the data exchange process and participants cecile town
TRANSCRIPT
The Data Exchange Process and Participants
Cecile Town
Objectives
• Assign roles and responsibilities at the Area level for immunization data exchange programmatic and technical support
• Define IIS/RPMS testing scenarios vs. production data exchange
• Communicate effectively with IIS staff and vendors about IHS data exchange capability
What’s an Immunization Information System ?
• Also known as Immunization Registries, Immunization Information Systems (IIS) are confidential, population-based, computerized information systems
• They collect vaccination data about all children within a geographic area (usually statewide)
• Some registries also collect vaccine data for adults.
The IHS Data Exchange Initiative
IHS contracted to develop RPMS-compatibleImmunization Data Exchange software
Benefits- Facilities continue to use the RPMS as their
primary information source- Eliminates the need for double data entry- Data can be pulled from the IIS directly into
individual RPMS records- Built to CDC standards
Software Used
• RPMS Immunization Module - BI
• IHS Immunization Data Exchange Software – BYIM – usually IIMM on RPMS Menu
• HL7 Communications Bridge – non IHS software
IHS Data Sharing Policy• Under HIPAA, sharing immunization data with
state registries is permitted• IHS issued a policy memo stating sharing
data with state registries is permitted and encouraged according to routine use
• Ultimately, participation is determined by the tribe
• SECURE TRANSACTIONS– Check with your ISSO
Why do IHS, Tribal and Urban providers participate in IIS?
Rationale for Data Exchange
States Need:• Timely information on patients seen at IHS
and tribal sites• Standardized exchange
Issues for Data Exchange
IHS Needs:• Timely information on patients seen at other
clinics• Standardized exchange
– 35 different states– Crossing of state lines
• Bi-directional exchange
Data Exchange with IIS
One-way - RPMS Export to IIS– ITU sends all patient immunizations to IIS and they
are de-duplicated and added– Site must look up patient records in the IIS
Two-way - RPMS Export/Import– ITU sends all patient immunizations, registry de-
duplicates & matches, sends back to facility to add to individual RPMS record
– Both processes are piloted tested with one site before going into production phase & roll-out to other sites
What we know • Majority of sites send
information to the IIS, direct data entry is method most frequently used
• In 2009, 88% of those doing direct data entry also performed double data entry. Of those, 40.9% indicate that this is a barrier to facility participation in IIS.
• Most ITU’s use look-up capability from the IIS.
• Although two-way interfaces account for only 10-11% of all participation, 94% of respondents feel it would be useful to have.
• MU attestation is interface based
What is to come?
Meaningful Use Stage 1 will drive new interfaces in
19
states!
IHS needs an increased support network for these interfaces
Stages of Data Exchange• Discover
– State & IHS initial Q & A• Plan
– Determine contacts, meetings• Develop
– Determine software specifications, transport methods
• Test – the “handshake”
Stages of Data Exchange• Certify
– Verify data quality, test phase• Install
– Kickoff meeting, train providers• Live
– production data exchange at pilots• Rollout
– data exchange implemented at additional facilities following successful pilot
Interface Project Management
Interfaces
• GOAL – share data between RPMS & IIS• What data? – Local immunization data• Which format? – HL7 2.4• How will the data get there? IIS dependent• Who will send data? – local provider• How often will they send data? – site
dependent• Who identifies and addresses issues?
Data Exchange: Who Does What?
National Data Exchange TeamTechnical/ProgrammingTom Love - BYIMNathan Bunker - Transport
Testers/Super UsersJohn Parker, RNScott Hamstra, MDMary Brickell
Programmatic Coordination/Partnering Cecile Town
BYIM Coordinates with Immunization Package Development: Amy Groom Ros SingletonMike Remillard
Who makes data exchange work?
• Clinical providers• IT Site Managers• Clinical Applications Coordinators• Area Immunization Coordinators• IT Site Analysts• OIT Helpdesk• State IIS personnel• State IIS vendors
Roles IIS/IHS
Role IHS IIS
Coordination/Facilitation Data Exchange Coordinator
IIS Manager
Technical – HL7 messaging
BYIM Programmer IIS Vendor
Technical – Transport Transport Consultant IIS Vendor
Troubleshooting Message Content
PHNs/Immunization Coordinators
IIS HL7 Specialist
Troubleshooting Transmission issues
Tiers 1 -3 – ALL IIS Vendor/HL7 Specialist
Interface Project Management
Area Teams
• Clinical Applications Coordinators• Immunization Coordinators• PHN Consultants • IT Site analysts• Meaningful Use Coordinators/Consultants
Technical Support Snapshot
• Immunization Program presenting an IT solution for RPMS providers
• Immunization Program advances interface nationally & actively partners with IIS community
• OIT funds support software development • Technical support & development are contracted• OIT Help Desk requests are routed to the Immunization
Program• Documentation, testing, training, installation and
troubleshooting --- National Data Exchange Team• Meaningful Use kicks off rapid growth of data exchange,
creating need for enhanced technical support
Consent Issues - FYI
• While software solutions exist, provider practices and requirements differ by Area, State
• Information security & consent differ • IHS policy memo & individual level
consent
Lessons Learned From the Field
• Software capabilities do not equal feasible practice
• IHS IT presence critical• Process must be assigned & ongoing• It’s a partnership – clinical & IT • Time spent on the front end will be time
saved on the back end
What could this slide look like for your Area?
• Facilitator, Data Exchange POCCecile Town – [email protected]
• Contact for provider issuesScott Hamstra – [email protected]
• Contact(s) for IT & software issuesJohn Parker – [email protected] Love
• Contact for questions about MU attestationJoAnne Hawkins – [email protected]
