Download - Survey of Immunization Reporting to Immunization Information Systems by Major U.S. Pharmacies
Presented by: Rebecca Coyle MSEd.
AIRA Executive Director
A Summary of the Methods, Successes and Challenges of Pharmacy-IIS Interfaces
What is AIRA• AIRA is viewed by its members as the
centralized core of activity for IIS development, standardization, and best practices
• Provides knowledge sharing opportunities and capacity building activities
• Promotes, advocates for, develops, and disseminates IIS data exchange standards consistent with national standards that increase the visibility of IIS as public health best practice models for interoperable and integrated health management systems
Percentage of children aged <6 years participating* in an Immunization Information System (IIS) – United States, five cities+, and the District of Columbia, 2012
* Participation is defined as having two or more vaccinations recorded in the IIS+Chicago, Illinois; Houston, Texas; New York, New York; Philadelphia, Pennsylvania; and San Antonio, Texas.
National child participation: 86%
Percentage of adolescents aged 11 through 17 years participating* in an Immunization Information System (IIS) – United States, five cities+, and the District of Columbia, 2012
* Participation is defined as having two or more vaccinations administered during adolescence recorded in the IIS+Chicago, Illinois; Houston, Texas; New York, New York; Philadelphia, Pennsylvania; and San Antonio, Texas.
National adolescent participation: 54%
Percentage of adults aged ≥19 years participating* in an Immunization Information System (IIS) – United States, five cities+, and the District of Columbia, 2012
* Participation is defined as having one or more vaccinations administered during adulthood recorded in the IIS+Chicago, Illinois; Houston, Texas; New York, New York; Philadelphia, Pennsylvania; and San Antonio, Texas.
National adult participation: 25%
Methods
Survey Purpose• Examine what is being done to connect IIS
and Pharmacies and how it is being done. • Which pharmacies are providing
immunizations • Which pharmacies are reporting vaccinations
administered to the IIS, and Of those reporting, what is the nature and quality of
the data being received • Capture the successes and challenges of the
pharmacy-IIS reporting relationship and • What efforts are being made to increase the
number of pharmacies reporting to the IIS
Pharmacy Interview Purpose• Gain a better understanding of the
chain’s corporate approach to vaccination and reporting
• Provide balance and validation of responses captured during the IIS Survey phase
Map of IIS Survey Responses
Major Findings
• Of the state and project areas responding 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
Types of Vaccinations Reported by Frequency
Most Common Data Submission Methods & Frequency• Flat files loaded manually (26%), • HL7 batch (25%) and • Manual data entry (23%)
• For Electronic Interfaces: Weekly data feeds (42%) Daily feeds (28%)
Reporting Methods by Frequency
Reporting (cont.)
• For pharmacies reporting electronically (n = 64), a multi-site feed including all sites/clinics in the jurisdiction was by far the most common practice (83%).
• For manual submissions (n=22), data entry is almost always performed at the individual site/clinic level (82%).
Most Common Transport Methods• FTP/SFTP (47%) • SOAP over HTTP(s) (24%)
Success
IIS Pharmacy
Partnerships with the pharmacy community is critical when recruiting & interfacing with new pharmacy partners
Significant increase in adult immunization records
Improved quality of adult data
The improvement of overall patient care
Role of pharmacies in the patient care continuum
System improvements
Challenges – IIS Perspective• Data quality issues• Lack of unique patient identifiers• Variations in patient’s name• Lack of patient address• Inability to collect required data
elements• Inability to generate a file format
supported by the IIS
Challenges – Pharmacy Perspective• Restrictions on the type of files that IIS
are willing or able to accept (e.g. pharmacy can generate a flat file but state requires HL7 or vice versa)
• Limited staffing resources and infrastructure on the IIS side can lead to a lengthy onboarding process
• State variations in the IIS specifications• IIS consent requirements mandated
through state/local law
Recommendations1. Evaluate IIS reporting
specifications/recommendations on a more global scale to standardize the reporting process for external partners that span multiple states/jurisdictions (specifically required fields, reporting methods supported, reporting timelines).
2. Assemble partners with the ability to influence public health policy and pharmacy vaccination practice to recommend standardization in laws defining pharmacy vaccination programs, mandatory reporting requirements, and consent/disclosure limitations.
Recommendations (cont.)3. IIS should work with pharmacy reporting
partners to identify alternative reporting options and/or establish feasible transition plans and timelines to facilitate reporting until pharmacy systems can report in the IIS’s preferred reporting method. All efforts should be made to avoid requiring pharmacies to perform unnecessary duplicate data entry.
4. IIS not capable of supporting the most current HL7 2.5 specification should establish timelines for implementing the new standards and communicate those timelines to the more advanced pharmacy partners.
Recommendations (cont.)5. Consider moving to NDC as the
standard for vaccine type and manufacturer reporting, or enhance IIS to support NDC in addition to CPT/CVX codes.
6. Include pharmacy partners in immunization and IIS related meetings and educational opportunities whenever appropriate.
Recommendations (cont.)7. Leverage partnerships to increase the
number of Pharmacy-IIS interfaces, evolve reporting processes and improve patient care.
8. Consider future study opportunities to evaluate pharmacy data quality when compared to other provider submissions, investigate possibility of getting pharmacy data through a centralized billing system, and assess the feasibility of pharmacies incorporating review of records in the IIS into the routine vaccination workflow.
AIRA Website Resources
www.immregistries.org
Danielle Reader-JolleyParticipating Immunization Information Systems
CVSKroger Rite Aid
Safeway Surescripts
Walgreens
Type of Data Exchange
Transport Modes by Frequency