Tag: Meaningful Use

Certification/MU tweaks to support patient subscriptions

This is a quick description of the minimum requirements to turn patient-mediated “transmit” into a usable system for feeding clinical data to a patient’s preferred endpoints. In my blog post last month, I described a small, incremental “trust tweak” asking ONC and CMS to converge on the Blue Button Patient Trust Bundle, so that any patient anywhere has the capability to send data to any app in the bundle.

This proposal builds on that initial tweak. I should be clear that the ideas here aren’t novel: they borrow very clearly from the Blue Button+ Direct implementation guide (which is not part of certification or MU — but aspects of it ought to be).

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Improving patient access: small steps and patch-ups

In a blog post earlier this month, I advocated for ONC and CMS to adopt a grand scheme to improve patient data access through the SMART on FHIR API. Here, I’ll advocate for a very small scheme that ignores some of the big issues, but aims to patch up one of the most broken aspects of today’s system.

The problem: patient-facing “transmit” is broken

Not to mince words: ONC’s certification program and CMS’s attestation program are out of sync on patient access. As a result, patient portals don’t offer reliable “transmit” capabilities.

2014-certified EHR systems must demonstrate support for portal-based Direct message transmission, but providers don’t need to make these capabilities available for patients in real life. Today, two loopholes prevent patient access:
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SMART Advice on JASON (and PCAST)

As architect for SMART Platforms and community lead for the Blue Button REST API, I’m defining open APIs for health data that spark innovation in patient care, consumer empowerment, clinical research. So I was very pleased last month at an invitation to join a newly-formed Federal Advisory Committee called the JASON Task Force, helping ONC respond to the JASON Report (“A Robust Health Data Infrastructure”).

We’re charged with making recommendations to ONC about how to proceed toward building practical, broad-reaching interoperability in Meaningful Use Stage 3 and beyond. Our committee is still meeting and forming recommendations throughout the summer and into the fall, but I wanted to share my initial thoughts on the scope of the problem; where we are today; and how we can make real progress as we move forward.

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Introducing the SMART C-CDA Collaborative

Overview

With support from ONC, the SMART Platforms team is working with Lantana Consulting Group to simplify and improve data exchange based on the HL7 Consolidated Clinical Document Architecture (C-CDA) standard for health summary data. We are working to ensure that real-world Health IT software can consistently produce and consume C-CDA documents, which will be a Meaningful Use Stage 2 (MU2) requirement for transitions of care between providers and for patients’ access to their own data. To this end, we’re formulating clear, “fill-in-the-gaps” implementation guidance for MU2 certification and beyond.

We’ve assembled a team of Health IT organizations for lightweight participation in a pioneering interoperability collaboration. We will identify and address “grey areas” in at least seven key domains of the C-CDA specification: demographics, medications, problems, allergies, vital signs, lab results, smoking status.
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Webinar Video with Transcript: Getting SMART about C-CDA

Enjoy this interactive transcript of Josh Mandel’s popular webinar about SMART’s open-source tools, synchronized to the video recording. Now you can:

  • Follow along in the text as the video plays
  • Click any word in the transcript to jump to its location in the video
  • Search for a specific keyword and then jump to each occurrence of that word
  • View the transcript in “scan view,” similar to a word cloud
  • Print the transcript
  • Download the transcript

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Introducing the SMART C-CDA Scorecard

The SMART team is proud to introduce the C-CDA Scorecard, a web-based tool to help vendors, providers and other health data holders produce high-quality clinical summaries for Meaningful Use Stage 2.

Get ready for Meaningful Use Stage 2

Consolidated Clinical Document Architecture (C-CDA) is the specification cited by Meaningful Use Stage 2 for creating structured clinical summary documents. C-CDA documents are required by MU2 to support transitions of care, to enable patient-driven “view/download/transmit” objectives, and to promote medical record data portability.

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CCD: Show me the codes!

In my 7/24/2012 post, I observed that exchanging uncoded lab results is the state of the art.

Why worry? SMART is pushing to enable third-party apps on disparate health IT systems, and codes are the glue holding meaning together. Without coded data, apps can’t tell a Hemoglobin A1c measurement from a monocyte percentage!

In the USA we have substantial infrastructure to promote the flow of coded data. So where do things break down?

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