1. Returning Next-Due Recommendations Upon External Queries via HL-7
Contra Costa County Health Services
Siu Wing Tong, Ph.D.
Bay Area Regional Registry
Harry J. Martin
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

2. What is CCAIR? Contra Costa Automated Immunization Registry
centralized data repository
accept and consolidate all immunization history records from multiple providers
Prototype developed in 1995
CA DHS (partial) funding started in January 1996
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

3. What is CCAIR?, Cont’d
Porting of client-server version to Microsoft dot-NET
With dual front-end, browser and Windows
User beta testing in October 2003 within Contra Costa County
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

4. Why This is Needed
Vendors asked for ways for CCAIR to send over Next-due recommendations
By sending patient DOB and past shot history
Without storing the client shot history in CCAIR or any IZ Registry
Without distributing source code to outside vendors
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

5. HL-7 Compliant Interface Requirement
What is HL-7
Standardized messaging protocol for interchange of healthcare data
Why HL-7
Agencies and their vendors prefer standard interface & protocol
HL-7 protocol popular in healthcare computing environment
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

6. Architecture
Use the same “HL-7 Gateway Web Service” architecture to send & receive messages
Presented during the 2nd day HL-7 symposium during the 3rd IRC in PA hosted by Susan Abernathy
4-page description of the gateway published in 3rd IRC available
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

7. Architecture, Cont’d
Free HL-7 parser and message generator, Chameleon, from InterfaceWare of Canada, at the time of participation in Susan Abernathy’s project in
Other commercially available HL-7 parsers such as Neotool are expected to work as well
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

8. Architecture, Cont’d
Cannot embed HL-7 parsers in our new, dot-NET compiled IZ system because neither in-house Neotool nor Chameleon were compatible with dot-NET (in 2001)
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

9. Architecture, Cont’d HL-7 parser wrapped in Microsoft web services
Advantages of web services
Web services solved platform incompatibility
Additional flexibility
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

11. Develop a Test Client Application
Special front-end to simulate other systems such as physician office management systems
Capture from users query conditions such as patient name and DOB
Create an HL-7 message sent to web services
Display returned results
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

12. Contra Costa County Health Services. Bay Area Regional Registry [BARR]
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

13. Example of HL-7 Message Flow
Quick example of “normal” usage and message flow
VXQ, followed by VXX, then VXQ, and finally VXR
Cannot use VXQ in this case
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

14. Problem with Existing HL-7 Protocol and Messages
No such message for this purpose
VXR the only message that can carry past shot history
VXR is response, not for query
Tweak existing VXR message to substitute for VXQ in order to send shot history
Propose future change in HL-7 standard
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

15. Gateway Returns Info Web service gateway returns info in standard VXR
With next-due date info
As well as dose numbers for shots previously given
To show validation or invalidation of shots in history
“WHY Button” text
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

17. Sends “WHY Button” Text
Using LOINC code “ ” for explanation of logic “why button”. This code would be used to describe the “reason applied by forecast logic to project this vaccine”. Reference can be found in Implementation Guide, ver. 2.1, Sep 2002, Appendix A1, page A1-20.
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

18. Sends “WHY Button” Text, Cont’d
LOINC code obtained via special request made to HL-7 by Susan Abernathy of CDC
Used in combination of LOINC code “ ” which is for “Vaccine Due Next”.
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

19. References
Implementation Guide URL =
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

20. Contributors Bhumil Shah Erika H. Jenssen Siu Wing Tong
Harry J. Martin
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California

21. Contact Us Siu Wing Tong, Ph.D. Information Technology Supervisor
Contra Costa County Health Services
595 Center Ave, Suite 200
Martinez, CA 94553
Contra Costa County Health Services *** Bay Area Regional Registry [BARR] *** California