HLN Consulting

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A Consulting Firm Attempts a Transition to Open Source Health Software (Part 1 of 2)

Andy Oram | EMR & HIPAA | September 6, 2016

Open source is increasingly understood to be the future of software, because communities working together on shared needs can produce code that is at least as good as proprietary products, while representing user interests more effectively and interoperating without friction. But running an open source project is a complex task, and keeping a business going on it is absolutely perilous. In his 2001 book The Cathedral & the Bazaar, Eric S. Raymond listed half a dozen ways for businesses to profit on open source software, but today only one or two are visible in the field (and they differ from his list).

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A Consulting Firm Transition to Open Source Health Software

Andy Oram | EMR and HIPPA | September 7, 2016

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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A Public Health Perspective on the CMS Quality Payment Program

I have seen several pretty good summaries of the recently 0release Centers for Medicare and Medicaid Services (CMS) 2019 Inpatient Prospective Payment System Notice of Proposed Rulemaking (NPRM) to Quality Payment Program (one from AMIA, one from CDC). Here are just a few additional tidbits I picked out of the NPRM. Of course, this document is written like stereo instructions so I welcome any corrections or comments to my interpretation of what’s in the rule. I put page numbers (from final FBO version referenced above which has just been released) where relevant in parenthesis. And I apologize in advance as much of what’s here is cryptic to anyone who has not been exposed to this before and I don’t make much of an attempt to explain the context (or even the acronyms)...

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Approaches for Immunization Information System (IIS) Project Collaboration with HIE Networks

We have written in a previous policy white paper about collaboration between Immunization Information System (IIS) projects and Health Information Exchange (HIE) networks, and a second more technical white paper about options for interoperability between IIS and electronic health record (EHR) systems. We described a range of interoperability options for EHR users and IIS and the strengths and challenges of each alternative...

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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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HLN and Oregon Health Authority Present Optional Approaches to Oregon's School Immunization Reporting Process at Atlanta Conference

At the 2018 National Immunization Conference (NIC) held in Atlanta May 15-17, HLN co-presented Diverse Stakeholder Perspectives to Improve Oregon’s School Immunization Reporting Process in collaboration with the Oregon Immunization Program (OIP). Aaron Dunn, Oregon’s Immunization Program Manager, and Marcey Propp, HLN Project Manager, presented the project context, approach, and outcomes as part of the segment for Improving measurement and reporting to foster clear vaccine communication. The project context included antiquated technology, the growing complexity of vaccine requirements, and excessive, redundant and unnecessary workload that culminated in making the current school immunization reporting process unsustainable.

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HLN Consulting

For more than twenty years HLN Consulting has been a leading public health informatics consulting company focused on developing and supporting robust technical solutions addressing pressing public health needs. Founded in 1997, HLN Consulting, LLC brings together an academic heritage and technology perspective in a collaborative approach to health information technology. We learn through partnerships with our clients to bring insight into pressing informatics issues with regard to public health policy and practice.

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HLN Releases New Version of Award Winning Open Source Immunization Forecaster

Press Release | HLN Consulting | March 15, 2018

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 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 Submits Comments to the CMS Quality Payment Program

On June 14, 2018 HLN submitted the following comments on the Centers for Medicare and Medicaid Services (CMS) 2019 Inpatient Prospective Payment System Notice of Proposed Rulemaking (NPRM) to Quality Payment Program based on our earlier comments...We are quite concerned by both the overall direction and the specific recommendations regarding public health objectives and measures in the NRPM. Regarding the changes to the proposed measures, CMS has not provided any explanation for why Syndromic Surveillance reporting was selected as the required measure. Other public health measures (e.g., Immunization reporting, Electronic Laboratory Reporting, Electronic Case Reporting) continue to require incentives for implementation.

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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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Key exhibitor booths at HIMSS18 for open solutions, collaboration, and interoperability

The annual gargantuan HIMSS conference is back at Las Vegas with over 40,000 participants, over a thousand exhibitors, and more than 600 presentations. As we saw last year in Orlando, more than half of the conference presentations are focused on applications based on open source such as FHIR and Blockchain, and a great emphasis on open solutions for interoperability. With so many presentations and exhibits, it is impossible to provide a full overview. Below are a few of some of the most interesting exhibits of open solutions this year.

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