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…

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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.

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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…

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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…

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  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…

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  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…

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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).

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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]

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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.

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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.

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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…

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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.

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

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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).

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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…

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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…

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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…

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