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.
New Kids on the Blockchain
The most notable activities from PMAL were those surrounding Blockchain Technology. In March, IRIS’ management and hosting of the ONC/Chamber of Digital Commerce “Blockchain in Healthcare Code-A-Thon” made headlines as it became the first ever federally sponsored Code-A-Thon with blockchain as its focus. This historical 2-day competition was a follow-on to the wildly successful and publicized ONC Challenge “The Use of Blockchain in Health IT and Health-related Research” and subsequent 2-day Workshop in late 2016 which IRIS coordinated and MC’d at National Institute of Standards and Technology (NIST). It was to facilitate such an event and gain a deeper understanding of the distributed ledger technology that has revolutionized the financial industry and saw firsthand it’s applicability to healthcare.
HIMSS Interoperability Showcase
In February IRIS celebrated it’s 10th year supporting the HIMSS Interoperability Showcase where Federal agencies along with their public, private and local sector partners come together to demonstrate their HIE advancements spanning a range of health use cases. Eric Larson, IRIS’ HIMSS Government Interoperability Showcase lead, remarked that ,“It is a great opportunity to see our federal tax dollars being utilized to advance the care provided to its citizens here and abroad. For me personally it has been a great educational experience and a great way to see various health IT implementations first hand.” The Government Interoperability Showcase has been a main feature at HIMSS drawing thousands to witness cutting edge projects advancing health interoperability in the Federal sector.
FHIR® enabling the VSAC
Through FHA’s partnership with the Naitonal Library of Medicine (NLM), IRIS SMEs successfully delivered the initial implementation of a FHIR® RESTful API that provides users access to the current Value Set Authority Center value sets and supported code systems. HL7’s FHIR® is intended to enable health information exchange in a wide variety of settings. Creating a service that would FHIR® “enable” the VSAC seemed like a crucial step in advancing the HIT’s communities shared interest in achieving information interoperability. The team looks forward to continuing its work with FHA and the NLM to expand this capability.
Security Frameworks Analysis
As a result of changes to NIST publication 800-63, new standard operating procedures (SOPs) for current FICAM processes were developed that effect the way federal health agencies procure and manage their security certificates. IRIS provides workgroup leadership along with representatives from ONC, VHA, DHA, CMS and SSA that are administering these changes, providing comment to the respective organizations, and producing recommendations for the federal agencies to follow.
NIEM Health Domain: Providing Support to the NIEM Community
FHA has been the steward of the National Information Exchange Model’s (NIEM) health domain since 2013. Recognizing the plethora of Health IT standards, terminologies and health elements that already exist for Health IT, FHA asked IRIS to align the NIEM and clinical Health IT communities without reinventing what already exists. IRIS determined it will publish online tutorials supporting the NIEM Community user in need of exchanging health elements navigate the complexities of Health IT and discover these health elements for inclusion in their information exchange package documents (IEPDs). IRIS will work with FHA and the NIEM PMO to model elements in the health domain if it is determined that they do not already exist. IRIS developed a NIEM Health Community of Interest and kicked-off it’s first of several meetings in October.
IRIS HELPS DHA ON SUSTAINMENT, INTEGRATION AND GENESIS
IRIS has been supporting the on-going sustainment of DoD’s AHLTA and CHCS systems for more than nine years. IRIS also provides key integration engineering support for vendors who want to make their products interoperable with AHLTA. So, it was a natural fit for IRIS to begin supporting the next generation EHR for DoD, Cerner’s Genesis product. This project is managed by the DoD DHMSM office and completed its first-year objective of establishing an Initial Operating Capability in the Pacific Northwest, including four military treatment facilities. Fairchild, Oak Harbor, Bremerton, and finally Madigan launched over the last year. The government is now reviewing those implementations and making plans to move forward. IRIS supported these efforts with on-site expertise to assist with training, implementation, and change management.
IRIS Launches a Suite of Business Intelligence Tools For Semantic Interoperability
IRIS had many successes with its clients in 2017 but one of the most exciting from a company standpoint has been the products we’ve produced. Earlier this year IRIS began development on a semantic interoperability platform providing modeling tools to assist its customers with the difficult task of standards mapping. IRIS’ architects and analysts saw a need in the ever-evolving heath IT ecosystem to automatically navigate or map the different standards. Making the modification of legacy healthcare data systems to support the emerging standards easier by leveraging the Federal Health Information Model (FHIM), Fast Health Interoperability Resources (FHIR), the National Information Exchange Model (NIEM) and the Value Set Authorization Center (VSAC).
To facilitate greater interoperability throughout the United States IRIS began development of a semantic interoperability platform with the launch of several new data model visualization tools to help the industry and provide a mechanism for health organizations to improve semantic data harmonization challenges. FHIMView™ and FHIRView™ were launched in 2017 with NIEMView™ and VSACView™ expected to be completed in early 2018. Together, these tools can be leveraged for rapid data harmonization by supporting gap analysis and the creation of detailed exchange models from diverse sources.
The Proposed Sunsetting of FHA as an E-Gov Line of Business
IRIS Celebrated its 9th year supporting the Federal Health Architecture program. Having spent many years across many directors and national coordinators providing subject matter experts, architects and seasoned HIT analysts, we learned that a vote by the FHA Managing Board was made to sunset the program as an e-gov line of business in 2019. Our senior staff was as surprised as many other industry professionals to learn of this decision, given the still obvious need for an enterprise view of the Federal health ecosystem to help save costs and make changes to critical systems faster. Without such an organization, the Federal health agencies will continue to have stove piped efforts resulting in higher costs. The program’s fate has not been sealed just yet, there are still several appeals to HHS and OMB to be made; even if sunsetted as an e-gov line of business, there is still an opportunity to reinvent FHA to serve a new purpose. It is an uncertain time but we are optimistic that the value of FHA will be realized and continue to serve the federal partners in their health IT initiatives.