The Data Exchange Process and Participants

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

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.gov • Contact for provider issues Scott Hamstra – scott.hamstra@ihs.gov • Contact(s) for IT & software issues John Parker – john.parker@ihs.gov Tom Love • Contact for questions about MU attestation JoAnne Hawkins – joanne.hawkins@ihs.gov