1. Proof of Concept: A Critical Milestone on the Road to a New Immunization Information System
Jenne McKibben, Oregon ALERT IIS
National Immunization Conference
Wednesday, April 21, 2010

2. Background: Oregon’s Immunization Systems
ALERT: A statewide IIS since 1995
Lifespan since 2008
100% of public providers and 92% of private providers participate
~4 million demographic records, ~45 million immunization records
IRIS: An immunization medical record system in use in most Local Health Departments since 2003
~1.1 million demographic records, ~12 million immunization records
Clients linked with WIC
Oregon currently has two immunization systems:
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Both systems were aging, but in the community, both were used heavily and both had many advocates/followers.

3. Motivation for Change
Data was exchanged between the two systems, but synchronization was challenging
Both systems were aging
Expensive to support and maintain
Data needs were growing exponentially
Oregon’s population was increasing
ALERT was expanding to lifespan
ACIP schedule was becoming more complex

4. The Process of the Search
Worked with partners to develop 300+ requirements for new IIS
Conducted Request for Information, Market Analysis, Request for Proposal
Chose a public domain system as base
The Wisconsin Immunization Registry, as modified by New York State
Oregon extends our deep appreciation to all the states and organizations who generously shared their requirements, their lessons learned and their challenges

5. The New ALERT IIS
The new system will replace IRIS and the existing ALERT Registry
Robust Oracle platform, hosted and supported by Hewlett-Packard
Scalable to accommodate growing data needs, and provides emphasis on capacity for bidirectional electronic data exchange/health information exchange

6. The Contracting Path Broke transition down into two phases:
Proof of Concept (POC)
Phase 1: period of 3-6 months
Contract with HP to set up instance of New York State IIS for Oregon to test
Contract signed
System Implementation
Phase 2: period of 5 years
Contract with HP to construct and host Oregon IIS
Contract signed

7. Reasons for Proof of Concept
Offered opportunity to evaluate base system more fully against Oregon requirements
Provided go/no go decision point with relatively small initial investment (~$70,000)
Oregon team wanted hands-on experience with base system
(Read: we have control issues)

8. Oregon Team POC Responsibilities
Ensure staff is available to be trained on the system.
Provide training facility and equipment.
Review documentation provided by Contractor pertaining to the Proposed WIR.
Conduct in-depth analysis of Proposed WIR solution versus the DHS Requirements.

9. Oregon Team POC Responsibilities
Participate in an in-depth analysis, led by Contractor, of Proposed WIR solution versus Base WIR.
Manage the Requirements refinement process and conduct requirements review meetings as needed.
Review and approve final Deliverables.

10. HP Team POC Responsibilities
Host POC and provide access of the system to DHS Project Team.
Train DHS Project Team in operational and technical aspects of system.
Provide access to all system documentation.
Respond to DHS questions regarding system policies, practices, procedures and operations.

11. HP Team POC Responsibilities
Participate in Requirements analysis meetings with DHS Project Team.
Conduct and present to DHS an in-depth analysis of Proposed versus Base WIR.
Document findings of these meetings and prepare draft outline of the Proof of Concept Report for review and comment.
Prepare a Validated Set of Requirements that shall be managed as a baseline to guide work to be performed in subsequent Project Tasks and Phases.

12. HP Team POC Responsibilities
Conduct a walk-through of the Validated Set of Requirements with appropriate DHS staff.
Develop and submit a Proof of Concept Report that confirms that the Contractor’s Solution meets Oregon Requirements.
Prepare and submit final Deliverables for approval.

13. Summary of Phase 1 Deliverables
Proof of Concept Report
Validated set of requirements
Passed
Passed with Modification
Customization
Follow-Up
Preliminary Planning Documents
System Design Documents

14. Proof of Concept - Outcomes
The vast majority of mandatory requirements passed
Some minor modifications were needed
Ex: Adding instructions for minimum search criteria, allowing sub-potent dose flagging on historical (as well as administered) shots, etc.
Some information led to additional requirements development
A few key gaps were identified

15. Key Gaps re: Oregon Needs
Tracking Eligibility by Dose
Forecaster Algorithms
Statewide Reminder Recall
Deducting Inventory via Data Exchange

16. Outcomes: Launchpad for Phase 2 (Implementation)
HP delivered on all written mandatory requirements and agreed to remedy key gaps
Based in part on POC outcomes, Oregon decided to choose 18 optional requirements
Ex: tracking/monitoring same level of detail, providing evaluation reports, duplicating close date algorithms, providing tools related to test deck and site database, redesigning data entry user interface, etc.
Oregon also added 17 additional requirements
Ex: prioritization of reported doses (primary vs. secondary sources), reminder recall enhancements, etc.

17. Outcomes: Staff Acceptance
Internal partners gained knowledge about and familiarity with new system
Increased confidence
Provided assistance with business transition planning
Gave visibility into essential training and communication messages

18. IIS Team Perspective: Proof of Concept Results
A very strong system, customized for Oregon
Increased customizations = fewer process changes
Increased confidence, decreased risk in implementation phase
Stonger IIS Team/Vendor Team relationship <mostly>

19. Why Proof of Concept Works… Vendor Team Perspective
Product familiarization occurred prior to delivery teams coming together
Developed common understanding of base product
Provided platform for discussions

20. Why Proof of Concept Works… Vendor Team Perspective
Provided an opportunity to establish common terminology for discussions
Huge impact on requirements gathering
Requirements were clearer, more defined early on
Moved us further - faster

21. So – is the process perfect?
“It’s like buying a car before you’ve have a chance to fully test-drive it…”
- Gregg Russell, Immunization Coordinator, Washington County, Oregon

22. Next Steps: Implementation
User Acceptance Testing: May 15th
First Wave Public Site Roll-Out: July 15th
Private Site Roll-Out: August, 2010
Schools and Childcare: Fall, 2010
Long Vacations for HP Team and Oregon IIS Team: 2011

23. Acknowledgements Co-authors Rick Hammontree, IIS Project Manager
Mary Beth Kurilo, ALERT Director
Katie Reed, HP Project Manager
Rick Hammontree, IIS Project Manager
ALERT IIS Team
HP Development Team

24. Questions/Discussion?

25. Contact Information
Jenne McKibben, ALERT Training Lead