Lantana Group Blog

Courtney Panaia-Rodi,
PMP, Director of PMO and
Meenaxi Gosai, Information Analyst

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2019 Interoperability Standards Advisory (ISA)

Lantana has engaged in standards development and deployment for over ten years and supported the development of over 70 specifications. We were pleased to take the opportunity to respond and contribute comments on the 2019 Interoperability Standards Advisory (ISA) issued by the Office of the National Coordinator for Health Information Technology’s (ONC). Our key recommendations…

An Expedition to Quality at Lantana

My healthcare IT journey began in 1988 when I accepted a clerical position in the Ambulatory Care department at St. Michael’s Hospital in Toronto, Canada. The department was implementing a new computerized Patient Registration system, which I learned relatively easily, and I was intrigued with the accuracy and efficiency of this new process. The new system allowed for more precise patient scheduling and the ability to view all outpatient clinic activity. I wanted to learn more, so I took classes on Computerized Business Systems and Programming at Ryerson University in the evenings, while working at the hospital in the daytime.

FHIR® and Trifolia-on-FHIR Training Like No Other

Our Lantana Academy provides a hands-on, immersive, learning lab environment focused on HL7’s FHIR®, FHIR® Implementation Guides (IGs), and the tools you need to get started. The Academy holds small classes for one-on-one interaction with expert instructors, led by Rick Geimer, a FHIR-I co-chair, author of several implementation guides, and co-developer of our open-source tool,…

Public Health Analyst Series: Wendy’s Journey

I grew up in rural northern Ohio playing outside and exploring the countryside—rain, snow, or sunshine. I loved being outside, active, and just playing in the dirt. I also loved school, especially biology and art class. I was good at both. I was expected to go to college, while my best friend joined the Army.…

Public Health Analyst Series: Amy’s Journey

As a teen, when people asked what I wanted to be when I grew up, I always said a doctor. In high school, my favorite classes were biology and human anatomy, and I enjoyed listening to and helping people. As a summer lifeguard, I enjoyed the feeling of saving lives and keeping people safe. (Yes, I did actually save people during my tenure! Learning to swim is a life-saving skill!) Becoming a doctor seemed like a logical career path.

CleanMed Conference

In May, I attended the CleanMed conference in Nashville where professionals from across the industry including clinicians, architects, hospital administrators, policy consultants, sustainability officers, hospital vendors and a very nice veterinary specialist discussed sustainability in their healthcare institutions.

Nursing Informatics Series: Dawn’s Journey

When I was growing up, I wanted to become a veterinarian because I love animals. However, when I was twelve, my grandfather, who had a chronic health condition, came down with influenza A and passed away after only three days in the hospital. As my family sat with him, the nurses came in to monitor his condition frequently to make him comfortable. Their compassionate care to him was wonderful, but they didn’t just care for him.

Nursing Informatics Series: Olga’s Journey

I always knew I wanted to become a nurse. I wanted to save the world by helping others, and as a young adult, I thought helping others always meant being at the patient’s side.

Nursing Informatics Series: Robin’s Journey

Growing up, my role models were family friends who were registered nurses. They were compassionate and confident. I wanted to be like them. After graduating nursing school, I went to work in surgical ICU. Looking back now, I realize I have always relied on and have learned to trust technology even when it was electronic devices connected to my ICU patients.

Nursing Informatics Series: Zabrina’s Journey

I took an indirect path to nursing informatics. I started on my journey early—as a candy striper volunteer in a tertiary care center at the age of 13. This experience was my first contact with patients in a hospital setting.

My First HL7

HL7 Working Group Meetings (WGM) – #HL7WGM in my social media-oriented mind– are bustling, busy, eventful gatherings held three times a year that draw standards-minded people from around the world. I experienced my first HL7 WGM January in San Antonio, and from my short amount of time in the health IT (HIT) industry and little experience with standards in general, you could say I was overwhelmed but learned a ton.

Public Health Analyst Series: Laura’s Journey

The me of ten years ago never would have predicted the career that I have now. Ten years ago, I was majoring in mathematics and economics at the University of California San Diego, on track to become a retirement actuary. I took a class on the US healthcare system to fulfill one of my general education requirements, and the professor assigned us a paper on a local healthcare organization of our choice.

Public Health Analyst Series: Hector’s Journey

In the summer of 2001, I had one of those life-defining moments while interning at Harvard Medical School; I discovered the public health field. Up to that point, all I ever wanted to be was a family medicine physician with a dream of one day opening a private practice to help those in my community back in Peekskill, New York.

Public Health Analysts: Who We Are and What We Do

The American Public Health Association (APHA) observes National Public Health Week during the first week of April each year. Each of Lantana’s public health analysts has a story to tell of their journey–we couldn’t let the nursing informaticists have all the fun. Keep an eye out for upcoming blogs about the individual journeys each of…

Nursing Informatics Series: Marla’s Journey

Over the past 25 years, my nursing journey has taken me down different professional paths.  At each crossroad in my career, I used the Servant Leadership philosophy as my compass to guide my journey.  During my master’s program in nursing, I read Servant Leadership in Nursing by Mary Elizabeth O’Brien.  I was finally able to put a…

Wellness in the Workplace – The Social Dimension

Previous Wellness in the Workplace blogs covered the physical dimension1 of wellness. Today’s blog covers the social dimension in a virtual environment. Social wellness refers to cultivating relationships and connecting with others. In a distributed company like Lantana, this can be challenging since we are physically separated from our coworkers. As the map shows, our staff are…

Transitioning from CDA to FHIR

FHIR, HL7’s latest standard, supports the document paradigm without document restrictions. FHIR includes a RESTful API out of the box, as well as alternate syntaxes (i.e., XML and JSON). The industry will need transition strategies for those invested heavily in CDA while new implementers move directly to FHIR.

Annual Retreat 2018

Fifteen minutes into the 2017 film Wonder Woman, my only thought was, “I want to work with them!”—the fictional Amazon warriors of Themyscira. While I haven’t ended up performing heavy sword work and archery, I believe I’ve come across the next best thing: Lantana. Like the Amazons, my telework colleagues are brilliant and ready to…

Reduce Provider Burden by Rethinking the eCQM Development Process

I’ve looked at the feds, I’ve looked at the vendors,I’ve tried to find the keyto 50 million burdens.         (with apologies to The Who) The electronic health record promised a transformation in the quality and accessibility of health information. It also promised relief from tedious paper-based documentation chores. The results, so far, are sobering. The transformative benefits…

Nursing Informatics Series: Angela’s Journey

As a former home health nurse, I know firsthand the importance of real-time patient health information. Today’s nurses can easily document and upload information that is instantaneously accessible to other health team members. But it wasn’t always so. When I was starting out, documenting an initial assessment and care plan for a new home health…

Nursing Informatics Series: Lynn’s Journey

Today, as a Senior Nurse Informaticist at Lantana, I am part of a team of clinical, program and policy analysts, working with IT engineers to develop standards-based solutions permitting interoperable—platform independent—exchange of health information. Twenty-five years ago, I was a young nurse starting out—just look at me here at my “capping and pinning” ceremony! Here…

Working from Home (#WFH): How working remotely is one millennial’s dream job

Working from home, once an unimaginable idea, is a regular part of many professionals’ lives. Technology innovation and improvements enable many to work from their houses, apartments, and even RVs. The Millennial generation, having grown up with computers nearby and cell phones in hand, want to hop aboard the WFH train. Statistics show “68% of…

Has the Clock Run Out on Electronic Claims Attachments?

With the shift towards value-based care, payers still need access to clinical information for reimbursement decisions as well as for cost and quality metrics and standardizing enough of the clinical record to satisfy the anticipated attachments reg would be an excellent next step in that direction.

Nursing informaticists: who we are and what we do

  All around the world, May 12 is celebrated as International Nurses Day. It marks the end, in the U.S., of National Nurses Week—a time to honor and recognize nurses for their contribution to health care. May 12 is also the birthday of Florence Nightingale, the nineteenth-century English nurse who became legendary for her work…

Pleasant surprise with open-source development

This is a story of how a health IT guy goes looking for an easier way of doing a tedious task, can’t find that easier way anywhere, ends up building it himself, saves a lot of time, and gets a happy lesson in the value of shared, open-source software. In my position as a ­­­­­software…

Extreme Vacation

  Lantana provides a unique benefit to its employees: after seven years of employment, an employee can take a two-month paid vacation—the “sabbatical.” I’ve now been working for the company for over seven years (over eight if you include my contracting time), and I recently finished my sabbatical, and it was amazing! Here are my…

Patient-Generated Health Data and EHR Integration

  The PGHD Revolution   With the rise in popularity of mobile health apps and wearable technology, the volume of patient-generated health data (PGHD) is rapidly outpacing providers’ ability to incorporate it into care. In fact, almost half of U.S. smart phone owners report using a mobile health tracking app. These new technologies create data…

Electronic Attachments Tell a Comprehensive Health Story

  Anticipated HHS regulations are expected to provide standards for electronic documents used as attachments to support reimbursement-related transactions. On February 5, I was joined by Mary Lynn Bushman, Sr. EDI Analyst at National Government Services, Inc., in presenting a HIMSS Health Story Project webinar on the attachment standards: their usage, the business case for…

Reporting Into the Antimicrobial Use and Resistance (AUR) Module

Hospitals report and analyze AUR data via the AUR Module. The AUR Module covers two reporting options, one for antimicrobial use (AU) and one for antimicrobial resistance (AR). Facilities can participate in one (just AU or just AR) or both (AU and AR) at any given time.

2017 Annual Retreat: My First Week at Lantana

I started a new job last month, joining Lantana Consulting Group as a Public Health Analyst, and my first week there was a little out of the ordinary. Lantana is a distributed company, which makes it easier to hire the best people no matter where they live. The tricky part of working remotely, with no…

Wellness in the Workplace – Powerlifting

How do you begin your day? If you’re like Crystal Kallem, Lantana’s Executive Director of Analysis and Policy, you begin with an intense weight lifting session.

Working from Home (#WFH): Wendy’s RV Office

Lantana’s distributed environment allows for some pretty exciting adventures. From international travels to unconventional living, that flexibility can make for some rather unique “offices”.

Wellness in the Workplace

In honor of National Wellness Week, we are kicking off our Wellness in the Workplace series. Over the next few months, you can read about Lantana’s spin on some of these dimensions of wellness. In this post, we focus on how Lantana supports physical wellness. 

Proposed Interoperability Standards Measurement Framework

Lantana Consulting Group submitted comments on July 31, 2017 in response to the Office of the National Coordinator’s (ONC) request for feedback on the Proposed Interoperability Standards Measurement Framework.

Measurement Framework to Assess Nationwide Progress Related to Interoperable Health Information Exchange to Support the National Quality Strategy

Lantana Consulting Group submitted comments on June 30, 2017 in response to the National Quality Forum’s (NQF) request for comments on the Measurement Framework to Assess Nationwide Progress Related to Interoperable Health Information Exchange to Support the National Quality Strategy.

CDA in the Wild: Conclusion (Installment #8)

Clinical Documents were never meant to hold 10 pounds of coded data. CDA is a 5-pound bag, containing the actual words, either written directly by a clinician or spoken and transcribed, with the minimal coding necessary for the use case.

What is AUR and Why Do We Care?

AUR is more than an airport code for a commune in southern France (Aurillac, if you are curious). AUR is an important facet of public health. Using the Antimicrobial Use and Resistance (AUR) reporting module, hospitals can report and analyze antimicrobial use and/or resistance data.

Notes from the Field

Recently a team of Lantana clinical analysts had the opportunity to go out in the field. As part of a national field test related to electronic reporting from clinical systems, our team was instrumental in providing hands-on training through site visits, collecting and assessing data on approximately 150 data elements, conducting focus groups, and providing feedback to the client.

Working at Lantana: Annual Retreat

We traveled to Oracle, AZ for our last retreat. We hiked, hosted an employee cocktail competition, sang karaoke, toured an artist commune, explored Biosphere 2 (my personal favorite), and stargazed from a certified dark sky park.

Road Warrior’s Utility Belt

  A benefit of Lantana’s virtual structure is the ability to work almost anywhere. Most days, this means working from our home offices (boring!). Occasionally, we truly work from anywhere, setting up a temporary office in a different city or even country. Some of us have worked from cities in India, Indonesia, Dominican Republic, and…

Lantana Selects Cool Effect Projects to Offset Carbon Emissions

How does a distributed company in the health information technology industry offset emissions from business travel? Set criteria, choose a vendor, and ask the staff to vote!

Why Payers Should Play with FHIR

This blog introduces participants working on clinical data exchange and value-based care to HL7’s Fast Healthcare Interoperability Resources (FHIR) standard and Connectathon, an event that tests FHIR’s interoperability mettle. Since Connectathon 1 in 2012, the buzz around FHIR has grown exponentially. Word on the street is HL7 has trouble finding hotel conference rooms large enough to fit all attendees! HL7 will host Connectathon 14 in January 2017 in San Antonio.

Why Payers Should Play with FHIR – Part 2

This is Part 2 of the Why Payers Should Play With FHIR. To read part 1 click here. HL7 holds Connectathons on the Saturday and Sunday before the working group meeting. Plan to arrive the evening before to settle in. Attendees can register as observers or participants. Review the Connectathon 14 wiki page before arriving.…

Working at Lantana: Professional Development

Setting professional goals at Lantana is an intentionally structured process. We take time to think about where we are in our career and what kinds of skills make us better at what we do.

Carbon Offsets for Lantana Business Travel—Where to Put Our Money?

Lantana’s business travel is a major source of our corporate greenhouse gasses emissions that we can mitigate by buying carbon offsets. How do we choose where to put our money?

New Public CDA Stylesheet

Lantana is happy to announce the release of a new public CDA Stylesheet, an open-source renderer for CDA documents. The stylesheet transforms the XML of a CDA document into a webpage that can be viewed in a browser or other XSLT-compatible application.

Trifolia Open Source Update

Lantana is happy to announce the release of Trifolia 4.1, the second release as open source code. With the initial release, we announced plans to improve installation, documentation, to pre-load data, and to simplify authentication. We have made progress on all of these.

CDA in the Wild: Timing is Everything (Installment #7)

Will time be cruel to CDA? Some think so, we think it is still alive and kicking. The hard part of CDA has always been its HL7 V3 heritage, and it is HL7 V3, not CDA that needs to join the dinosaurs, buried in shale and crushed into carbon.

Conversations from the SideFrontlines: Get Ready for CQL to Change the Game

The Clinical Quality Language is a new expression language that defines logic for quality artifacts. With its introduction into eCQMs, the industry has taken the first step towards a harmonized standards landscape.

Trifolia 4.0.0 Release Notes

This is the second major open source release of Trifolia. The update simplifies the installation process for users who wish to install Trifolia on their own systems, and improves support for the latest release of FHIR. It also includes bug fixes for users in China who were unable to log in due to the use of Google Captcha. Finally, it allows users to import data from other Trifolia installations, making it easier to share data between instances of Trifolia.

Offering an Open Source Terminology Tool

  I have been working with Robin Williams, RN, and Zabrina Gonzaga, RN, two of our clinical analysts, to update the value sets used by Camara, our clinical document editor. Our main goal is incorporating more realistic terms, so clinicians can create clinical documents using familiar terminology.   Months ago, when Lantana created the Camara…

When You Have to Travel for Work, Invest in Carbon Offsets

Lantana is a distributed company that does not manufacture products. We do not have corporate offices to retrofit for energy efficiency, so what can our business do to reduce its impact on the planet? One important option is to address our greenhouse gas emissions from business travel.

Working at Lantana: Onboarding

There’s always an anxious excitement associated with joining a new company and meeting new team members. A new chair that requires some breaking in, an empty work-space that will eventually become a reflection of your work style. Things are a little different at Lantana. So what can you expect when your workplace already feels like home?

What Eligible Clinicians Need to Know About Proposed Changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

The Medicare Access and CHIP Reauthorization Act of 2015 changed the way Medicare rewards clinicians for providing quality care. CMS released a proposed rule in April 2016 to carry out key provisions of MACRA and implement two payment paths available to “eligible clinicians” (EC) as part of the proposed “Quality Payment Program”: (1) the Merit-Based Incentive Payment System and (2) the Alternative Payment Model Incentive. The proposed “Quality Payment Program” replaces the Sustainable Growth Rate (SGR) formula for paying eligible clinicians based on value and quality of care, which aligns with CMS’s goal to replace Fee-for-Service (FFS) volume-based payment with a value-based system.

Does Risk-Adjustment for Sociodemographic Status (SDS) Have an Impact on Hospital Performance?

Ongoing research examines the impact of applying sociodemographic status (SDS) risk-adjustment to the Centers for Medicare & Medicaid Services (CMS) quality reporting programs. The main driver for investigation is a community assertion that SDS risk-adjustment is necessary to accurately gauge the quality of care given to patients of diverse backgrounds. Contrary to popular belief, recent research produced evidence that SDS risk-adjustment has little to no impact on hospital performance ratings.

greenLantana: The Case Against Commuting

  One of the many benefits of a distributed environment is flexibility. At Lantana Consulting Group, employees establish productive work environments wherever Wi-Fi can reach. Rather than joining millions of commuters across the United States, we embrace the freedom of working anywhere.   This Earth Day, we celebrate our commitment to reducing Lantana’s carbon footprint…

CDA in the Wild: Coded Data Issues (Installment #6)

  This week, I have left the bush behind and retreated to the comfort of my office. I am attempting to decode the works of the famous biologist Brice Schneuer, who spent the later part of his career dedicated to Wild CDA research.   Although he published many authoritative works on the species, Schneuer jealously…

Comments on Standards for Claims Attachments

Co-author: Kanwarpreet Sethi   Lantana Consulting Group commented on the testimony provided on February 16, 2016, to the National Committee on Vital and Health Statistics (NCVHS) Subcommittee on Standards, Hearing on HIPAA and ACA Administrative Simplification — Phase IV Operating Rules and Attachment Standard (Part 2). We agree with the many comments urging a low…

2017 Interoperability Standards Advisory

Lantana Consulting Group submitted comments on March 18, 2016 in response to the Office of the National Coordinator’s (ONC) request for feedback on the 2017 Interoperability Standards Advisory (2016 Advisory). ONC’s consideration of public comments informs the development of the 2017 Advisory and prompts dialogue, debate, and consensus among industry stakeholders. Lantana’s response outlined suggestions…

Trifolia Release 3: New Functionalities

Co-author: Robin Williams, RN   Trifolia (https://trifolia.lantanagroup.com/) is a web-based tool for standards development work. Trifolia produces HL7 Clinical Document Architecture (CDA) templates and Fast Healthcare Interoperability Resources (FHIR) profiles. Trifolia helps users rapidly develop standards-compliant electronic documents for cost-effective standards implementation. See https://www.lantanagroup.com/resources/trifolia/ for a full description of Trifolia and its existing features.  …

Conversation from the Sidelines: HL7 January 2016 in Orlando, FL

  “Conversation from the Sidelines” is a new series at Lantana’s blog. We’ll share experiences from conferences or events that gave us a different perspective on the industry.   First up, the HL7 January 2016 Working Group Meeting (WGM) in Orlando, FL. gave me an opportunity to fill-in for Crystal Kallem as an Interim Co-Chair…

CDA in the Wild: Narrative Issues (Installment #5)

  A solitary Wild CDA has left its pride. We can only presume it is searching for a mate by its extravagantly complex header and the swish of its long tail of codes. However, research tells us that while a long code tail is nice to have, it is the mating call of the CDA,…

Consolidated CDA: Pursuing Continuous Improvement

  Recently, I helped a team of HIT vendors implement an experiment to study the new HL7 Consolidated CDA (C-CDA) Care Plan Document template. This template includes constraints on a base standard, called HL7 Clinical Document Architecture (CDA), to meet the requirements for care plan information sharing. The CDA standard is a draft standard for…

Certification Frequency and Requirements

  Earlier this quarter, ONC and CMS requested information on program requirements for certification frequency for reporting quality measures. Lantana Consulting Group supports eMeasure development and has a sharp interest in the success of quality measure reporting programs as a transformative agent for healthcare. Our feedback centered on certification frequency, minimum requirements, and testing recommendations…

CDA in the Wild: Validation and Schematron (Installment #4)

  It has been weeks since our last episode. Frankly, the sight of that genetically mutated Wild-CDA/North-American-XHTML hybrid left my team so repulsed that many could not continue. But after discussing the importance of this work, and a few crew changes, we are back in the field.   And we are documenting something never seen…

Quality C-CDAs can lead to Quality Reporting

As standards developers and data analysts, we rely on finding patterns in our day to day work. We apply our patented “pattern recognition algorithm” (note: not a real patent) to identify the questions our clients ask most often. “How can we leverage our healthcare data to perform quality reporting?” Closely followed by, “and can we use C-CDA to import that data into our analytics environment?” Although we’d prefer a simple “yes”, the solution is rarely simple.

ASCO Augments Clinical Oncology Treatment Plan and Summary with Survivorship Care Plan

Co-authored by: Edward P. Ambinder, MD Jeremy L. Warner, MD The cancer journey, from diagnosis to treatment to survivorship, involves multiple interventions and stakeholders. Survivorship begins after completing a bulk of the definitive treatment, and addresses psychosocial developments, as well as late medical issues, resulting from treatment. In 2014, the American Society of Clinical Oncology…

Draft 2016 Interoperability Standards Advisory: Lantana Response

Everyone understands today that standards for data, communication, and terminology are the lynch pins of health information exchange across clinical care. But who is doing something about it? Earlier this quarter, the Office of the National Coordinator (ONC) published a draft seeking feedback in three major areas: Vocabulary, Code Set, and Terminology Content and Structure…

MIPS

Earlier this quarter, CMS came out with a rule that establishes a new methodology for MIPS eligible providers and encourages eligible professionals to participate in APMs. Lantana supports several stages in the value-based purchasing information lifecycle, and we have a sharp interest in the success of these programs as a transformative agent for healthcare. Our…

CDA in the Wild: Validation – XML Schema (Installment #3)

  During our last episode, we stumbled upon a wild CDA lying dead in the grass. Not wanting to pass up such an opportunity, we decided to dissect the beast to uncover the cause of death. The immediate cause turned out to be a malformed end tag that resulted in catastrophic system failure.   Further…

CDA In The Wild: Basic XML Issues (Installment #2)

  Move in closer now…do you see that? It’s a wild CDA lying motionless in the grass. Surely it’s waiting for prey to…wait, it’s not moving – something’s wrong…   Ah, this one was dead when we got here.   A fair number of wild CDAs suffer from basic XML issues. This means they are…

CDA in the Wild – Introduction

Shh…
…beyond the bushes ahead you will see the Wild CDA in its natural habitat…
Lantana Consulting Group presents the first installment of CDA in the Wild by Rick Geimer, a blog series that identifies top errors found in CDAs (and how to fix them).

We go greenLantana

greenLantana is the name of our collective effort to measure, evaluate, and improve the corporate, social, and environmental impacts of our Lantana way of doing business. As the name suggests, our initiative emphasizes environmental responsibility and includes support for “corporate social responsibility”[1] and the “triple bottom line”.[2]

What Does LTPAC Want – for Interoperability?

The Long-Term and Post-Acute Care (LTPAC) Health IT (HIT) Collaborative held its 10th Annual Summit in Baltimore at the end of June. HIT leaders, policy makers, providers, and vendors, convened to discuss industry initiatives and priorities from the Collaborative’s latest Roadmap for Health IT in LTPAC. We participated in and attended several sessions on continuity of care and quality reporting.

The Lifecycle of a Template – Part 2: Template Characteristics and Lifecycle

HIT Stakeholders at all levels benefit from understanding the template lifecycle. System engineers and clinical analysts who design templates, implementers who use templates, and participants who govern templates need this knowledge to do their jobs. Understanding the lifecycle of a template requires you have the following: Appreciation the relationship between a template and its versions.…

The Lifecycle of a Template – Part 1: Stability and Progress

A template’s inaugural design often doesn’t seem like a “version”. It is difficult for designers while working closely to solve a problem, to envision that someday, perhaps even in the not too distant future, the solution they are in the midst of creating will need to change. And so it is with templates.

Wash, rinse, and repeat (Part 2)

My last blog post detailed some of the features of Trifolia that help make my life as an information analyst easier. In this post, I discuss the part of the workflow I use to develop an implementation guide (IG) and the templates contained in it. This part of the workflow starts after the analysis and…

Trifolia, how do I love thee? Let Me Count the Ways (Part 1)

I’ve worked with various incarnations of HL7 Implementation Guides (IG) for roughly 8 years. My first exposure was in the UK with the NHS Connecting for Health’s Message Implementation Manual (MIM) for V3 messages. I wasn’t involved in building this specification, but I did use it for coding. Later, I was responsible for creating the Clinical Document Architecture (CDA) IGs for Australia’s national eHealth program. Back then, these were manually created Word documents that evolved into partially automated DocBook created PDF documents.

What’s New in Trifolia 2.17

The most recent Trifolia update addresses requesting permissions, permissions notifications, default setting for exporting to MS Word and MS Word value set settings. Read our latest blog post for details of the full development log.

HIT on Parade at the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting

HIT vendors eager to advance the cause of shareable clinical information – and their products – can do so this Spring in a first-of-a-kind interoperability demonstration. ASCO is not primarily a trade or HIT show. It is the central venue for 25,000+ cancer clinicians, researchers, and other stakeholders from around the world.

What’s New in Trifolia 2.16?

Released on Thursday, Oct 23, 2014 Retired Template Status Trifolia now supports a “Retired” template status, representing a template that should no longer be used. The Retired status is only used on templates that have been versioned. The Retired status omits the template from the main body of the MS Word document and includes an…

Free Text Sig

Discord is afoot. It has been for some time now. The cause is a little understood data element known as “Free Text Sig”.

CDA Experts on FHIR

At Lantana, we are all pretty comfortable working with CDA. I think we are also pretty open to understanding its limitations. The current CDA, Release 2, was developed ten years ago. It was designed to meet a range of requirements from simple, transformed-from-dictation documents to fully coded, semantically interoperable reports. A key design consideration, a requirement for passing ballot within HL7 at that time, was full compatibility with Version 3 messaging and an explicit tie-in to the Reference Information Model (RIM).

What’s New in Trifolia 2.15

The latest release of Trifolia is available. Check out what is new in Trifolia 2.15.

Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative

Upgrades to electronic health record (EHR) systems scheduled to be introduced in the USA in 2014 will advance document interoperability between care providers. Specifically, the second stage of the federal incentive program for EHR adoption, known as Meaningful Use, requires use of the Consolidated Clinical Document Architecture (C-CDA) for document exchange. In an effort to…

What’s new in Trifolia 2.14

Trifolia version 2.14 is now available. Several updates have been made to the user interface, template editor, template viewer and browsing functions to improve user experience.

Proposed Delays to 2014 Meaningful Use Timeline & and Changes to Certified Electronic Health Care Technology (CEHRT). How will you be affected?

Today, CMS announced proposed changes to Medicare and Medicaid electronic health record incentive program timeline for 2014 and revisions to the CEHRT definition. As a courtesy, Lantana put this summary together outlining the changes and how they may affect vendors and care providers. The full fact sheet can be found here. Why the change? CMS…

Brag Blog: HAIMS Nails it for Veterans

The great thing about a career in health IT is that we have so many problems to solve. The drag is that it occasionally feels as if we operate on a treadmill of ever-receding achievement. In this space, I want to recognize a solid achievement in health IT in which Lantana played a part. It…

Lantana Annual Retreat: Full Speed Forward

Lantana’s company retreat started out with a review of the company vision statement, pared down to the following: “We want to see health information available across the spectrum of care, supporting safe, effective, affordable healthcare that improves well-being, public health, quality of care, and research.”

From there, we spent a day and a half reviewing our goals, strategy, and tactics to realize this vision. We found, to our satisfaction, that our long-time company motto[i], “have fun, make money, improve the industry” works just fine to articulate our goals.

Rest Secure

A security update for the long-standing CDA style sheet is available from Lantana Consulting Group here. This update addresses a potential vulnerability exposed by use of the style sheet in many current internet applications by preventing malicious insertion of executable code into the display instructions for non-XML clinical documents (allowed as the body in Consolidated…

HIMSS Health Story Project: Our Successful Demonstration of the SEE Tool in a Patient-Centric Use Case

Lantana demonstrated the SEE Tool as part of HIMSS Health Story showed how physicians without an EHR can still access the HIE & update a patients record.

Proposed Voluntary Certification for Long-term and Post-acute Care (LTPAC) Providers

The Health IT Policy Committee’s Certification and Adoption Workgroup recently held a virtual hearing on a proposed long-term and post-acute care (LTPAC) certification program.

Conformance Drift in Consolidated CDA R2; Part Three of Three

The C-CDA Implementation Guide development team settled on five heuristics in resolving ballot comments grouped as “tighten constraints.” Here are my thoughts on the applicability of those heuristics.

Conformance Drift in Consolidated CDA R2; Part Two of Three

The HL7 Consolidated Clinical Document Architecture (C-CDA) Release 2 ballot received an unprecedented 1,000+ comments. A number of those comments include proposals to tighten various constraints within the document. Here are some arguments towards constraint tightening.

Conformance Drift in Consolidated CDA R2; Part One of Three

The HL7 Consolidated Clinical Document Architecture (C-CDA) Release 2 ballot received an unprecedented 1,000+ comments. A number of those comments include proposals to tighten various constraints within the document. Although tightened constraints sometimes are necessary, they may also represent bad spec design in the form of a “conformance drift,” a situation in which increasingly restrictive conformance verbs are applied to truly optional elements thus idealizing one implementation of the spec to the exclusion of others.

Now Available: Write-Enabled Trifolia Workbench

The write-enabled version of the Trifolia Workbench: HL7 Web Edition is now available for HL7 members.

Template Versioning for Consolidated CDA (C-CDA)

The HL7 Structured Documents Working Group (SDWG) is discussing approaches to template versioning in Consolidated CDA (C-CDA). I suggest here a strategy that is consistent with current policy on identifiers.

Ready for Write-Enabled Trifolia Workbench?

Lantana will soon release an enhanced, write-enabled version of the Trifolia Workbench: HL7 Web Edition for HL7 Members. Trifolia Workbench is a web-based standards development tool that supports designers, developers and implementers in capturing and managing HL7 RIM-based templates, such as the Clinical Document Architecture (CDA) and the Healthcare Quality Measure Format (HQMF/eMeasure).

Public Webinar This Week: Role of Standards in Quality Measurement

Crystal Kallem, RHIA, CPHQ, will review the current state and vision for quality measurement and the role of foundational quality specifications that are requirements in Meaningful Use Stage 2.

CDA Academy Hat Visits Machu Picchu

CDA Academy Alumnus, David Swiezy, Allscripts, took his CDA Academy hat along on several adventures—to Machu Picchu in Peru and to the Galapagos Islands.

Join the Ballot Pool for C-CDA (by Monday)

As part of the ongoing effort to enable more consistent and accurate clinical data exchange, the HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm) Draft Standard for Trial Use Release 2 continues to build on the library of CDA R2 templates consolidated within the first release.

Accelerating Health Information Exchange: Highlight from ONC/CMS Webinar

I recently dialed in for a webinar on Accelerating Health Information Exchange hosted by both the Office of the National Coordinator for HHS (ONC) and the Centers for Medicare and Medicaid (CMS). The government had received over 200 public comment submissions on policies that can strengthen the business case for exchanging information across providers seamlessly and securely. Here are some takeaways from the webinar.

Where’s Your Hat?

Each student who attends our CDA Academy workshop receives a super soft, unstructured, eco-friendly, bamboo and cotton blend, red hat with white CDA Academy logo. We’ve been handing out the same popular hat for the past eight workshops…

Administrative Simplification: Highlight from CMS eHealth Summit Webinar

We believe C-CDA can provide the requisite information to automate the pre-authorization process, providing immense efficiencies for both providers and payers.

Updated C-CDA and QRDA Specs Now Available

The updates address errata approved by the HL7 Structured Document Work Group. Both draft standards for trial use are referenced in the Certification Criteria for Meaningful Use Stage 2…

Join Us: New Quality Reporting Track for CDA Academy VIII

We are excited to announce a new two-day track on Implementing Quality Reporting at CDA Academy VIII…

Lantana at HIMSS13: Hello, New Orleans

Eight of us will be in the Crescent City for the better part of a great week. We’re looking forward to meeting with colleagues, clients, prospective clients, old friends and people who share our passion for HIT interoperability, music and good food. Here’s what’s up…

Are There Really Any Health IT Standards?

“What would you say to someone who says, ‘There are no standards [in health IT].’?” …

Our Perspective on Updating Consolidated CDA

Several proposals have come forward to augment HL7 Consolidated CDA with additional templates. The Structured Documents Work Group has taken the position that new templates supporting long term care will be added in an addendum rather than integrated into a new release of the spec. I think this position needs to be reconsidered both as a general course and for the specific material. Here’s why.

At Your Service!

We are taking advantage of our upcoming meeting with 25,000 of our closest associates — we will show greenCDA technology in the Health Story portion of the HIMSS12 Interoperability Showcase, Hall G, #11000.

How green is greenCDA?

The answer is, “potentially, pretty darn green.” I was invited to speak at the 2nd Annual Global Healthcare Conference where the topic is the greening of healthcare – reducing the environmental impact of care delivery in the US and around the world…

2nd Annual Global Healthcare Conference: The Green Revolution in Health Information Technology

Uncovers environmental impact of electronic health records and a strong tie to standards in the incentive to reduce visits.

Academy V: Around the Corner and Out on the West Coast

Hard to believe that we are already going into our fifth edition of the CDA Academy, the premier place to learn, absorb, ponder and explore everything related to the core specification behind Meaningful Use of electronic health records and all types of clinical information exchange.

Lantana is Growing

We are looking for a qualified operations manager, clinical information analyst, terminology analyst and software qa engineer…

New Tool for Managing CDA Templates Now Available

Our beta release of a tool for capturing, storing and managing CDA templates is now available through HL7.

Academy IV: Almost here…

The source for comprehensive training in the core specifications required for Meaningful Use, the CDA Academy, comes around again in Academy IV, now enhanced with a track for policy makers and planners.

Direction Needed

Health Story recently participated in an advocacy day on Capitol Hill. I helped prepare a broadsheet, and it came to mind when I was asked (again) yesterday about recognition for the Consolidation Project effort.

Template Database Now Open Source

The Lantana Consulting Group is proud to release our Template Database (TDB) as open source software under the Eclipse Public License.

That Was the Year That Was

We are just wrapping up our fifth annual Lantana retreat here at the sunny, frigid and idyllic C.O.D. Ranch in Oracle, AZ. Looking back, it’s been quite a year for us and for the industry.

Launch of the “HL7/IHE Health Story Consolidation Project under the ONC S&I Framework”

If the official title of the Consolidation Project is looongg, that is in part why it is exciting – there are many hands involved here, and we expect to make light work of a number of important tasks.

Welcome to the Lantana Consulting Group Blog!

Moving into our beautiful new site is like getting a new home. It’s a great opportunity to see ourselves in a new light.

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