E-Health Designs, LLC

NHIN 2.0 Gateway Code Released

I recently attended an outstanding NHIN connect training conference, attended by over 1200 representatives from government, industry and academia.

I have worked with many of the key individuals in the companies in the HIE space.

The momentum for actually establishing the NHIN is high.

There are many new cutting edge technologies and standards involved.

The latest NHIN 2.0 code can be found at:  http://www.connectopensource.org/display/NHINR2/

Release+2.0+Home;jsessionid=C2640BB1D07CF4D900963717596B3BE2

If you need independent, objective advice or implementation assistance regarding the NHIN, please e-mail me or call.

Robert E. Connors, FACHE, PMP, CEO, E-Health Designs, LLC to attend NHIN Connect Training, 29 and 30 June 2009

Robert E. Connors, FACHE, PMP, CEO, E-Health Designs, LLC will attend NHIN Connect Training, 29 and 30 June 2009, and is available to meet with clients in the evenings.

U.S. Army Telemedicine and Advanced Technology Research Center Showcases Emerging and Enabling Healthcare Technologies

On 17 and 18 June 2009, U.S. Army TATRC held an exhibition in a deployable field hospital tent called the OASIS, to showcase emerging and enabling healthcare technologies.

Emerging Technology and Organizations highlighted at the Annual Expo included:

Medical Modeling and Simulation Training Technologies

Compartment Syndrome Simulation System: Touch of Life Technologies
Physical Abdominal Model: Operative Experience, Inc.
Pandemic Influenza and Burr Hole Simulation: SimQuest, LLC
Laproscopic Ventral Hernia Procedure: University of Maryland Medical Center
Ft. Sam 68 Whiskey Combat Medic Simulation: WISER Institute, University of Pittsburgh
Ultra High Resolution Display for Army Medicine: eMagin Corporation

Medical Logistics (MEDLOG) and Telehealth

Deployable Remote Surgery Consultation: San Francisco VA/SRI Inc.
Automated Neuropsychological Assessment Metrics (ANAM): University of Oklahoma
Innovative Distance Based Health professional Programs: CERMUSA, St. Francis University
U.S. Army Knowledge Online Teleconsulting:
Mobile Access Point Robot: CERMUSA, St. Francis University
Alpha 20 Waste Treatment Research Project: Innovasan Corporation
Automated Identification Technology System (AIT): Eigent Technologies, Inc.
Deployable Hospital Asset Tracking: Agility Health Care Solutions
Mobile Communications: TATRC
Telemaintenance: U.S. Army Medical Material Development Agency (USAMMDA)
Teleradiology: MedWeb, Inc.
TELESYNERGY – International Telemedicine System: National Institute of Health (NIH)
Ad Hoc Networked Tags for Active RFID: InfinID Technologies, Inc.
Compact Rugged Mobile Auto ID Tech Warehouse Scanning System: VedaSee Solutions, Inc.

IM-IT (Information Technology-Information Management) Healthcare Projects

MEDCOM AHLTA Provider Satisfaction (MAPS): Office of the U.S. Army Surgeon General
AHLTA Mobile – Cell Phone Access Vice CDE/PAWS: TATRC
Medical Device Interoperability: Moberg Research, Inc. & CIMIT (Harvard/MIT)
Ultra-Wide Band Electronic Information Carrier (EIC): Realtek, Inc.
Prospectively Validated Decision Support Algorithms for Combat Casualty Care: Biotechnology High Performance Computing Software Application Institute, TATRC
Natural Language Processing (NLP): Progeny Systems/Language and Computing, Inc./Carnegie Mellon University
Clinical Looking Glass (CLG): Emerging Health, Inc./Montefiore Medical Center
Nationwide Health Information Network (NHIN): TATRC Advanced Info Technology Group

Technologies for Combat Support Hospital (CSH)

Total Intravenous Anesthesia: Penn State University
Rapid, Microfluidic Enhanced Diagnostics ABORhCard and PanNAT fpr Rapid, Point of Care, Nucleic Acid Testing: Micronics, Inc.
Miniature In Vivo Surgical Robots: University of Nebraska
Mirasol – Pathogen Reduction Technology: CardiaBCT Biotechnologies, LLC
Near Infrared Spectroscopy (NIRS) to Evaluate Pain & Consciousness: CIMIT (Harvard/MIT)
Hand Htgiene Reminder and Monitoring System: CIMIT (Harvard/MIT)
Smart Pad Wireless, Adhesive, Electrode-Free, Autonomous ECG Acquisition System: CIMIT (Harvard/MIT)

Robotic Extraction and Evacuation

Piasecki Aircraft Combat Medic UAS for Medical Re-Supply & CASEVAC: Piasecki Aircraft
GPS-Zigbee patient Tracker/Data Logger: NAVSYS
M-4 Rifle Grip & iGlove Robotic Controllers: Anthrotronix, Inc.
Combat Medic UAS for Medical Re-Supply and CASEVAC- Dragonfly DP-6 Whisper Demonstrator: Dragonfly Pictures
Comuter Assisted Interventions and Medical Robotics (CAIMR): Georgetown University
Robotic Bio Identification Robot (ROBI) on ARES UGV: ChemImage, Inc.
Robotic Manipulator & CASEVAC Mission Software: National Center for Defense Robotics & Applied Perception a Foster Miller Company
Serpentine Robotic Manipulator Arm: Carnegie Mellon University
Stand-off Remote Triage Sensor Array for Robotic Casualty Extraction Systems: PERL Research, Inc.
Robotic Stand-off Neck and Spinal Injury Assessment Device: American GNC, Inc.
Battlefield Extraction Assist Robot (BEAR): Vecna Technologies, Inc.
Chem/Bio BEAR: Robotic Force Protection from Chem Bio Agemts and IEDs: Vecna Technologies, Inc.
Alternative Mobile Power Station (AMPS): Woodward Bewley Tech Development, LLC

See http://www.wtop.com/?nid=25&sid=1700097

Why Healthcare IT Should Look Like the iPhone

Here is a great article on why EHRs should look like the iPhone.

http://chip.org/platform

What do you think?

Is the EHR really any more complicated than an iPhone?

Office of the National Coordinator (ONC) for Healthcare Information Technology Continues Discussions on “Meaningful Use” of Electronic Healthcare Records

I hope you find this link “meaningful”, but according to Dr. Blumenthal, you can decide for yourself what these discussions mean!

http://www.healthcareitnews.com/news/onc-goes-back-drawing-board-meaningful-use

FHA CONNECT TRAINING, 29 AND 30 JUNE 2009

FHA has announced training on the use and implementation of the new open source CONNECT gateway and enteprise service component, to be held 29 and 30 June 2009, at the JW Marriot Hotel in DC. Registration is already at nearly 800.  Registration is approaching capacity.  See http://connectopensource.org/display/NHINEVENTS/29-30+June+2009+CONNECT+User+Training+Seminar

IBM Blue Spruce

I recently got a chance to see a demonstration of the evolving IBM Blue Spruce collaborative web environment, that allows many-to-many on-line collaborations, and is totally web-based and operates inside a browser. I see many applications in medicine, such as joint clinician collaboration on analyzing an image, or distributed clinical group counseling sessions. The technology also might be used to provide an unified view of multiple inputs and applications for medical situational awareness. The technology uses open source components such as Java. See http://www.readwriteweb.com/archives/ibm_blue_spruce_first_look.php

HITSP Update

HITSP Update from John D. Halamka MD, HITSP Chair, as reported originally by Dr. Hufnagel, DOD representative to the HITSP:

“Folks:

Today the HIT Standards Committee met for the first time. We formed three workgroups – Clinical Operations, Clinical Quality, and Security. The 90 day HITSP tiger team focus on ARRA is producing the exact deliverables needed by these workgroups. Over the next 2-3 months the HIT Standards Committee will review HITSP’s work and will recommend standards in support of meaningful use to the National Coordinator. As HITSP Chair and HIT Standards Committee Co-chair, I will work hard to provide great communication between the two organizations.”

AHLTA CITRIX Roaming Sessions

AHLTA, DoD’s Electronic Health Record, has been getting some bad press lately due to user interface and performance and reliabilty issues, but instead of complaining, some saavy military CIOs, like Captain William E. Sorrells, MSC, USAF, FACHE, CPHIMS, are doing something to improve the situation now.   Volume 12, Issue 6, September 2008 of Military Medical Technology reports that 3rd Medical Group had great success in deploying a roaming session environment for several applications.  The CITRIX roaming sessions keep a single session open all day for a provider. The provider can access this session all day as he/she moves from room to room.  This simple innovation saved 2880 hours per year for the 18 providers at Elmendorf.  Many MTFs have  yet to implement this option for AHLTA.

NHIN CONNECT Enterprise Service Component (ESC) Code and SDK Released!

As previously reported at http://www.ehealthdesigns.com, the HHS ONC for healthcare IT announced the release of open source NHIN CONNECT Code and SDK at the 2009 annual HIMSS conference. The code may be used under a government BSD, non viral license.  LCDR Steve Steffensen, MC, USN, and Captain (Sel) Emory Fry, MC, USN, were instrumental in working with the FHA to develop the adapter layer and common access layer, which will allow the NHIN gateway and enterprise service components to connect to back end federal and commercial EHRs.

The NHIN 2.0 gateway download site is http://www.connectopensource.org/display/NHINR2/Release+2.0+Home;jsessionid=C2640BB1D07CF4D900963717596B3BE2.  This is a significant advance towards the national goal of exchanging interoperable healthcare data, in that the code and SDK will allow software developers to connect federal agency back-end government and commercial healthcare systems to the NHIN.

Per the CONNECT website:

“If the Nationwide Health Information Network (NHIN) is the information highway for health data exchange, CONNECT is the universal on-ramp for federal agencies. CONNECT is a software solution that lets federal agencies securely link their existing systems to the NHIN. More than 20 federal agencies collaborated to build CONNECT through the Federal Health Architecture (FHA), and as a result, agencies are heading down the road toward interoperability.

The Office of the National Coordinator for Health Information Technology (ONC) has been facilitating development of the NHIN, which will tie together health information exchanges, integrated delivery networks, pharmacies, government, labs, providers, payors and other stakeholders into a “network of networks.” The NHIN provides a mechanism for previously disconnected systems and exchanges to connect to each other and share data using nationally recognized interoperability standards, specifications, participation agreements and policies. The ability to share data electronically among organizations will provide a wide range of benefits to citizens, among them: having up-to-date records available at the point of care; enhancing population health screening; and being able to collect case research faster to facilitate disability claims.

The CONNECT software is the outcome of a 2008 decision by federal agencies to begin work on connecting their health IT systems into the NHIN. Rather than individually build the software required to make this possible, the federal agencies collaborated through the Federal Health Architecture program to create a single solution that can be reused by each agency within its own environment. The agencies built CONNECT in open source in order to keep costs low when it is deployed in each organization. An additional benefit of developing the offering in open source is that CONNECT has now been made available to the healthcare industry at large. CONNECT will act as an accelerant to promote NHIN adoption and additional innovation in the industry.

The CONNECT Gateway is built on open source technologies and will be made available to the public in March of 2009. Three primary elements make up the CONNECT Gateway:

• The NHIN Gateway implements the core NHIN services enabling such functions as locating patients at other health organizations within the NHIN, requesting and receiving documents associated with the patient, and recording these transactions for subsequent auditing by patients and others. Other features include authenticating network participants, formulating and evaluating authorizations for the release of medical information, and honoring consumer preferences for sharing their information.

• The Enterprise Service Component (ESC) provides default implementations of many critical enterprise components required to support electronic health information exchange, including a Master Patient Index (MPI), Document Registry and Repository, Authorization Policy Engine, Consumer Preferences Manager, HIPAA-compliant Audit Log and others. Agencies are free to adopt the default enterprise component implementations packaged in the CONNECT ESC or to plug in existing agency implementations of these service components. This component also includes a software development kit (SDK) for developing adapters to plug in existing systems such as electronic health record solutions to turn on information flows to support the secure exchange of health information across the NHIN. This makes CONNECT a platform for participation in health information exchanges.

• The Universal Client Framework enables agencies to develop end-user applications using the enterprise service components in the ESC. This makes CONNECT a platform for innovation.”

As of 8:00 AM on 7 April 2009, there was very high demand for the software, and HHS put a limit on the number of downloads.  If you cannot get into the download site, keep trying!  E-Health Designs, LLC has subsequently learned that in order to get the code, one must register first with a user name, password, and valid e-mail address.  Upon registration, an e-mail is sent back to the user and he/she must validate that address prior to moving to the next step and being able to actually download the software.  As of 9 April 2009, I was still waiting on the e-mail to arrive so I could validate it.  I presumed that this was an automated process similar to other web sites, however, an FHA representative confirmed to me this afternoon that there is a human involved in the process to send the e-mail, and he/she is back-logged.  FHA is looking to an alternative solution so as to make the downloads more available.