Direct protocol

See the following -

Halamka on the JASON Report

On 4/09/2014, AHRQ released the JASON report, facilitated by Mitre. JASON is an independent group of scientists who advise the United States government on matters of science and technology. The intent of the report is to make recommendations for a new healthcare IT architecture to accelerate interoperability. Read More »

Halamka on What's Next for Electronic Health Records

With the Department of Justice announcement of the $155 million dollar eClinicalWorks settlement (including personal liability for the CEO, CMO and COO), many stakeholders are wondering what’s next for EHRs. Clearly the industry is in a state of transition. eCW will be distracted by its 5 year corporate integrity agreement. AthenaHealth will have to focus on the activist investors at Elliott Management   who now own 10% of the company and have a track record of changing management/preparing companies for sale. As mergers and acquisitions result in more enterprise solutions, Epic (and to some extent Cerner) will displace other vendors in large healthcare systems. However, the ongoing operational cost of these enterprise solutions will cause many to re-examine alternatives such as Meditech...

Health Information Exchange Resist Cures (Part 2)

Andy Oram | EMR & EHR | March 23, 2016

The previous section of this paper introduced problems found in HIE by two reports: one from the Office of the National Coordinator and another from experts at the Oregon Health & Science University. Tracing the causes of these problems is necessarily somewhat speculative, but the research helps to confirm impressions I have built up over the years. The ONC noted that developing HIE is very resource intensive, and not yet sustainable. (p. 6) I attribute these problems to the persistence of the old-fashioned, heavyweight model of bureaucratic, geographically limited organizations hooking together clinicians. (If you go to another state, better carry your medical records with you.) Evidence of their continued drag on the field appeared in the report...

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Interoperability and the Trough of Disillusionment

Every technology has an adoption journey. The classic Gartner hype curve travels from a Technology Trigger  to the Peak of Inflated Expectations followed by the Trough of Disillusionment. It often takes years before organizations reach the Slope of Enlightenment and finally achieve a Plateau of Productivity. Have you noticed that Congress and the popular press have entered the Trough of Disillusionment for EHRs and interoperability over the past month? Congressional staffers writing the 21st Century Cures bill (which is not yet law) seem to have concluded...

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NantHealth Acquires Harris Healthcare Solutions

Press Release | NantHealth | July 16, 2015

NantHealth, a subsidiary of NantWorks, LLC, today announced it has completed the acquisition of Harris Corporation’s (NYSE:HRS) commercial Healthcare Solutions business, a clinical systems integration innovator. Harris retained its government healthcare services business. NantHealth’s existing cOS, eviti and omics platforms, combined with Harris’ FusionFX® suite of products, delivers on the promise of whole health systems integration and revolutionizes the patient-clinician experience by bringing molecular medicine insights directly to the point-of-care.

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ONC's Trusted Exchange: A Public Health Perspective

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.

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The Evolving Landscape of Health Information Exchange

The original vision for nationwide health information exchange was a “network of networks” model where local HIEs would interact HIE-to-HIE to form a virtual national network. But notice that many of the new initiatives are essentially solving a different problem: they are enabling point-to-point connections across a wider geography and set of clinical sites. This seems more like a large, single national network rather than leverage of more distributed organizations or implementations. Only time will tell if these private sector initiatives will collaborate, converge or compete. And only time will tell of the limitations of ONC’s ability to influence and provide leadership will creates gaps or provide new opportunities for innovation.

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