relatively minimal mention of core public health reporting certification criteria in this NPRM, there is still a fairly large potential impact on public health. Topics, descriptions, issues, impacts, and potential opportunities discussed in this article and associated documents are based on our careful read of the NPRM and related material. But please note that this information is voluminous and at times confusing. Ongoing discussion and review will attempt to clarify (and if necessary correct) initial ideas presented here.

In order to help focus the reader, I have prepared a detailed table of Public Health Issues, Impacts, and Opportunities (currently at Version 15) which will be updated periodically, as well as a separate detailed response to the ONC Patient Matching RFI and CMS Patient Matching RFI.

GAO Report on Patient Matching: Nothing New Under the Sun

by Noam Arzton February 24, 2019

On January 15, 2019 the US Government Accountability Office (GAO) released a new report to Congress, Health Information Technology: Approaches and Challenges to Electronically Matching Patients’ Records across Providers. This report is in response to mandate in the 21st Century Cures Act for the GAO to study patient matching. To develop this report, GAO reviewed available literature and interviewed more than thirty-five stakeholders (who are not identified) over the course of a year.

I have written several blogs and a feature article on patient matching developments in the US. Similarly, this new GAO report is an excellent retrospective on industry efforts over the past several years. It includes a clear statement of the problem, good discussion on both barriers and progress to date, insights from the stakeholders interviewed on their practical issues, and a review of various initiatives by the Office of the National Coordinator for Health Information Technology (ONC) over the past several years. The footnotes alone are worth the read as they contain excellent sources and side comments.

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.

Update on Patient Matching Activities

by Noam Arzton December 14, 2017

I have written several times about patient matching in the US, both in a blog entry and a published article. On December 11, 2017 the Office of the National Coordinator for Health Information Technology (ONC) sponsored a half-day “Interoperability in Action” webinar focused on Patient Matching Milestones at ONC (see agenda and slides). The webinar focused on four ONC projects from the past year. Here’s a quick run-down on what they covered.

New Article Published: Is There a National Strategy Emerging for Patient Matching in the US?

by Noam Arzton April 18, 2017

New article by Dr. Noam Arzt published in Medical Research Archives:

Is There a National Strategy Emerging for Patient Matching in the US?

Patient record matching has been a key area of emphasis for healthcare, with several major efforts to identify best practices in the past decade. Because of a lack of a national patient identifier, several distinct approaches to patient matching in both the public and private sectors have emerged, which do not appear to be converging. One major focus of a number of patient matching initiatives is the identification of a core set of data elements found in most patient records, regardless of setting, to facilitate matching. These initiatives have also not yet converged. Some organizations participate in master patient index (MPI) deployments within their agency or jurisdiction. But participation in a shared MPI can also be challenging, and policies and processes for synchronizing record changes, among other issues, must be carefully considered. “Promising practices” should be identified from those jurisdictions that have lived through a migration to an enterprise MPI.

http://journals.ke-i.org/index.php/mra/article/view/1150