Noam H. Arzt

See the following -

Are Open Source Clinical Decision Support (CDS) Services Subject to HIPAA Regulations?

Clinical Decision Support (CDS) services such as HLN’s Immunization Calculation Engine (ICE) are modular, loosely-coupled components of larger systems accessed via web services in a service-oriented architecture (SOA). Under HIPAA, services provided to Covered Entities (CE) which involve protected health information (PHI) as defined in the statute are subject to the regulation. But are CDS services such as ICE subject to this regulation?

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Consumer Access to Health Care Data: Still a Challenge

Consumers continue to be frustrated with lack of access to their healthcare data, even as wearables and other consumer-targeted devices and services continue to sprout. Recently, ONC launched a Consumer Health Data Aggregator Challenge to spur the development of new applications and partnerships to provide aggregated health data to patients. While the financial “prize” for this effort is meager, recognition by ONC might be the real brass ring. This challenge focuses on the use of FHIR exclusively to support interoperability between systems and present data to consumers. I suspect that applicants will have some trouble meeting the requirements of the challenge effectively, and this is indicative of the broader challenge in supporting this type of data access.

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HLN Releases New Version of Open Source Immunization Forecaster

Press Release | HLN Consulting | August 2, 2017

HLN Consulting has released a new version of the award winning Immunization Calculation Engine (ICE). ICE is a service-oriented, standards-based immunization forecasting software system that evaluates a patient's immunization history and generates the appropriate immunization recommendations. ICE can be used in Immunization Information Systems (IIS), Electronic Health Records (EHR), Health Information Exchanges (HIEs), and Personal Health Record (PHR) Systems. The release includes changes to the rules for several vaccine series, including Polio, Meningococcal ACWY, and Influenza.

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HLN Releases Roadmap for Open Source Immunization Forecaster

Press Release | HLN Consulting | September 18, 2017

On September 7, 2017 HLN Consulting released a product Roadmap for its award winning Immunization Calculation Engine (ICE). ICE is an open source service-oriented, standards-based immunization forecasting software system that evaluates a patient's immunization history and generates the appropriate immunization recommendations. The Roadmap describes modifications that have already been scheduled for inclusion in new releases of ICE in the near future, in addition to ongoing changes that may be required to maintain compliance with Advisory Committee on Immunization Practices (ACIP) recommendations...

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HLN Releases v 1.9.1.0 of its Open Source Immunization Forecaster

Press Release | HLN Consulting | October 11, 2017

HLN Consulting has released a new version of the award winning Immunization Calculation Engine (ICE). ICE is a service-oriented, standards-based immunization forecasting software system that evaluates a patient's immunization history and generates the appropriate immunization recommendations. ICE can be used in Immunization Information Systems (IIS), Electronic Health Records (EHR), Health Information Exchanges (HIEs), and Personal Health Record (PHR) Systems...

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HLN's Open Source Immunization Forecaster Receives 2017 Upshot Award

Press Release | HLN Consulting | June 12, 2017

On June 6, 2017, HLN was awarded the 2017 Upshot Award for Excellence in Vaccine Supply, Access, and Use by the US Department of Health and Human Services National Vaccine Program Office (NVPO) for its ICE Open Source Immunization Forecaster. In the letter of award, Dr. Jewel Mullen, Principal Deputy Assistant Secretary for Health commented that, "HLN Consulting's efforts on the Immunization Calculation Engine (ICE) are impressive. This powerful tool-including its open-source nature and seamless integration into clinical workflows-holds great promise for improving clinical decision-support and ultimately vaccination rates. Thank you for daring to innovate, collaborate, and lead in an area that is not only complex, but constantly evolving."

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HLN's Report on Patient Centered CDS Learning Network Conference

The Learning Network is an initiative funded by the Agency for Healthcare Research and Quality (AHRQ) whose goal is to encourage collaboration and development of tools and resources to support clinical decision support (CDS) as it relates to individual patients and their caregivers. This work is an offshoot of the Patient-Centered Outcomes Research (PCOR) initiative which focuses on the relationship between healthcare providers in patients in making better, more informed, healthcare decisions. A sister project to the Learning Network is the AHRQ-funded CDS Connect Repository which has begun to house shareable CDS artifacts which represent evidence-based standards of care.

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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 coming year (and beyond). Several key reports have come out – mostly from government sources – which are worth serious consideration for any Health IT planner...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.

Report on the 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 late 2016. Several hundred participants attended a series of panel presentations and discussions. The forum took place over one-and-a-half-days. The forum covered 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.

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Successful Public Health IT Project Collaboration

Most public health information technology projects rely on strong collaboration to be successful, especially across vendor-client boundaries. Here are some successful strategies: Clear vision. A concise and clear vision focused on public health outcomes is embraced and articulated by all participants in the project; Strong support and leadership from senior management. Without strong support from senior management, projects are rarely given the priority to enable success. This prioritization includes both agency and vendor commitment.

The Reduction of State-coordinated HIE: How Should Public Health React?

Noam ArztA recent article in HealthAffairs describes a significant decline in the number of both operational HIEs and HIEs in the planning stage from several years earlier. The authors note continuing barriers to broad-based HIE and a shift to vendor-driven exchange which diminishes the effectiveness of community-based networks. In effect, this translates to a shift away from geographic-based/dominated HIEs to product-dominated HIEs. We have already noted (see The Interoperability of Things) the lack of a national strategy on HIE, and ONC’s Nationwide Interoperability Roadmap barely mentions the concept.

Update on Patient Matching Activities

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 slides). The webinar focused on four ONC projects from the past year. Here’s a quick run-down on what they covered. Read More »

Why Cloud-Based Public Health Solutions are a Good Option for Clinical Decision Support

Cloud computing is one of the most powerful technology deployment strategies in use today. In fact, the notion of cloud resources has become prominent in consumer computing with only a limited understanding of what it means or does (e.g., Apple iCloud and Google Cloud). In this article we will examine some of the key reasons to host public health clinical decision support (CDS) solutions in the cloud. In a recent national survey, 95% of respondents indicated that they were using some form of cloud computing in their environment...The first step is to to understand the difference between cloud computing and traditional computing.

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