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DoD’s Next Generation EHR: How bumpy will the ride be from here to there?

This blog was written by IRIS’ Chief Technology Officet (CTO) Roger McCreery. Roger is the systems engineering lead for IRIS’s  DoD Military Health System (MHS) projects.

One of my favorite success stories of government accomplishment was the accomplishments of the MUMPS Underground within the VA to build an early electronic health record (EHR) in the 1980’s and 1990’s. Teams that were comprised of clinicians and programmers worked together to jointly design and develop a significant product that helped satisfy many of VA’s clinical needs and provide a foundation for the future technology within the VA. However, the product, the Decentralized Hospital Computer Program (DHCP), included the ability of VA Medical Center personnel to do substantial modifications to the code and code sets such that the eventual centralization of data across VA was a significant challenge. To this day, establishing standards across the enterprise is an on-going challenge at VA.

Somewhere in those early years, DoD chose to take a copy of DHCP and modify it to support DoD Military Treatment Facility needs. With significant outside assistance, most notably from SAIC, the Composite Health Care System (CHCS) had many of the same good ideas – and obstacles. AHLTA eventually provided broader enterprise-wide support including a centralized Clinical Data Repository (CDR). Vestiges of CHCS persist today.  More importantly, the culture of technical staff working with clinical staff to deliver exactly what is needed continued. While certainly laudable, this approach also came with a large amount of customization and, of course, maintenance expenses. Continue reading

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2017- The Year of the Interoperabilitists™

2017 marked the 11th year of IRIS’ work helping organizations with health information interoperability challenges. We are humbled by the great people we work with as partners, customers and employees. In these experiences we share knowledge and the common focus of nationwide health interoperability. In 2017, IRIS trademarked the term Interoperabilitsts™, a term IRIS’ staff coined to describe the IRIS team’s core function on the projects they support.

Coordinating Patient Matching Activities Through PCOR

IRIS supported The Office of the National Coordinator for Health IT (ONC) on the Patient Matching Algorithm and Linkage (PMAL) project, one of 5 projects funded by a partnership between ONC and the Assistant Secretary for Planning and Evaluation (ASPE) and is one of many Patient Centered Outcome and Research (PCOR) programs. In this role we provided project management services and coordinated many initiatives supporting patient matching including Population Health, Electronic Quality Measures (eCQMs), and Gold Standard Algorithm Testing. In addition, PMAL facilitated several monetary challenges including Move Health Data Forward, Oh, The Places Health Data Goes and The Patient Matching Algorithm Challenge. Continue reading

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FHIRView™: Easy Navigation of Complex Health IT Specifications. Brought to you by IRIS Health Solutions, LLC.

IRIS Health Solutions applies business intelligence to FHIR in the form of an easy to use Mind Map: a few clicks take you precisely to the health element information you need without having to read the entire specification.

Leveraging the latest advances in web based technologies, HL7’s Fast Healthcare Interoperability Resource (FHIR) is the disruptive change that is quickly transforming legacy-based eHR approaches into web platforms. With industry leaders investing resources towards web-based Application Program Interface (API) collaborations such as the Argonaut Project, the Healthcare Services Platform Consortium (HSPC), Smart Genomics, and clinical decision support (CDS) in the form of CDS Hooks, FHIR is clearly here to stay. Continue reading

Health Information Interoperability Can Prevent Medical Errors

Recent research from Johns Hopkins, once again identified medical errors as the third leading cause of death in the US. A patient is injured by a preventable medical error every 5 seconds in this country. But what is being done about it?
Since the original report in 1999 by the Institute of Medicine, “To Err is Human” only modest inroads have been made. Diagnostic errors, medication errors, discharge errors, monitoring and communication errors are abundant in the US healthcare system, accidentally killing infants, children and adults.

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John Forrester, PM (IRIS) presenting Federal Health Architecture’s structured process for analyzing and presenting opportunities for federal, state, local, tribal and private health participants to engage and streamline information exchange criteria. [Photo: Eric Larson]

HIMSS 2017 – ONC & FHA Highlight Innovations in Health Information Sharing

John Forrester, PM (IRIS) presenting Federal Health Architecture’s structured process for analyzing and presenting opportunities for federal, state, local, tribal and private health participants to engage and streamline information exchange criteria. [Photo: Eric Larson]

John Forrester, PM (IRIS) presenting Federal Health Architecture’s structured process for analyzing and presenting opportunities for federal, state, local, tribal and private health participants to engage and streamline information exchange criteria. [Photo: Eric Larson]

KUDOS once again to the IRIS Team supporting the HHS/Office of the National Coordinator for Health IT (ONC) and the Federal Health Architecture (FHA) at the Annual HIMSS Conference held in Orlando, FL (February 19-23, 2017).  Eric Larson, John Forrester, Alberto Llanes and Caitlin Ryan did outstanding work both behind the scenes and up-front and center in organizing, supporting and presenting at the Government Interoperability Showcase and the Federal Health IT Solutions Pavilion.  

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Connect 4.6 Released as an eHealth Exchange Validated Product

On March 17, 2016, the CONNECT Gateway for Health Information Exchange released CONNECT 4.6 to the developer community and healthcare marketplace as a fully tested and approved eHealth Exchange Validated Product. CONNECT 4.6 includes an Audit Logging System Administration Module with a viewer that enables users to search and view audit events. These enhancements to audit logging improve usability particularly for transaction monitoring, troubleshooting and reporting and are fully compliant with NwHIN/ATNA audit message requirements for Patient Discovery (PD), Query for Documents (QD), Retrieve Documents (RD), Document Submission (DS), and SOAP/X12 services. Continue reading

IRIS Helps Lead the Interoperability Showcase @ HIMSS 2016 Annual Conference & Exhibition in Las Vegas, Nevada

The IRIS team was at it again this year supporting the Federal Health Architecture program at the HIMSS 2016 Annual Conference & Exhibition held in Las Vegas, Nevada, February 29th thru March 4th, 2016. This HIMSS was especially momentous for the team as it marked our 10th year coordinating the FHA Interoperability Showcase.

Eric Larson, IRIS’ “resident HIMSS expert” with over 6 years of experience preparing and hosting the FHA showcase, lead coordination activities six months prior to the conference. Eric hosted bi-weekly meetings with federal agency participants to review their demonstrations, talk about day-of logistics and kiosk preparation support. Given the excellent feedback and visitor turnout, this planning proved instrumental in the showcase’s success. Our team’s efforts helped to drive traffic to the Interoperability Showcase kiosks and highlight and give greater visibility to the interoperability initiatives taking place across our federal agency partners. Continue reading

Healthcare CyberSecurity: Securing Patient Data isn’t the Only Challenge

Recent security breaches instigated by hackers targeting the healthcare industry, particularly health insurance providers, are focusing our attention on the range of challenges faced in the securing of confidential patient data.

Myriad security issues were recently discussed by senior healthcare security executives representing five major hospitals and the HIMSS Foundation in an industry forum, “Cybersecurity in Healthcare: The Growing Challenge of Securing Patient Data”, conducted in Washington, D.C. on October 6, 2015. The panel discussion was in-depth and lively, demonstrating real-world security experience within the healthcare industry, as well as with other government agencies, the military, and private sector businesses. Continue reading

The Intrinsic Business Value of Enterprise Architecture for Healthcare Organizations


The following are excerpts from a recent article by David E. Clark, IRIS President, published in the August 2015 edition of “The Pulse – A Bi-Monthly Newsletter” from the Federal Health Architecture.


Enterprise architecture is one of the more commonly misunderstood technical disciplines, leaving healthcare business and policy professionals pondering the usefulness of it. The intrinsic business value is that enterprise architecture can save time, money and improve business and policy functions by developing clear baselines that lead to improved organizational awareness and decision making. If leveraged correctly, enterprise architecture can provide the framework to support sound technology choices, timely business process improvements and improved policies to support specific missions or functions. Continue reading