HLN ConsultingSoftware and Services for Public Health

Category Archives

12 Articles

ONC Selects Noam Arzt to serve on the Trusted Exchange Framework Task Force

Share

ONC Selects Noam Arzt to serve on the Trusted Exchange Framework Task Force

The Office of the National Coordinator for Health Information Technology (ONC) has selected Dr. Noam H. Arzt, President of HLN Consulting (HLN), as a member of the Trusted Exchange ...

The Office of the National Coordinator for Health Information Technology (ONC) has selected Dr. Noam H. Arzt, President of HLN Consulting (HLN), as a member of the Trusted Exchange Framework Task Force. This group of healthcare and health information technology specialists will advise ONC on various aspects of the Draft Trusted Exchange Framework. This framework outlines a common set of principles for trusted exchange of health information records and minimum terms and conditions for trusted exchange as directed by Congress in the 21st Century Cures Act.

The task force is expected to consider a number of important implementation issues for the framework, including the nature of the coordinating body that ONC envisions for this activity (the Recognized Coordinating Entity, or RCE); the definition, attributes, and functioning of the organizations that will operate within this framework to exchange data (the Qualified Health Information Networks, or QHINs); issues related to privacy and security that must be understood and settled before interoperability can take place; and determination of exactly what activities and uses will be supported by the network.

Dr. Arzt has been a vocal proponent of health data interoperability and health information exchange for many years, with particular emphasis on public health’s needs and activities. Dr. Arzt has written extensively on the challenges and potential solutions to interoperability, including The Interoperability of Things which describes why interoperability in the US seems so hard to achieve. In a recent blog post (HIE: The New Landscape), Dr. Arzt described the state of health information exchange today and the changes that have taken place since Federal funding under the HITECH Act ended. He has also written key articles on important issues in health information technology such as information blocking, the state of patient matching strategy in the US, and cloud computing.

Dr. Arzt recently submitted public comments related to TEFCA on behalf of HLN, and participated in the responses developed and submitted by key organizations including the American Immunization Registry Association (AIRA), American Medical Informatics Associations (AMIA), Healthcare Information and Management Systems Society (HIMSS), and the Joint Public Health Informatics Task Force (JPHIT).

TEFCA: A Public Health Perspective (final)

Share

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).

New GAO Report Chides HHS About Situation Awareness System

Share

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.

HLN Participates in 12th Annual Stewards of Change Institute National Symposium

Share

HLN Participates in 12th Annual Stewards of Change Institute National Symposium

On June 19-20, 2017, Dr. Noam Arzt, President of HLN, participated by invitation in the 12th Annual Stewards of Change Institute National Symposium on behalf of the Healthcare Info ...

On June 19-20, 2017, Dr. Noam Arzt, President of HLN, participated by invitation in the 12th Annual Stewards of Change Institute National Symposium on behalf of the Healthcare Information and Management Systems Society (HIMSS). This symposium provided a unique opportunity to discuss key issues in data management and interoperability with a small, but diverse set of stakeholders across the health and human services. The symposium included a particular focus on issues surrounding the current opioid epidemic. In addition, a new National Interoperability Collaborative (NIC) was launched (with funding from the Kresge Foundation) to spearhead information sharing regarding interoperability strategies and activities. Though there was no CDC participation at this symposium, there was a very nice briefing from several representatives of the Department of Health and Human Services including the new National Coordinator for Health Information Technology, Dr. Don Rucker.

This symposium represents a welcomed expansion of the Stewards of Change focus from human services into the health domain. This expanded conversation will allow public health to participate more fully as the shift to our collective concern about wellness requires a more holistic view of people, their requirements, and their circumstances. We look forward to continuing engagement with this community and an opportunity to bring what we have learned in public health about interoperability into this new forum.

Preparing for 2017: Four Important Reports

Share

Preparing for 2017: Four Important Reports

With so much transition ahead of us at the Federal, state, and local levels in 2017, it is important to begin to plan for what the Health IT landscapes will look like for the comin ...

With so much transition ahead of us at the Federal, state, and local levels in 2017, it is important to begin to plan for what the Health IT landscapes will look like for the coming year (and beyond). Several key reports have come out – mostly from government sources – which are worth serious consideration for any Health IT planner:

HHS Public Health 3.0 White Paper: This seminal paper sets the stage for ongoing maturation of the public health infrastructure and capability at all levels of government to continue to assure the public’s health.

ONC 2017 Interoperability Standards Advisory: Now in its third year, this material gets longer and longer, and more and more complex each time. The current incarnation is a navigable website chock full of standards, though you can still download a PDF by clicking on the “2017 ISA Reference Edition” or “ISA 2017” links.

ONC 2016 Report to Congress on Health IT Progress: This HITECH-required report updates Congress about progress during the past year. While it is a really good summary of recent and current activities and initiatives, it only deals with what is really going on (or not going on) on the ground in a cursory way.

National Governors Association Road Map for States to Improve Health Information Flow Between Providers: A very detailed report aimed at State policy makers with clear guidance – and lots of examples – to try to move interoperability forward at the State level.

There are no easy answers here, and it’s easy to get overwhelmed by the information presented in these reports. But they cannot be ignored and can help form the basis of a solid organizational or governmental strategy.