1. Status of Immunization Information System Data Exchange: Results of a National Survey
Angel Aponte1, Kevin Davidson2, Dennis Michaud3, Lisa Roberts4, Ina Kichen5
1=New York City Department of Health and Mental Hygiene
2=Netsmart Technologies Inc.
3=Massachusetts Department of Public Health
4=Georgia Department of Human Resources - Division of Public Health
5=American Immunization Registry Association
Organization they work for.

2. Background American Immunization Registry Association (AIRA)
Vision: Nationwide network of immunization registries
Mission: Use immunization registries to prevent and control vaccine-preventable disease
One of many goals: Universal registry standards
Results achieved through AIRA workgroups
Transport Layer Workgroup – Standardize electronic data communication between Immunization Information Systems (IIS)

3. Objectives
Define the current state of Immunization Information System (IIS) data exchange
To what extent are IIS exchanging patient information electronically?
Who are IIS exchanging data with?
Are standard messages and communication protocols being used?
Identify barriers to adoption of data exchange standards
As a first step…Need to understand the current situation, so we know where to go next.

4. Methods Developed survey questions during workgroup teleconferences
Asked questions about:
Data exchange
Use of standard messages
Use of standard communication protocols
Use of encryption
Barriers
72 sites invited to participate
CDC list of Immunization Information Systems (IIS)
List of Immunization Program Managers from the American Immunization Managers Website
12 regions in CA; 1 region in upstate NY.
Cities = NYC, Philly, San Antonio, and Houston
Territories = Micronesia, Puerto Rico, US Virgin Islands, Marianas Islands
Plus Indian Health Service

5. Results 32 of 72 (44%) IIS responded 24 of 50 states 4 of 13 regions
3 of 4 cities
1 of 4 territories

10. Stress the importance of custom messages when communicating with partners.
Barrier to the expansion of HL7 is partner adoption.
Make the point about challenges in implementing HL7.

13. Other = Capabilities of EMR systems, Available internal resources, Development staff turnover, Agency philosophy, We are testing our HL7 messaging with CDC.

14. Other = Partners do not use HL7, EMR systems not supporting HL7 message types related to immunization registries, Available resources, Development staff turnover, Priorities of system implementation, In process in conjunction with state IIS.
Order these.
Tie back to partners.

15. Conclusions Significant barriers exist to standardizing communication
Need to facilitate IIS data exchange through:
Simpler HL7 messages
Selection of a standard protocol for message delivery
Providing additional IIS funding for implementation of standard messages and protocols

16. Limitations Only 44% of IIS responded
Results may not generalize to non-respondents, although non-responding IIS are similar to respondents

17. Future Work Expand survey to EMR/EHR software vendors
Perform a data communication technology assessment
Next step toward electronic message delivery standard
Review existing IIS communication interfaces
Propose standard interfaces for widely-adopted protocols
Standardize data exchange to facilitate communication between IIS

18. Acknowledgements and Contact Information
Acknowledgements
Transport Layer Workgroup Members
AIRA
CDC
Contacts
Angel Aponte
Kevin Davidson