At a Glance
2015 Priority List
Use established immunization messaging standards
A) The system shall use the messaging standards established through Meaningful Use requirements to send data to Immunization Information Systems (IISs) or other Health Information Exchanges (HIEs).
B) The system shall use the messaging standards established through Meaningful Use requirements to receive data from Immunization Information Systems (IISs) or other Health Information Exchanges (HIEs).
There are very few IIS that can exchange immnunization information presently. Vendors may not have a pediatric volume in those uncovered geographic locations worth developing. However, this situation has changed rapidly in response to problems encountered during phase 1 of Meaningful Use that led to funding, assistance, and monitoring of state readiness for immunization messaging use standards.
Established immunization messaging standards are very mature because of the long history of using them for immunization registries, and they are based on HL7 version 2 and their use is part of Meaningful Use requirements. Meaningful Use incentive programs will end soon and it is better to link details of this requirement to the HIT Standards Committee and even better to link to CDC standards for IIS and immunizations coding (CVX vaccine type and MVX vaccine manufacturer
It is also important to consider the standards used for communication with other EHRs when patients change medical home or location of care. This is usually done using electronic patient summaries that are HL7 CCD and that should always include immunizations for children. If an EHR generates a document for the parents at each visit, it can always provide an immunization history.
This requirement is dependent upon the need for an EHR to enter all of the data required for transmission that should include refusals and contraindications. The correct coding of the vaccine needed for standards compliance can be assured by having the EHR read the barcodes that will be printed on all vaccine products per FDA regulations. There is also a need to connect this requirement to reporting of adverse reactions and to reporting for the vaccines for children program.
All interoperability functionality has three parts: the message or document content and format, the coding, and the transmission protocols. This only requires vendors to address the ability to produce or use appropriate messages or documents with required coding and terminology. Security and transmission protocols will always need to comply with requirement of the local IIS or HIE and thus any EHR cannot assure users that they can actually send or receive the messages or documents that the EHR is capable of producing. It will be helpful to users of EHR if the vendor can disclose which State or local systems they have successfully implemented in the past.