Noam H. Arzt

See the following -

Immunization Calculation Engine (ICE)

The Immunization Calculation Engine (ICE) is a state-of-the-art open-source software system that provides clinical decision support for immunizations (CDSi), commonly referred to as “immunization forecasting.” ICE has two major components: The ICE Web Service evaluates a patient’s immunization history and generates the appropriate immunization recommendations for the patient. The Clinical Decision Support Administration Tool (CAT) is a web-based GUI tool that enables subject matter experts to manage ICE rules and configuration without the intervention of software developers.

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Is the US Finally Ready to Get Serious About Biodefense?

Biological and other disaster threats - whether accidental, driven by forces of nature, or intentional - pose fairly grave risks to the United States and the world. Situational awareness has been a conspicuous topic ever since the 9/11 attacks and the anthrax scare that followed shortly thereafter. Since then we have experienced numerous disasters: health impacts of major weather events such as hurricanes and earthquakes, new virus outbreaks like Ebola in Africa, raging wildfires on the West Coast (I live in California), and the ever-present threat of pandemic flu which a hundred years ago infected some 500 million people across the globe and killed an estimated 50 million people worldwide, according to the Center for Disease Control and Preparedness (CDC). But since the initial flurry of public health preparedness funds in the ensuing several years after the 9/11 attacks, this topic has not had a high priority at CDC nor the funding necessary to implement it successfully.

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Multiple New Reports on Interoperability Released

Two new reports on interoperability, and a related Call to Action were released in fall 2017 with potential impact on public health. The reports focus on the perceived successes and barriers to health information exchange and interoperability. We draw out the relevance of these reports to public health as well as some of our own observations on these issues from a past working paper. The Call to Action released by the Health Information Management and Systems Society (HIMSS) calls on the Department of Health and Human Services (HHS) to demonstrate leadership and promote progress in a number of key areas.

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New Modalities for Technical Assistance Consulting

Technical assistance (TA) is provided by expert consultants to public health systems projects in order to improve their performance against functional standards or to help solve recurring or one-time problems or issues. Unlike other forms of training or support, TA is usually focused or tailored to a specific circumstance or situation. Common examples of TA include assistance to a jurisdiction in migrating from one product to another, consultation related to a specific programmatic initiative such as school immunization health compliance, EHR interoperability implementation, or data quality review.

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Noam H. Arzt, Ph.D.

With over twenty years in managing information technology initiatives, Noam H. Arzt, Ph.D. understands how to develop, deploy and support systems on any scale. As an administrator and researcher at the University of Pennsylvania, he honed his skills including successfully guiding Federal, State and foundation grants and contracts. In 1997, Dr. Arzt launched his consulting company, HLN Consulting, LLC, which provides services and support to public health agencies around the country. HLN Consulting is a leading public health software application developer, has been at the forefront of Open Source software development, use, and support for public health.

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ONC EHR Reporting Program RFI: A Public Health Perspective

On August 24, 2018, the Office of the National Coordinator for Health Information Technology (ONC) released a Request for Information (RFI) related to the EHR Reporting Program. This RFI is required by the 21st Century Cures Act and its primary purpose is to gather ideas and suggestions related to how ONC might provide better information about Certified EHR Technology (CEHRT). Apparently, the initial intention was to create a "star rating" like the type used in Consumer Reports to use to rate EHRs, but that seems to have been abandoned in favor of some kind of measurement system. But it is far from clear exactly how this would be done.

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ONC Gets It Mostly Right with TEFCA 2.0

On April 17, 2019 the Office of the National Coordinator for Health Information Technology (ONC) released the second draft of its Trusted Exchange Framework and Common Agreement (TEFCA) for comment. The initial version was released more than a year ago in January 2018 (see my original blog). As before, this is in response to a requirement imposed by Congress in the 21 Century Cures Act. After a somewhat lengthy (but well written) introduction, the document contains three parts (compared to just two parts the first time around)...

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ONC Patient Matching Project Moving Forward...Slowly

Last week, the Office of the National Coordinator for Health Information Technology (ONC) released the final report from its Patient Matching, Aggregation, and Linking (PMAL) Project, as well as an additional report describing a pilot project to test the Patient Demographic Data Quality Framework (PDDQ) to Support Patient Matching that was released several years ago. Funded from June 2015 through September 2018 by the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) through the Patient-Centered Outcomes Research (PCOR) Trust Fund, PMAL was one of the activities I described in an earlier post. The Final Report reviews the four challenged of patient matching and linking that the PMAL project attempted to address...

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ONC Releases 2018 HITECH Report

In early January the Office of the National Coordinator for Health Information Technology (ONC) issued its annual report to Congress for 2018 on the adoption of electronic health records (EHR) and interoperability. This report is required under the HITECH Act and is further informed by requirements of the later 21st Century Cures Act...One thing that I think is notable was a short discussion about barriers to interoperability that we have heard before. The report identifies three types: technical barriers, financial barriers, and trust barriers. Within trust barriers the report mentions legal incentives to keep data from moving (I guess that would have better been phrased as legal disincentives to sharing), but this misses the point: It is the patchwork of inconsistent and incompatible State and local laws and regulations - not intentional information blocking - that presents a bigger challenge and barrier.

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ONC Releases New NPRM on Interoperability: How Might it Affect Public Health?

On February 11, 2019, the Office of the National Coordinator for Health Information Technology (ONC) released its latest Notice of Proposed Rulemaking (NPRM) to Improve the Interoperability of Health Information. Referred to by some people as the "Information Blocking NPRM," since this was the primary topic anticipated, the document actually covers a host of other topics related to interoperability driven primarily by requirements of the 21st Century Cures Act. Besides the initial text of the NPRM, ONC also released a set of summary slides and fact sheets to help explain the document.

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ONC Selects Noam Arzt to serve on the ONC Trusted Exchange Framework Task Force

Press Release | HLN Consulting | February 19, 2018

The Office of the National Coordinator for Health Information Technology (ONC) has selected Dr. Noam H. Arzt, President of HLN Consulting (HLN), as a member of the Trusted Exchange Framework Task Force. This group of healthcare and health information technology specialists will advise ONC on various aspects of the Draft Trusted Exchange Framework. This framework outlines a common set of principles for trusted exchange of health information records and minimum terms and conditions for trusted exchange as directed by Congress in the 21st Century Cures Act.

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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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Open Source Immunization Forecaster Updated to Support Pfizer COVID Vaccine

Press Release | HLN Consulting | December 16, 2020

On December 15, 2020, HLN released a new version (v1.26.2) of the Immunization Calculation Engine (ICE) in support of the Pfizer COVID vaccine. 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. Version 1.26.2 includes support for new COVID-19 Vaccine Group (with the Pfizer vaccine only). A subsequent release, coming soon, will likely add support for the Moderna vaccine. Read More »

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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Preliminary Thoughts on CMS Proposed MIPS IP Rule Changes: A Public Health Perspective

Well, here we go again. The Centers for Medicare and Medicaid Services (CMS) has now released a new Notice of Proposed Rulemaking (NPRM)...The purpose of this NPRM is to address proposed changes for Year 3 of the Merit-based Incentive Payment System (MIPS), the provider (as opposed to hospital) side of the Quality Payment Program. The part that is most relevant to public health is the Medicaid Promoting Interoperability (IP) Program for Eligible Professionals (EP)” (the EHR Incentive Programs have been renamed). A major goal of this NPRM is to synchronize as much as possible the EP program with the hospital-based program that was addressed in a previous NPRM just a few months ago.

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