Maine’s IIS

Immunization

Information

System

(ImmPact2)

Maximizing System Value

Objectives:

Define the Immunization Info. System (IIS)/Registry.

Detail collected data and its drivers.

Describe data use by user types.

Describe Data Exchange work.

What is a Registry?

A single patient record, combining different sources in an expedited manner.

A single authoritative system for the application of Vaccine Related Information.

A combination of complementary tools available for its users at no cost.

Why is a Registry important? (Stakeholders)

Why is a Registry important? (Stakeholders)

Increase Immunization ratesScheduling – Reminder/Recall

Reduce the incidence of ‘extra’ dosingSingle Client, Single Record

Identify Factors of Low Immunization

Why is a Registry important? (IIS Owners)

When a Registry becomes an IIS

Registry = Client Record/Data

IIS = Integrated business practices and leveraged technological solutions Vaccine for Children Reporting Total Inventory Management AFIX self monitoring Reporting And more….

ImmPact2 Captures

Client Data Client Demographics Client Responsible Person VFC/Medicaid Status Vaccine Transactions/History

Provider Data Provider Demographics Vaccine Administration Data Vaccine Usage/Wastage CASA (4-3-1-3-3-1 UTD) rates Services/Activity Tracker

Data Exchange:

History ImmPact2 Functionality Work Flow Options Business Factors / Work Flow Choice Benefits Challenges

Data Exchange – History (p1)

2004: Began business negotiations with major hospitals and stakeholder groups.

2004: In preliminary meetings, Providers chose IIS-Centric Work Flow

2005 – 2007: Design and Business Planning 2007: Began development work on Data Exchange

that went through numerous iterations, starting with provider preferred IIS-Centric workflow

2008: Initiated a meeting with MHIN to discuss our efforts. No follow-up from MHIN until 2010. 

Data Exchange – History (p2)

2009: Maine General went LIVE with IIS-Centric workflow

2010: Maine Primary Care Association went LIVE with IIS-Centric workflow.

2010: Current Technological Efforts proceeding to effect IIS-Centric work-Flow: Maine Medical Center Eastern Maine Health Systems Eastern Maine Health Systems (Beacon) Pediatric Associates of Lewiston

Data Exchange – History (p3a)

2010: Current stakeholders having submitted a Data Exchange Survey and have received our Exchange Specifications State of Maine – Dept. of Education State of Maine - WIC City of Portland City of Bangor Central Maine Health Center Culbert Health DFD Russell Franklin County Health Network Harrington Family HC Houlton Regional Hospital Intermed Martin's Point Maine Health MDI Hospital Health

Data Exchange – History (p3b)

2010: Current stakeholders having submitted a Data Exchange Survey and have received our Exchange Specifications Parkview Penobscot Community Health Care Practice Partners Sage Saint Marys Searsport Skowhegan Family Practice Southern Maine Medical Center Stephens Memorial Stockton Springs Warren Family Medicine York Hospital 

Data Exchange – I2 Functionality (p1)

Unsolicited Outbound: A dose is recorded into the ImmPact2 system and sent to the EMR/Broker at an assigned interval. All providers have chosen this method of exchange

 Unsolicited Inbound: A dose is recorded into the EMR and sent to the ImmPact2 system at an assigned interval No providers have chosen this method. Indian Health Services agreed to engage in this

method as our system pilot. IHS has discussed converting to IIS-Centric once the

inbound exchange pilot is completed.

Data Exchange – I2 Functionality (p2)

Query/Response: Works like UO and UI Single client queries Client Match and immediate data return This method is generally used by State IIS to

communicate single client record look-ups. Other potential uses;

HEDIS reporting Insurer Queries Internal Systems Data Sharing

Data Exchange – Work Flow Def.

Work Flow Terms IIS Centric: The dose is recorded into the

ImmPact2 system as the 'Point of Origin" and them moved to the EMR/Broker.

EMR Centric: The dose is recorded into the EMR and send to the ImmPact2 system.

[Note: All provider negotiations to date have resulted in IIS-Centric work flow]

Data Exchange – Business Factorscontributing to Work Flow Choice (p1)

The following two issues are summarized, but the business implications for breaking the connection between inventory management and client administration are substantial.

Client Records: Using the ImmPact2 system allows a consolidated set of vaccines for the client no matter where administered state-wide.

Vaccine Requirements: Providers have a good number of mandatory record keeping requirements in order to receive and utilize State Supplied vaccine.

Data Exchange – Business Factorscontributing to Work Flow Choice (p2)

Work flow is less a technical issue and more a organizational, business, and expenditure issue. It takes more resources overall to support EMR centric workflow than IIS workflow due to reporting and business requirements of the provider office to complete the Maine Immunization Program requirements.

In order to simplify the provider work-flow and maintain the most complete client record, providers have recognized the advanced features of the ImmPact2 system.

Data Exchange – Benefits

Consolidated Official State Record Disease Outbreak Interventions Client transitions College Entrance

Reduction in ‘extra’ dosing Labor reductions Commodity gains / waste reduction Improved public relations

Reduced Cost

Data Exchange – Challenges

Dedicated SoM Data Exchange Staffing Exchange Management, Set-up, Maintenance Methodology of transfer: currently limited to HTTPS Fiscal – State:

No dedicated Federal Funding for Exchange No State Funding for Exchange

Fiscal - Provider: Unless falling under Meaningful use, little funding avail. Now being approached by multiple sharing entities.

 Knowledge:  SoM knowledge base for HL7 VXU SoM knowledge of HTTPS transport methodologies Provider knowledge base for HL7 VXU Provider knowledge of HTTPS transport methodologies

     

Exchange as an IIS Strategy

Maine Immunization Information System (IIS) ContactShawn M. Box, B.S.

Maine Immunization Program

Assistant Director

IIS Manager

Shawn.Box@Maine.Gov

207.287.3746