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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 reports focus on the perceived successes and barriers to health ...

Two new reports have been released on interoperability in September 2017 with potential impact on public health. The reports focus on the perceived successes and barriers to health information exchange and interoperability. We draw out the relevance of these reports to public health as well as some of our own observations on these issues from a past working paper.

Firth, 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.

Second, 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.

HLN Attends 2017 Netsmart Public Health Summit

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HLN Attends 2017 Netsmart Public Health Summit

Dr. Noam Arzt, President of HLN, attended  the second annual Netsmart Public Health Summit. This meeting brought together representatives from local public health agencies who prim ...

Dr. Noam Arzt, President of HLN, attended  the second annual Netsmart Public Health Summit. This meeting brought together representatives from local public health agencies who primarily use NetSmart’s public health electronic health records software. Dr. Arzt was invited to attend and he delivered a presentation on Clinical Decision Support Tools for Public Health.

New Version of HLN’s Award Winning Open Source Immunization Forecaster Released

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New Version of HLN’s Award Winning Open Source Immunization Forecaster Released

A new release (v1.8.1.0) of the Immunization Calculation Engine (ICE) is now available. (Download ICE 1.8.2.0). ICE is a state-of-the-art open-source software system that provides ...

A new release (v1.8.1.0) of the Immunization Calculation Engine (ICE) is now available. (Download ICE 1.8.2.0). ICE is a state-of-the-art open-source software system that provides clinical decision support for immunizations (CDSi) for use in Immunization Information Systems (IIS), Electronic Health Record (EHR) and Personal Health Record (PHR) Systems.

The release includes the following changes:

  • Updates to the Polio Vaccine Group and the Meningococcal ACWY Vaccine Group to better reflect latest guidelines, and addition of Influenza vaccine (CVX 185 and 186) to the Influenza Vaccine Group.
  • Combines PCV and PPSV vaccine groups into one, new vaccine group for Pneumococcal. This change was made to better account for shots administered across the patient’s lifetime. (To support this new Pneumococcal vaccine group, implementers may need to make adjustments to stop looking for the old PCV and PPSV vaccine group codes (700 and 720), and start looking for the new vaccine group code (750). Child and adult pneumococcal vaccinations are now evaluated and forecast under this new vaccine group. The PCV and PPSV vaccine groups are no longer supported.)
  • Release notes which describe the above changes to the vaccine group logic in more detail.

Implementers should refer to the new ICE Implementation Guide (v2r15) when making adjustments to be compatible with this latest release, including the new Pneumococcal vaccine group as well as a few other vaccine and evaluation reason codes that have been added. (A “track changes” version of the guide is also available to make it easy to see what has changed since the last release.)

You can determine which release of ICE you are using by viewing the README.HISTORY file that is included with each distribution.

Please feel free to e-mail us at ice@hln.com if you have any questions.

See press release.

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

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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.