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,…

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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…

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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…

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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…

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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.

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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…

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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…

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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…

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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…

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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…

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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).

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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]

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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.

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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.…

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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.

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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…

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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.

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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.

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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…

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