public health agencies

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Immunization and COVID-19: Open Source Solutions

The United States is starting to emerge from a nation-wide shut down imposed to slow down the spread of COVID-19. Most states are starting to reopen, and while higher education will likely stay largely remote this fall, primary and secondary schools are expected to reopen as the economy tries to get back on its feet. As both children and adults begin to spend more time together again, it is important to understand the impact that COVID-19 is having on current immunization practices and services, and how open source software is being leveraged to keep the population safe.

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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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AHRQ Releases Draft Guide for Registry Interoperability: Does Public Health Have a Role?

On January 11, 2019, the Agency for Healthcare Research and Quality (AHRQ) released a draft Addendum to the Third Edition of Registries for Evaluating Patient Outcomes: A User's Guide called Tool and Technologies for Registry Interoperability. AHRQ has long written about registries - largely from a research standpoint - and I have been following this from afar for some time. This new guide is focused on helping those who both create and use registries understand the issue surrounding leveraging external data to improve registry completeness, accuracy, and usefulness. This report covers lots of ground and does a good job of summarizing important subtopics. Each chapter is overflowing with footnotes and sources.

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An Open Source Project To Improve The Accuracy Of CDC's Mortality Data

Paula Braun | HealthData.Gov | June 4, 2015

As part of the National Day of Civic Hacking, which will take place world-wide on Saturday, June 6th, CDC would like to launch an open-source project to develop a Cause-of-Death companion application that will a) help guide medical certifiers through the process of filling out a death certificate and b) provide real-time feedback for common mistakes at the point of data entry. 

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Anatomy of a Public Health Open Source Project: HLN's Immunization Calculation Engine (ICE)

An immunization information system (IIS) aggregates immunization information for children (and some adults) living or receiving immunization services in a jurisdiction. One of the core components of an IIS is its immunization evaluation and forecasting system: the computerized algorithm that is used to determine if vaccine doses that were administered to the patient are clinically valid (evaluation) and to project what doses are due now and in the future (forecasting). These algorithms are used to support clinical decision support (CDS) at the point of care and also to help public health agencies understand and manage the immunization status of whole populations.

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careMESH Raises $5M in Seed Funding to Scale Integration of its Healthcare Communications Platform

Press Release | careMESH | June 16, 2020

careMESH today announced that it has closed an initial $5M seed round led by Assurance Capital and Pavey Family Investments, with participation by other early-stage investor funds and individuals. The funding will be used to scale adoption of its first-of-a-kind communications platform, which brings a National Provider Directory, patient event notifications, secure communications, and transition of care workflows into a single service for hospitals, health systems and other healthcare delivery organizations

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CMS To Invest $5+ Billion a Year in Open Source and Cloud-based IT Infrastructure for Medicaid

After more than 40 years of relying on monolithic mainframe platforms to administer its services, the Centers for Medicare & Medicaid Services (CMS) has embraced a new modular, open and agile approach to Medicaid health information technology for the Federal government and States. In many ways, this is the best of what open source advocates and technology innovators could have hoped for when it comes to open source policy from a government agency. According to Andrew Slavitt, Acting Administrator of CMS, the agency will spend more than $5 billion a year to fund this transformation.

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Doctors and Disaster Relief: Technology and Data for HealthTap

Andy Oram | EMR & EHR | February 2, 2016

In November 2015, when Tamil areas of southwestern India suffered from serious monsoon-related flooding that killed hundreds and caused the major city Chennai to essentially shut down for a week, local residents asked for help from an unusual source: HealthTap, the online service that offers medical advice and concierge care. This article explains the unique technical and organizational resources HealthTap offered, making it a valuable source of information for anyone in the disaster area with a cell phone or Internet access. At the end I will ask: what can public health institutions do to replicate HealthTap’s success in aiding the people of Chennai?

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Electronic Case Reporting (eCR) Takes Front Stage at PHI2018 Conference

But the real buzz at the conference seemed to be about electronic case reporting (eCR). This refers to the national effort to replace the current paper and FAX process of submitting reportable conditions from clinical care sites to state and local public health agencies with a more automated electronic process fed from electronic health records (EHRs)...HLN demonstrated the workflow for eCR at the HIMSS18 Interoperability Showcase. However, we did not see a lot of interest on eCR at the HIMSS conference. At PHI2018 we had significant interest, both among public health officials who were anxious to see how they could initiate eCR in their jurisdictions, and other vendor and stakeholder groups who seemed to feel eCR was becoming viable and more “real.”

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GAO Report on Patient Matching: Nothing New Under the Sun

On January 15, 2019 the US Government Accountability Office (GAO) released a new report to Congress, Health Information Technology: Approaches and Challenges to Electronically Matching Patients' Records across Providers. This report is in response to the mandate in the 21st Century Cures Act for the GAO to study patient matching. To develop this report, GAO reviewed available literature and interviewed more than thirty-five stakeholders (who are not identified) over the course of a year. I have written several blogs and a feature article on patient matching developments in the US. Similarly, this new GAO report is an excellent retrospective on industry efforts over the past several years.

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Health Organizations Implore Congress to Fund Public Health Surveillance Systems

HLN Consulting joined more than eighty organizations, institutions, and companies in imploring Congress to fund public health surveillance systems. The appropriations request letters – one to the House and one to the Senate – seek one billion in funding over ten years (and $100 million in FY 2020) for the Centers for Disease Control and Prevention (CDC). This funding would allow CDC, state, local, tribal, and territorial health departments to move from sluggish, manual, paper-based data collection to seamless, automated, interoperable IT systems and to recruit and retain skilled data scientists to use them.

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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 »

New Report Finds Nation's Public Health Emergencies Are Increasing While State Emergency Preparedness Levels face Challenges

Press Release | Trust for America’s Health | February 12, 2019

The report takes an annual snapshot of states' public health and emergency readiness. Authored by TFAH since 2003, it...highlights pressing needs for additional action particularly as weather- related and other public health emergencies become more frequent...It identifies specific action-steps that if taken would improve the jurisdiction's overall level of emergency preparedness, including dedicated funding for health security initiatives, modernizing and supporting technologies and innovations within public health programs, and building multisectoral collaboration and leadership.

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ONC Releases Final Rule on Interoperability: How Might it Affect Public Health?

On March 9, 2020 the Office of the National Coordinator for Health Information Technology (ONC) released its final rule on the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program. Referred to by some people as the "Information Blocking Rule," since this is the primary topic, the document actually covers a host of other issues related to interoperability driven primarily by requirements of the 21st Century Cures Act. In addition to the final rule itself you can read the ONC press release, a comparison between the proposed and final rules, and lots of other resources.

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Open Source Solutions For Public Health Case Reporting and COVID-19

The United States is continuing its slow emergence from a nation-wide shut down imposed to slow down the spread of COVID-19. Most states have started to reopen, with bars, restaurants, and many workplaces starting to fill. As people begin to spend more time together again, it is critically important that public health agencies do everything they can to help prevent further spread of the infection and continue to monitor the level of infection within the population. Data is an important tool that public health has to understand what is going on in the country. Years of limited government investment and neglect of current systems has limited public health's ability to meet the challenges of managing both localized outbreaks and pandemics.

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