1. Immunization Data Exchange (BYIM v 2.0*1) Identifying and Addressing Data Exchange Issues Scott Hamstra Updated 8/24/11

2. Resolving Issues Active Troubleshooting Passive Troubleshooting

3. Support Tiers Tier 1 –Local operator –the IHS site support group, e.g. IT site manager Tier 2 –Regional or secondary local support –IHS Area support group, e.g. Area (Region) CIO or IT support division Tier 3 –IHS National support, HQ

4. Tier 3 Request Form Collect information needed Help identify problem quickly Only one page

5. Three Areas Installation –Unable to setup interface Transport –The messages are not being sent Message –The data being sent is incorrect

6. Area 1: Transport Assume that you have already followed installation steps Asks for basic environment questions

7. Area 2: Transport Two areas that can have problems: –Sending Are you having problems sending data to State IIS? –Receiving Are you having problems receiving data from State IIS?

8. Area 2: Transport

9. Area 3: Message Two areas where issues can start –Local BYIM –State IIS

10. Scenario 1 IHS AREA “A” has done the initial set up for the data exchange in Mountain State because most software installations are executed from the Area, rather than at the Site level. After BYIM & Bridge installation, the Area Site Analyst submitted files from each facility to the Mountain State Immunization Information System (MSIIS).

11. After the state reviewed the test files, they notified the National Data Exchange Coordinator: I have looked at the two test files we received. The formatting is good with both test files, from Site #1 and Site #2. Issue 1 - One trend with the content of the messages that I saw is incomplete records. So, the RXA segment will indicate that the immunization was given by the site, but the lot number, administering provider, and manufacturer fields are blank. Issue 2 - Also, for these we would like to see an additional RXR segment that is not included in your current HL7 message, which communicates the administration body site and route of administration. Issue 3 - We have not received files from the Site #3 site yet. The site reports that an HL7 message was generated, but when they open those files, the file is empty/blank.

12. Scenario #2 Facility A called their Area IT Site Analyst to report that they are not receiving anything from the IIS in their response directory. The IT Analyst checked the response folder and it said “couldn’t connect” and called the IIS programmer who reported that there was a power outage and the state server was not able to process any exports to providers for a 24 hour period. This probably impacted all the sites, but only one site detected the issue.

13. Scenario #3 – One Way Manual Exchange Nurse looks into IIS and sees that immunizations they would expect to see there did not cross over in the HL7 message. Why would this happen? How would you trouble shoot it?