Inter-State Sharing of an Immunization Registry Application The Wisconsin-Minnesota Experience Thomas Maerz Wisconsin Department of Health & Family Services Wisconsin Immunization Registry (WIR) Karen White Minnesota Department of Health Minnesota Immunization Information Connection (MIIC)

Session Objective For participants to learn about practical issues faced in inter-state sharing of a registry application, including: legal and other policy issues identifying and sharing costs on future enhancements testing and deployment

Main Points Sharing of publicly funded applications is needed and generally desirable Differences between projects make it unlikely an application can be imported and deployed without changes The opportunities are there for projects to work together on ongoing enhancements Such collaboration takes thoughtful planning and implementation, usually more time than working alone, and regular communication Differences can include state laws, infrastructure/architecture, registry models

Issues in Making WIR Available Time commitment Immunization functionality questions and is it really free Technical question regarding architecture and platform Providing documents (user manual, technical documentation, license), license discussion and negotiation Creation and distribution of software CD with updated documentation CDC enhancement requests

License Agreement Provisions Current version of the WIR software is provided Licensee cannot sell or give away any of the licensed materials Possibility of sharing in code enhancements Acknowledgement in publications of Wisconsin’s development efforts

Minnesota as Recipient Chose WIR because of its functionality, privacy protections, and potential benefits to border providers and families Problems with old applications Considered 11 vendors Regional registry staff made the choice Data practices: government documents are public; not all WIR materials (I.e., the license agreement itself) could be classified as trade secret, so we would have to give to someone who ask for them.

Minnesota Immunization Information Connection A statewide network of regional immunization services Community Health Information Collaborative (CHIC) Communities Caring for Children (CCC) Not yet affiliated with an immunization registry Cass Crow Wing North Central Immunization Connection (NCIC) Central Minnesota Immunization Connection (CMIC) Southwest Minnesota Immunization Information Connection (SW-MIIC) 71 ImmuLink Immtrack Southeast Minnesota Immunization Connection (SEMIC)

Minnesota as Recipient Needed small change to license agreement because of our data practices law Install and manage in-house or source out? Choosing a vendor Data practices: government documents are public; not all WIR materials (I.e., the license agreement itself) could be classified as trade secret, so we would have to give to someone who ask for them.

Sharing in Enhancements Each state has a list of priorities Identify mutually beneficial items Divide enhancement list Develop and approve change definitions Testing both sets of enhancements Deploying in each environment Examples of current and future enhancements (Karen) ·               Multiple VIS dates, ·               etc. Some “medium” priorities that could now be “high.”

Smallpox enhancement Weekly calls around project definition Detailed system design document approved by both states Programming done in WI’s development environment by both the WI and the MN teams at EDS Final testing in each state Moved to production servers prior to any smallpox clinics (2/7/03)

Challenges Requires more definition time than working alone Differences in models (e.g., centralized vs. decentralized) can lead to differences in priorities and even differences in definitions (e.g., “historical data”).

Benefits More enhancements in a shorter period of time Cost savings to partners

Summary – Effective sharing requires… Reasonable expectations Commitment to finding mutual benefits Understanding that an application must reflect the needs of each project and they may not be identical Realization that we can learn from each other ·               Opportunities exist; it’s the right thing to do for lots of reasons ·               But it’s not a slam dunk. ·               It takes: o              reasonable expectations - nothing is going to meet all your needs right out of the box; you can’t expect the donor project to do much more than make the application available. o              a commitment to finding mutually-beneficial enhancements o              an understanding that some enhancements will be unique to each project, so the application cannot remain identical across all users. a realization that we’re in the registry development business together, and that we have a lot to learn from each other.

Questions? Thomas Maerz WIR Project Manager 608-261-6755 maerztr@dhfs.state.wi.us Eloise Gelner MIIC Project Manager 612-676-5471 eloise.gelner@health.state.mn.us