AMERICAN IMMUNIZATION REGISTRY ASSOCIATION A L I S O N C H I, P R O G R A M D I R E C T O R
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1 AMERICAN IMMUNIZATION REGISTRY ASSOCIATION A L I S O N C H I, P R O G R A M D I R E C T O R
2 WHAT IS AIRA A way to work together to develop standards, best practices, develop and share strategies and provide education to IIS. AIRA s mission is to promote and support the use of immunization information to ensure healthy communities. AIRA s vision is to facilitate the sharing and use of immunization information by all partners and ensure that immunization information systems are fully supported and represented.
3 WHAT IS AIRA? Non-profit organization made up of: Jurisdictional registry staff (state, city, county, territories) Registry technology developers (vendors) National organizations with similar interests Centers for Disease Control and Prevention registry staff Individuals
4 NATIONAL THEMES Interoperability with EHRs Small Area Analysis/AFIX Standardization Adult Immunization Joint Development Interstate Exchange
5 IIS & ADULT IMMUNIZATION Why is increased use of IIS a strategy for increasing adult immunization rates? For the same reasons it has been a strategy for increasing childhood immunization rates for the past 20 years IIS create a comprehensive immunization record by collecting immunization data from both private and public health care providers, pharmacies, and other immunizers IIS generate reminders to ensure on-time immunization IIS assist with clinical decision support and forecasting to avoid over-immunizing or missed opportunities IIS assist with vaccine ordering and inventory management
6 DATA EHR HIE IIS Query Query Provider EHR History & Forecast History & Forecast Enter data Data HIE Repository Data IIS ACK or Error Message ACK or Error Message
7 IIS & ADULT IMMUNIZATIONS: AUTHORITY TO OPERATE Jurisdictions Authorized to Operate an IIS for Adults Laws authorize operation of IIS Laws authorize sharing of immunization information Laws allow sharing of health care information Rely on general public health statues or regulations Martin DW, Lowery NE, Brand B, Gold R, Horlick G. Immunization Information Systems: A Decade of Progress in Law and Policy. Journal of Public Health Management and Practice, July/August Issue 4.
8 IIS & ADULT IMMUNIZATIONS: 31 IIS WITH REPORTING MANDATES Mandate at least 1 type of provider/entity to report No mandate Martin DW, Lowery NE, Brand B, Gold R, Horlick G. Immunization Information Systems: A Decade of Progress in Law and Policy. Journal of Public Health Management and Practice, July/August Issue 4.
9 IIS & ADULT IMMUNIZATIONS: For jurisdictions with mandates (31), who is mandated to report? pharmacies/pharmacists 22 private providers 21 VFC providers 23 public health providers 27 all immunization providers 21 Martin DW, Lowery NE, Brand B, Gold R, Horlick G. Immunization Information Systems: A Decade of Progress in Law and Policy. Journal of Public Health Management and Practice, July/August Issue 4.
10 IIS & ADULT IMMUNIZATIONS: For jurisdictions with mandates (31), for whom do shots get reported? 2 only young children (upper age limits of 6 or 7 years old) 17 immunizations for children/adolescents/young adults (upper age limits franging from 10 to 26 years) 12 all immunizations for all age groups Martin DW, Lowery NE, Brand B, Gold R, Horlick G. Immunization Information Systems: A Decade of Progress in Law and Policy. Journal of Public Health Management and Practice, July/August Issue 4.
11 IIS & ADULT IMMUNIZATIONS: Consent to share adult immunization information (51 jurisdictions) 8 explicit consent required 1 can be shared without consent, with opt out 8 can be shared without consent, without opt out 34 rely upon implied consent to share with IIS, with right to opt out Martin DW, Lowery NE, Brand B, Gold R, Horlick G. Immunization Information Systems: A Decade of Progress in Law and Policy. Journal of Public Health Management and Practice, July/August Issue 4.
12 USING IIS TO IMPROVE ADULT IMMUNIZATION RATES: EXAMPLES Arizona Currently testing the impact of providing access to state IIS for employer on-site flu clinics Iowa Added adult benchmark reports in 2013 Minnesota Washington State Creating assessment reports & tools; working with pharmacies; healthcare worker vaccination program Pilot tested the impact of providing on-line real-time IIS access to pharmacists when a customer requested an immunization. Pilot was done in partnership with STC & Bartell Drugs
13 USING IIS TO IMPROVE ADULT IMMUNIZATION RATES: MINNESOTA Minnesota focus on IIS/adult immunization initiatives: Adult immunizations included in quarterly assessment provided to local public health & regional coordinators to identify areas with low adult immunization rates/enable targeted outreach Currently building an adult assessment report into IIS user interface Modifying IIS Client Follow-Up tool to include adult immunizations. Will allow a provider to directly follow-up with their patients who are due or overdue for immunizations Pharmacy Initiatives developed a video for pharmacists showing that the IIS is an easy tool to use in assessing a patients immunization needs and recommending appropriate vaccines for patients. The video can be seen on MDH YouTube channel Healthcare worker vaccination program all reporting for program is done through the IIS
14 USING IIS TO IMPROVE ADULT IMMUNIZATION RATES: WASHINGTON Results of Washington State pilot providing on-line real-time IIS access to pharmacists: Immunizations provided to individuals from 5 85 years of age Pharmacists were able to access the state IIS for an individual 94% of the time, and 78% of the customers queried were found in the IIS 72% of customers were determined through decision support to be due or past due for an immunization Averaged over 2 additional immunizations needed per adult
15 PHARMACIES & IIS January AIRA published report on survey of immunization reporting to IIS by major U.S. pharmacies Paper.pdf Major findings: Of the state and project areas that responded to the survey (n=45), pharmacies are allowed to provide vaccinations in 42 (93%) of the project areas. Pharmacies report doses administered to IIS in 36 (80%) jurisdictions and are required to report in 22 (49%). Pharmacists will generally administer whatever vaccinations they are allowed to administer in accordance with individual state laws
16 PHARMACIES & IIS: EXAMPLE WALGREENS PHARMACY REPORTING TO STATE REGISTRIES, JUNE 2014 WA MT ND ME OR CA NV ID AZ UT WY CO NM SD NE KS OK MN IA MO AR WI IL MS MI OH IN WV KY TN AL GA PA VA NC SC NY VT NH RI CT NJ DE MD MA HI TX LA SA FL PR AK Key Production (44) Under Development (5) TBD (5) No Pharmacies
17 PHARMACIES & IIS Successes Significant increase in adult immunization records Improved quality of adult data Improvement of overall patient care Challenges: IIS perspective: data quality issues, inability to collect required data elements, inability to generate file format supported by IIS Pharmacy perspective: restrictions on type of files IIS are willing to accept, IIS consent requirements, limited staffing resources on IIS side
18 PROVIDERS & IIS Provider Benefits: Decision support Determine if patients are due or past due for an immunization Reminder/Recall Use IIS to generate reminders, increase # of patients identified as due for immunizations Real-time bi-directional exchange with IIS Immediate decision support = increased # of patients identified as due for immunizations while patient is in front of provider Accessibility of information within provider workflow Avoid double data entry Inventory management Reduce the work of meeting accountability and reporting requirements
19 IIS CHALLENGES & SUCCESSES Successes All but one state has a IIS and they are in development Most IIS are able to electronically exchange information with medical providers Have standardized many operations and functions Patient de-duplication Vaccine Data Quality Patient status Vaccine Forecasting Challenges Percentage of adults in IIS still very low in many jurisdictions Policy issues still exist Can t easily exchange data with another state (but there is hope!) Implementing standards takes time & there is no mandate to implement standards There are still many areas that we would like to standardize
20 WHAT CAN AIRA DO FOR YOU? Visit our website to find useful materials and information us or call us with questions Join AIRA as a member and participate in our activities
21 AIRA WEBSITE RESOURCES
22 CONTACT INFORMATION American Immunization Registry Association Phone: (202) Fax: (202) Alison Chi, Program Director
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