Immunization Information Systems and Interstate Data Exchange: As-is and To-be

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Immunization Information Systems and Interstate Data Exchange: As-is and To-be Warren Williams, MPH NVAC Meeting Washington DC February 10, 2015 National Center for Immunization & Respiratory Diseases Immunization Information Systems Support Branch

Interstate Data Exchange: Historical Notes (As-is) Point to Point Exchange Different technical solutions Different policy and program negotiations with each jurisdiction Different data exchange approach Transport standards Message/Content standards Limited Priority focus on Interstate Focus on provider exchanges, data quality and functionality. Emergency Response Hurricane Katrina saw active data sharing agreements among IIS 2

Interstate data sharing among awardees United States, five cities +, and the District of Columbia, 2011 Does your IIS engage in interstate data exchange? (of 56 awardees) No IIS, 1, 2% No data, 1, 2% Yes, 11, 19% Yes No No IIS No data No, 43, 77% Immunization Information System Annual Report ( IISAR )

Interstate data exchange authorit y, 2012 Don't know, 2, 4% None, 15, 28% General authority, 10, 19% Data sharing agreement only, 15, 28% Specific statute or regulation, 11, 21% Data sharing agreement only Specific statute or regulation General authority None Don't know Martin DW et al. 2013: Immunization Information Systems: A Decade of Progress in Law and Policy. J Public Health Management Practice, 2013, 00(00), 1 8

Awardees that currently allow access to data in the IIS across state borders, 2012 No, 24, 45% Yes Yes, 29, 55% No Martin DW et al. 2013: Immunization Information Systems: A Decade of Progress in Law and Policy. J Public Health Management Practice, 2013, 00(00), 1 8

Recent Community and Environmental Impacts on IIS Community Program need: Value of the IIS to support federal and local immunization program efforts VTrckS Support/ExIS, IIS-AFIX integration, NIS support-national, local coverage assessment, pandemic preparedness, adult populations Health care industry developments: Meaningful Use/integration with EHRs, 2-D barcodes, exchange hubs, clinical decision support, HEDIS, emerging complementary vaccination providers (e.g. pharmacies) Evolving roles and responsibility with new market forces (e.g. private networks, EHR, exchange hubs) that are changing which entities are responsible for certain functions (such as reporting, consolidations, and electronic message use) and which new functions should be addressed Wide variability in IIS system: Policy, functionality, and data quality variation

Strategic Planning Effort For a fully compliant version of this image, go to page 11

IIS Strategic Plan Vision Statement: Real time, consolidated immunization data and services for all ages are available for authorized clinical, administrative, and public health users, and consumers, anytime and anywhere. In the category of Interoperability and Data Management referenced in the plan: Interstate Data Exchange project as a priority, because of the need to collaboratively develop a model/standards for interstate interoperability

Interstate Data Exchange: Future State (To-Be) Increase use of communit y practices Increase compliance with the use of industry standards Less customization and better ways to handle differences New/emerging ideas helping to facilitate interstate exchange Strategic plan Data Hubs (pilot models under way with ONC project) Service Centers Models (exploratory) Tighter standards Plans/tools for monitoring standards usage 9

Thanks Contact information : Warren Williams wxw4@cdc.gov 404 639-8867 10

IIS Vision Real time, consolidated immunization data and services for all ages are available for authorized clinical, administrative, and public health users, and consumers, anytime and anywhere. Outcomes Defined by Metrics IIS Functional Standards Nationwide Leadership Sustainability Service Delivery Capacity & Infrastructure Interoperability/Data Management