FEATURE
If APHL and AIMS could build
interfaces for even the top five
EHR systems, I wonder how many
hospitals I could quickly onboard.”
A Digital Gateway to Immunization Data
How many parents, or pediatricians, know exactly
which immunizations each of their charges has
had? Or even where that information is kept?
Keith Higginbotham, IT systems manager
AIMS might save, Higginbotham said it
took his IT team six months to build an
interface with the EHR system used by
most Alabama county health department
clinics. Yet having established that
interface, the public health laboratory now
transmits about 1,000 test results to those
clinics each day.
Peter Kyriacopoulos, APHL’s public policy
director, said the public health data bills
now pending on Capitol Hill represent “a
very strong expression of congressional
support” for public health data
modernization. He said, “APHL continues
to press the need for Congressional action
on data transformation and, on June 28,
hosted a Hill briefing on the subject,” with
partners, CSTE, NAPHSIS and HIMSS. “The
briefing room held 70 people and it was
packed—which is a very good sign of the
level of interest in this topic.”
@APHL
Daniel oversees the federal Immunization
Gateway Project, which aims to provide a single
gateway to US immunization data.
Almost every state and major jurisdiction
maintains an immunization registry, and most
require that at least childhood immunizations
be reported to that registry. The problem, said
Daniel, is that reporting laws are based on the
provider’s location, not the family’s. And families
move around.
“We didn’t want each immunization information
system (IIS) to have to connect with 63 others” to
get a complete immunization history, said Daniel.
“So we decided to build a hub; if you can connect
to this hub you can connect to all the other IISs
connected to it.”
Except, he said, “APHL had already built a
secure, government-approved, cloud-based
environment”— AIMS.
Said CDC’s Iademarco, “In the last five
years, we’ve developed the strategy [to
modernize public health data systems]
and the internal leadership to make
progress . . . . If we don’t [act now], we’re
going to lose our connection to the data.
And remember, it is foundational to our
public health mission to collect data,
analyze data and respond based on
that data. If we don’t get in the raging
river around this progress, we’re going
to be left behind, and that’s going to
undermine what public health does.
We’ve demonstrated we can do it. But,
there’s formidable work ahead of us that
needs to be paired with commensurate
resources.” n
PublicHealthLabs
James Daniel, MPH, public health coordinator in
the Office of the Chief Technology Officer at HHS,
explained, “Maybe [a child] gets an immunization
at school, maybe she gets one at a pharmacy. You
need to know the complete immunization history
before you give a child an immunization.”
used to authorize the sharing of IIS data across
jurisdictions.
The first two jurisdictions to “turn on this
functionality” were Philadelphia and Delaware.
Daniel said, “The very first week we turned it on,
[Philadelphia health authorities] realized Philly
moms were giving birth in Delaware hospitals.
And after birth is when the baby gets the first
doses of hepatitis B vaccine. When we turned
this system on, they realized those
immunizations weren’t being reported back to
Philly.”
This new knowledge, Daniel said, has important
financial and public health implications:
“Philadelphia doesn’t need to spend a lot of
money developing programs to boost infant hep
B immunization rates, because they’re not as low
as they thought.”
The same technology can be used to allow large
provider organizations, such as the US Indian
Health Service or Kaiser Permanente—keep
track of their patients’ immunization histories. A
longer-term goal is to allow consumer access to
the data as well.
Daniel said, the project “would have been
so much more expensive and so much more
difficult without AIMS. Plus AIMS has brand name
recognition with public health agencies; they
know that’s someone they can trust.”
In addition to providing technical expertise
and the messaging platform, APHL helped the
Immunization Gateway Project craft a standard
memorandum-of-understanding that can be
APHL.org
Fall 2019 LAB MATTERS
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