1. The Data Exchange Process and Participants Cecile Town

2. Objectives Assign roles and responsibilities at the Area level for immunization data exchange programmatic and technical support Define IIS/RPMS testing scenarios vs. production data exchange Communicate effectively with IIS staff and vendors about IHS data exchange capability

3. What’s an Immunization Information System ? Also known as Immunization Registries, Immunization Information Systems (IIS) are confidential, population-based, computerized information systems They collect vaccination data about all children within a geographic area (usually statewide) Some registries also collect vaccine data for adults.

4. The IHS Data Exchange Initiative IHS contracted to develop RPMS-compatible Immunization Data Exchange software Benefits -Facilities continue to use the RPMS as their primary information source -Eliminates the need for double data entry -Data can be pulled from the IIS directly into individual RPMS records -Built to CDC standards

5. Software Used RPMS Immunization Module - BI IHS Immunization Data Exchange Software – BYIM –usually IIMM on RPMS Menu HL7 Communications Bridge – non IHS software

6. IHS Data Sharing Policy Under HIPAA, sharing immunization data with state registries is permitted IHS issued a policy memo stating sharing data with state registries is permitted and encouraged according to routine use Ultimately, participation is determined by the tribe SECURE TRANSACTIONS –Check with your ISSO

7. Why do IHS, Tribal and Urban providers participate in IIS?

8. Rationale for Data Exchange States Need : Timely information on patients seen at IHS and tribal sites Standardized exchange

9. Issues for Data Exchange IHS Needs: Timely information on patients seen at other clinics Standardized exchange –35 different states –Crossing of state lines Bi-directional exchange

10. Data Exchange with IIS One-way - RPMS Export to IIS –ITU sends all patient immunizations to IIS and they are de-duplicated and added –Site must look up patient records in the IIS Two-way - RPMS Export/Import –ITU sends all patient immunizations, registry de- duplicates & matches, sends back to facility to add to individual RPMS record –Both processes are piloted tested with one site before going into production phase & roll-out to other sites

12. What we know Majority of sites send information to the IIS, direct data entry is method most frequently used In 2009, 88% of those doing direct data entry also performed double data entry. Of those, 40.9% indicate that this is a barrier to facility participation in IIS. Most ITU’s use look- up capability from the IIS. Although two-way interfaces account for only 10-11% of all participation, 94% of respondents feel it would be useful to have. MU attestation is interface based

13. What is to come? Meaningful Use Stage 1 will drive new interfaces in 19 states! IHS needs an increased support network for these interfaces

14. Stages of Data Exchange Discover –State & IHS initial Q & A Plan –Determine contacts, meetings Develop –Determine software specifications, transport methods Test –the “handshake”

15. Stages of Data Exchange Certify – Verify data quality, test phase Install –Kickoff meeting, train providers Live –production data exchange at pilots Rollout –data exchange implemented at additional facilities following successful pilot

16. Interface Project Management

17. Interfaces GOAL – share data between RPMS & IIS What data? – Local immunization data Which format? – HL7 2.4 How will the data get there? IIS dependent Who will send data? – local provider How often will they send data? – site dependent Who identifies and addresses issues?

18. Data Exchange: Who Does What?

19. National Data Exchange Team Technical/Programming Tom Love - BYIM Nathan Bunker - Transport Testers/Super Users John Parker, RN Scott Hamstra, MD Mary Brickell Programmatic Coordination/Partnering Cecile Town BYIM Coordinates with Immunization Package Development: Amy Groom Ros Singleton Mike Remillard

20. Who makes data exchange work? Clinical providers IT Site Managers Clinical Applications Coordinators Area Immunization Coordinators IT Site Analysts OIT Helpdesk State IIS personnel State IIS vendors

21. Roles IIS/IHS RoleIHSIIS Coordination/FacilitationData Exchange Coordinator IIS Manager Technical – HL7 messaging BYIM ProgrammerIIS Vendor Technical – TransportTransport ConsultantIIS Vendor Troubleshooting Message Content PHNs/Immunization Coordinators IIS HL7 Specialist Troubleshooting Transmission issues Tiers 1 -3 – ALLIIS Vendor/HL7 Specialist

22. Interface Project Management

23. Area Teams Clinical Applications Coordinators Immunization Coordinators PHN Consultants IT Site analysts Meaningful Use Coordinators/Consultants

24. Technical Support Snapshot Immunization Program presenting an IT solution for RPMS providers Immunization Program advances interface nationally & actively partners with IIS community OIT funds support software development Technical support & development are contracted OIT Help Desk requests are routed to the Immunization Program Documentation, testing, training, installation and troubleshooting --- National Data Exchange Team Meaningful Use kicks off rapid growth of data exchange, creating need for enhanced technical support

25. Consent Issues - FYI While software solutions exist, provider practices and requirements differ by Area, State Information security & consent differ IHS policy memo & individual level consent

26. Lessons Learned From the Field Software capabilities do not equal feasible practice IHS IT presence critical Process must be assigned & ongoing It’s a partnership – clinical & IT Time spent on the front end will be time saved on the back end

27. What could this slide look like for your Area? Facilitator, Data Exchange POC Cecile Town – Cecile.Town@ihs.govCecile.Town@ihs.gov Contact for provider issues Scott Hamstra – scott.hamstra@ihs.govscott.hamstra@ihs.gov Contact(s) for IT & software issues John Parker – john.parker@ihs.govjohn.parker@ihs.gov Tom Love Contact for questions about MU attestation JoAnne Hawkins – joanne.hawkins@ihs.govjoanne.hawkins@ihs.gov