On June 15, 2023, the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) Proposed Rule Task Force 2023 released its recommendations on the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) Proposed Rule which proposes new provisions from the 21st Century Cures Act and makes updates to the ONC Health IT Certification Program (Certification Program). The limited-engagement task force met intensely during April, May, and June 2023 to develop its own set of observations and recommendations which were submitted to the Office of the National Coordinator for Health Information Technology (ONC).
Noam Arzt
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A Consulting Firm Transition to Open Source Health Software (Part 2 of 2)
The best hope for sustaining HLN as an open source vendor is the customization model: when an agency needs a new feature or a customized clinical decision support rule, it contracts with HLN to develop it. Naturally, the agency could contract with anyone it wants to upgrade open source software, but HLN would be the first place to look because they are familiar with software they built originally. Other popular models include offering support as a paid service, and building proprietary tools on top of the basic open source version (“open core”). The temptation to skim off the cream of the product and profit by it is so compelling that one of the most vocal stalwarts of the open source process, MariaDB (based on the popular MySQL database) recently broke radically from its tradition and announced a proprietary license for its primary distinguishing extension.
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ASTHO Releases Two New Reports On IIS
In March 2023 the Association of State and Territorial Health Officers (ASTHO) released two environmental scans related to public health data and systems funded by a grant from ONC. The first report, Immunization Information Systems, and Health Information Exchanges: An Environmental Scan of Factors Influencing Data Sharing and Opportunities to Advance Population Health, provides a review of the state of both IIS and HIEs – as well as their points of intersection and support – especially as they were affected by the COVID-19 pandemic. ASTHO used a mixture of secondary source review (including our white paper on this topic from nearly ten years ago) and current interviews and focus groups to inform us about this complex and fluid topic.
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Bipartisan Commission on Biodefense Issues Call For a National Public Health Data System
In April 2022 the Bipartisan Commission on Biodefense released a new report titled The Athena Agenda: Advancing the Apollo Program for Biodefense. Established in 2014, the privately-funded commission convenes periodically and conducts research to assess the state of US biodefense efforts and to make recommendations for change and improvement. Spurred by the events surrounding the COVID-19 pandemic, this report challenges the country to prepare itself for future pandemics by establishing aggressive goals, gathering our “best and brightest” talent, developing action-oriented plans, and funding their accomplishment as the “next Apollo Program.”
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CMS Promoting Interoperability in 2021: All good things must come to an end?
We have spent years involved with the management of the Center for Medicare and Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Programs which were created by the HITECH Act (2009). These programs were recently renamed Promoting Interoperability (PI) programs. In a nutshell, these programs were tied to the Medicare and Medicaid insurance programs and provided financial incentives over a number of years to ambulatory providers and hospitals to adopt and use EHRs. Vendors submitted their technology products for testing and certification that they performed specific functions and could exchange data using specified message formats...But the provisions of the HITECH Act are due to expire on September 30, 2021 (see CMS timeline). These are the programs affected...
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CMS Releases Proposed Updates to Medicare MIPS Promoting Interoperability Program for Physicians
On July 29, 2022 the Centers for Medicare and Medicaid Services (CMS) released a notice of proposed rulemaking (NPRM) related to changes in the Medicare Program Physician Fee Schedule for 2013. Among the proposals in this lengthy document are those related to the Promoting Interoperability Program for physician practices, the successor to the Meaningful Use of Electronic Health Record (EHR) technology that was originally rooted in the 2009 HITECH Act. This program has been evolving over the years and this NPRM proposes some meaningful changes to the public health reporting component which would first be used for calendar year 2023.
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Dr. Noam Arzt named Fellow of the American Medical Informatics Association
Dr. Noam H. Arzt, president ofHLN Consulting, LLC, has been named a Fellow of the American Medical Informatics Association (AMIA). Dr. Arzt joins 129 of his colleagues in the inaugural class of fellows. The fellowship was created to recognize AMIA members who apply informatics skills and knowledge within their professional setting, who have demonstrated professional achievement and leadership, and who have contributed to the betterment of the organization. A member of AMIA since 1998, Dr. Arzt has been a leader in public health informatics for many years. He has been active in various AMIA task forces and workgroups, and has been a speaker at AMIA conferences, events, and webinars.
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Draft TEFCA Facilitated FHIR Implementation Guide: A Public Health Perspective
On October 7, 2022, the Trusted Exchange Framework and Common Agreement (TEFCA) project released a Draft TEFCA Facilitated FHIR Implementation Guide. As described in an earlier post, the project released a specific plan for integrating HL7 Fast Health Information Resources (FHIR) into the architecture that was defined explicitly in a new Roadmap for later implementation. This draft implementation guide (IG) provides the initial proposed details for this functionality. TEFCA only poses technical requirements on its direct participants, the Qualified Health Information Networks, or QHINs, but they are not the actual sources nor destinations of the data. The actual “FHIR details” are sketchy in this IG; maybe that is by design. It seems to specify just what the QHIN needs to know to do patient discovery and move the query and response around rather than any specifics on where a query originates nor where the response goes, let alone what data is contained.
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HITAC Task Force Comments on ONC HTI-1 NPRM
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HLN Releases New Version of Award Winning Open Source Immunization Forecaster
HLN released a new version (v1.11.1) of the Immunization Calculation Engine (ICE) on March 9, 2018. ICE is a state-of-the-art open-source software system that provides clinical decision support (CDS) for immunizations for use in Immunization Information Systems (IIS), Electronic Health Record (EHR) and Personal Health Record (PHR) Systems. The release includes support for Earliest Date and Overdue Date for immunizations that are forecasted. If enabled, ICE will output two additional forecast dates along with the existing Recommendation Date...
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HLN Releases Open Source Vaccine Provider Agreement System
HLN Consulting has just released a critical application to help complete the CDC's COVID-19 vaccination provider agreement requirements. HLN is a leading public health informatics consulting company that is focused on developing andsupporting robust open source solutions that address pressing public health requirements. HLN's application is designed to assist medical providers with a tool that can enhance and facilitate their tracking of critical vaccination information...
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HLN Releases Update to Open Source Immunization Forecaster in Preparation for COVID-19 Vaccine
On November 6, 2020, HLN released a new version (v1.24.2) of the Immunization Calculation Engine (ICE). ICE is a state-of-the-art open source software system that provides clinical decision support for immunizations for use in Immunization Information Systems (IIS), Electronic Health Record (EHR) and Personal Health Record (PHR) Systems.
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HLN's Immunization Calculation Engine (ICE) chosen as a Digital Public Goods Standard
HLN Consulting is thrilled to announce that the Immunization Calculation Engine (ICE) project has been chosen by the Digital Public Goods Alliance (DPGA) as an innovative openly licensed technology and listed in their Digital Public Goods registry. Technologies included in the list are considered to be digital public goods in alignment with the Digital Public Goods Standard. ICE now appears in the Digital Public Goods registry where it is discoverable as a digital public good and reflected on a growing network of catalogs and aggregated lists of digital public goods.
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Low-cost Aplication Platforms (LCAP): What They Should Mean to Public Health
Agency budgets continue to run tight, while the demands for data modernization continue to escalate. We are also seeing weakening markets – not strengthening markets – for core public health software systems like Immunization Information Systems (IIS) and Disease Surveillance/case management systems. One of the emerging, promising approaches are Low-cost Application Platforms (LCAP). What exactly are they, where did they come from, and are they a useful strategy for developing core public health applications?
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Major Interoperability Initiative Launched During the Annual Meeting of The Sequoia Project
On December 5, 2019, HLN Consulting, LLC participated in The Sequoia Project's day long annual meeting which was held just outside of Washington, D.C. at the Gaylord National Resort & Convention Center. As a leading healthcare informatics consulting company HLN monitors developments in healthcare interoperability nationally with particular emphasis on the impact to public health agencies and their stakeholders. This conference represented a good opportunity to participate in the start of a major interoperability initiative that will play out over the next several years. In addition to this report, the Sequoia Project posted the proceedings of the meeting online, including the recorded discussions as well as the slides from the presentations. Read More »
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Major Upgrade to Innovative Open Source Immunization Forecaster Released
Innovative open source software, originally developed for public health, is freely available to EHR and PHR systems to support clinical decision support for immunizations...ICE is a state-of-the-art open-source software system that provides clinical decision support for immunizations for use in Immunization Information Systems (IIS), Electronic Health Record (EHR) and Personal Health Record (PHR) Systems...HLN will be presenting this new version this week at the annual meeting of the American Immunization Registry Association (AIRA) and week of August 20 at the CDC Public Health Informatics Conference Read More »
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