Health IT Improves Immunization in the Time of COVID-19

While the world awaits new vaccines for COVID-19, which are expected to begin emerging from clinical trials as early as this fall—just as flu season begins—it is more important than ever to ensure the effectiveness of the systems that manage immunizations for the American people.

Health information technology plays a key role in ensuring Americans receive appropriate vaccinations on a timely basis—an area of national focus during Immunization Awareness Month, which is observed in the United States each August.

Following substantial disruption to routine medical care brought about by the pandemic, healthcare providers across the nation are implementing measures to help Americans safely and quickly receive routine healthcare services, including those related to prevention and immunization. Routine immunizations for children fell significantly as the number of COVID-19 cases increased and stay-at-home orders were implemented across the country.

The Role of Health Information Technology in Improving Immunization

Health IT—including electronic health records (EHRs)—plays a key role in supporting immunizations driven by both routine care and by public health crises. This role includes:

• Ensuring the right patient receives the right vaccination at the right time, through effective patient identification, review of the patient’s vaccination history and easy access to clinical guidelines that increase understanding of what vaccines and doses are needed, and when;
• Generating population-level reports to identify gaps in vaccination coverage to support improvements, as well as reporting of adverse events;
• Facilitating the exchange of information among healthcare providers—through their EHRs—and immunization registries (often referred to as IISs)to help ensure that both clinicians and public health agencies have the information they need to track vaccination coverage and reduce vaccine-preventable disease; and
• Enabling patients to have easy access to their immunization information.

Advancing effective health IT solutions that support immunization requires collaboration among stakeholders across the entire spectrum, including healthcare providers, EHR developers, health information exchanges (HIEs), IISs and other public health leaders.

The Immunization Integration Program

The Immunization Integration Program (IIP) is bringing stakeholders together to gain agreement on and advance the adoption of EHR capabilities and solutions that improve interoperability and the exchange of immunization information so clinicians and public health agencies have the information they need to increase appropriate immunization and improve the health of individuals across the U.S.

The IIP is a 7-year program currently supported by the Centers for Disease Control and Prevention (CDC) and convened by Chickasaw Health Consulting (CHC), the American Immunization Registry Association (AIRA), Drummond Group and HIMSS.

The IIP accomplishes its goals through two primary programs. The IIP Collaborative, brings stakeholders together to develop and drive the adoption of solutions to improve interoperability, data sharing and access to immunization information by clinicians and public health. IIP Testing and Recognition facilitates adoption of consensus immunization-related capabilities within EHRs to improve clinical decision-making and information sharing with IISs.

IIP Collaborative: Improving Immunization Data Sharing Among EHRs and IISs

Led by an Executive Committee, the IIP Collaborative is working in two primary areas to improve immunization data sharing and information needs.

Moving Towards a Unified Transport Standard

For two systems to successfully exchange data, they must use a common transport method. Although standardization among EHRs and IISs has improved over the past several years, considerable variability in use of transport protocols still exists, resulting in considerable burden. The Collaborative is bringing EHR developers, healthcare providers, HIEs and IISs together to gain agreement on and drive the adoption of strategies that support a unified method of transport.

Effectively Managing Acknowledgements

After a vaccine is administered, a healthcare provider records information within the EHR, which is subsequently transmitted to the IIS. Once the IIS receives the vaccine submission from the healthcare provider, it returns an acknowledgement, along with information that indicates success or failure, including error messages. There is significant variability in the way that healthcare providers, EHRs, HIEs and IISs handle acknowledgements, including their submission or receipt, routing, response and management of errors and rejections. The way acknowledgements are handled by all stakeholders involved in the process has an impact on the quality and completeness of immunization data available for both clinical and public health decision-making and use. The Collaborative is bringing these stakeholders together to assess the current state, identify the greatest opportunities for improvement and gain agreement on and drive the adoption of solutions to improve the way acknowledgements are handled across the continuum.

IIP Testing and Recognition: Advancing EHR Functionalities to Support Evolving Immunization Needs

Over the past seven years, the IIP Testing and Recognition program—an Office of the National Coordinator for Health Information Technology (ONC) approved testing partner—has facilitated market adoption of key EHR functionalities to improve interoperability and streamline how immunizations are administered and managed.

The program spans the following areas critical to the successful management of both routine vaccines and those needed in the time of crisis:

• Querying, receiving and reconciling immunization information from registries;
• Managing information to inform clinical decision-making;
• Administering and reporting vaccines to registries;
• Developing population-level reports to identify gaps and support improvements;
• Managing vaccine inventory;
• Reporting adverse events; and
• Providing access for patients.

Last month, the program’s Technical Advisory Panel reviewed and prioritized the next set of updates, drawing from the remaining IIP capabilities not yet integrated into testing, updates to support alignment with recently-released ONC final rules, recommendations emerging from the IIP Collaborative and high-priority capabilities needed for a new COVID-19 vaccine. The IIP plans to publish updates to the IIP Testing and Recognition program in the fall of 2020.

Learn more about the IIP or email iiphelp@himss.org for additional information.

Select AIRA 2020 National Meeting Presentations

IIP Collaborative co-convener, the American Immunization Registry Association (AIRA), is hosting a webinar series to showcase select AIRA 2020 National Meeting presentations on key issues impacting IIS during the pandemic. The webinars will occur every Tuesday from 3 -4 p.m. ET, Aug. 4 through Sept. 22. Register for the webinar series.