Immunization Integration Program

Out of sync vaccine-related code set values (e.g., NDCs for annual flu vaccine or new vaccines) between immunization data exchange partners impedes data interoperability and can prevent patients’ vaccinations from being recorded properly. The Code Sets work effort launched in fall 2022 to collaborate with key partners to develop recommendations. This project seeks to develop resources to reduce:

• The level of effort and length of time required to implement new values within vaccine-related code sets used for interoperability between IIS and other health IT systems
• The variation in understanding of code set values (e.g. use of specific v. generic, NOS codes) and code set metadata (e.g., “code is active”) between IIS and applications used by their trading partners (e.g., EHRs)

This effort builds upon the work done in AIRA’s 2020 Vaccine Code Set Considerations. In the fall of 2023, information was gathered from 50,000+ individuals who currently use CDC provided vaccine code set resources in the form of an online poll — once the poll is live, a link will be provided here. Contact us at iip@himss.org to learn more about the topic, share your expertise or participate in solution development.

• Inconsistency in how data is entered at the point of registration or vaccine administration such as dates entered in the future, birth date discrepancies, or missing fields can cause IIS to reject immunization messages. Assessing data for validity, completeness and accuracy before submission facilitates successful submission and reduces the amount of rejected data that must be investigated, corrected, and resubmitted.
• The IIP Data Validation Workgroup developed comprehensive strategies to improve successful immunization submission to IIS at the point of care including end-user training resources and a common data error template for customization by IIS. Contact us at iip@himss.org to learn more and explore technical assistance opportunities.

• On average, IIS receives twice as many queries as submissions. Key partner groups are unable to access the data they need in a timely manner because of disparate and/or inadequate query or bulk data protocols.
• The IIP Collaborative Bulk Query Workgroup developed a bulk query toolkit which includes best practice guidance for bulk query options. Contact us at iip@himss.org to learn more and explore technical assistance opportunities.

The IIP Acknowledgments Workgroup developed a guidance document and implemented a pilot program to promote and validate the guidance. The workgroup convened to address variability in acknowledgment message handling among EHRs, IIS, and clinicians to improve the quality of information used for decision making.

Technical assistance opportunities are available to implement the Acknowledgments Guidance with interested partners. Email iip@himss.org to learn about technical assistance opportunities.

The IIP Collaborative Multiple Match Query Workgroup developed a functionalities catalog and aggregate measures for multiple matches to improve the way in which multiple patient matches, from a query to an IIS, are handled among clinicians, clinical software systems, and HIEs.

• The IIP developed an educational brief to raise awareness around patient identification and matching to support immunization information sharing and management. When published, the educational brief will serve to inform:
  • Current national patient matching strategies to emphasize the need for faster policy change
  • Implications of the current unique health identifier federal funding ban
  • Provide unbiased education as a community of experts providing insight and consensus around immunization
  • Discussion supporting patient matching strategies

The IIP, implemented by HIMSS, AIRA, and Drummond Group under a cooperative agreement with CDC IDAB, brings together IIS, EHRs and other health IT, HIEs, clinicians, public health, pharmacy systems, and other critical partners to improve immunization interoperability, information sharing and management.

By improving immunization interoperability and functionality, the IIP aims to improve data quality spanning from the point of care to public health with the longer-term goals of increasing vaccination coverage and reducing vaccine-preventable diseases. The IIP achieves its goals in two primary ways:

• The Testing and Recognition initiative, which facilitates the adoption of consensus immunization-related capabilities within EHRs and other clinical software to improve clinical decision-making and information sharing with IIS.
• The Collaborative which brings IIS, EHRs and other health IT, HIEs, clinicians, public health and other critical partners together to develop and drive the adoption of solutions to improve interoperability, information sharing, and access to immunization information by clinicians and public health.

The Collaborative plays a key role in the project’s efforts to improve information sharing and enable access to immunization information among IIS, EHRs and other health IT, HIEs, clinicians, public health and other critical partners.

The purpose of the Collaborative is to identify challenges associated with EHR-IIS immunization information sharing and management and to develop and drive the adoption of solutions that address those challenges.

The IIP uses the following approach to accomplish its goals:

• Strengthen relationships among IIS, EHRs and other health IT, HIEs, clinicians, public health and other critical partners via a governance structure that includes these essential perspectives.
• Identify issues associated with interoperability and information sharing and management.
• Develop recommended solutions of the prioritized issues
• Create resources to raise awareness of the impact to the issues challenging immunization interoperability.
• Leverage channels to drive adoption of recommended solutions and their benefits to the immunization ecosystem

The program facilitates adoption of consensus immunization-related capabilities within EHRs that improve clinical decision-making, reduce burden and improve information sharing among vaccination providers and IIS by:

• Facilitating agreement on priority immunization-related software capabilities that improve clinical decision-making, reduce burden and improve information sharing among IIS, EHRs and other health IT, HIEs, clinicians, public health and other critical partners.
• Operating a voluntary testing and recognition initiative that enables EHR and other software developers to both integrate and demonstrate their products’ inclusion of immunization-related capabilities

Products that have received IIP recognition have successfully tested against immunization-related software capabilities across eight clinical domains:

• Registering and identifying a patient (to assure the provider and the registry are communicating about the same patient).
• Managing external query, response and reconciliation (to enable bidirectional data sharing with immunization registries, providing more accurate data for managing patient care).
• Managing information for clinical decision-making (to enable the right immunization at the right time for the right patients).
• Managing inventory (to assist with managing private vaccine and government guarantee program stock).
• Administering and reporting immunizations (to assure accurate, non-obtrusive data entry, enabling patient management and reporting to immunization registries).
• Managing cohorts of patients (to encourage timely vaccinations and help manage any vaccine recalls).
• Managing adverse events (to identify safety issues, help prevent future adverse events, and support reporting).
• Providing patient access to immunization information (to help patients and their caregivers access their immunization histories)

• The IIP has been approved by the ONC as an alternative testing method for the ONC Health IT Certification Program.
• Five of the core testing requirements under the IIP align with Certification Criteria within (f)(1) Transmission to Immunization Registries within the ONC Health IT Certification Program.
• IIP’s approval by ONC as an alternative testing method means that those software products that achieve IIP recognition can “get credit” for having successfully tested against the ONC Health IT Certification (f)(1) Certification Criteria.
• ONC-Approved Health IT Certification bodies can now rely upon IIP Recognition, and therefore, will not need to also test for compliance with ONC’s (f)(1) Certification Criteria.