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Bolstering the Public Health Network

by Lindsay Mello, Healthcare Transactions Manager

The measles outbreak that occurred at Disneyland in March thrust vaccinations into the headlines, bringing to the forefront the impact that they can have on the public health of America. While it’s unclear at this time what, if any, ramifications the outbreak might have on public policy or vaccination requirements, it is clear that having accurate data on who is – and who is not – vaccinated is key to understanding the outbreak and preventing similar occurrences in the future.

The Centers for Disease Control and Prevention’s (CDC) Immunization Information Systems (IIS) have been tracking and advocating for vaccinations for over 15 years. Throughout the last century, vaccinations have controlled smallpox, polio, measles, rubella, tetanus, and diphtheria; but to maintain this success, individuals need to receive the necessary vaccinations at the appropriate times, and those patients who change providers need an accurate record of their vaccinations to travel with them.

Until very recently, all vaccine records had to be manually entered into the IIS by providers or their staff. Obviously, this is time-consuming and opens up opportunities for errors or missing information. An improvement has surfaced in the form of the Meaningful Use immunization registry measure, which has pushed the industry to electronically transmit vaccine information from the providers’ office to the IIS.

The implications are astounding – and not just in the time and money saved by relieving the need for manual data entry. With this electronic exchange, the public health system has consistent, reliable, and complete data to pursue their honorable goals of maintaining the public’s safety.

But there’s a rub! There are over 55 immunization registries across the country and each has different requirements related to enrollment for electronic data exchange, testing, connectivity, and the specifications for how to transmit vaccine data. Even within a single jurisdiction, a health care provider’s office could get lost in the shuffle of registering, testing, and ultimately waiting in an IIS queue until they finally are able to begin transmitting live immunization data across the electronic interface. Small practices may not even have the bandwidth or technical requirements to set up such an interface. At athenahealth, we see this as an unnecessary burden. And we make sure that our cloud-based approach alleviates that burden. 

Inside the Healthcare Transactions Team

We have worked with nearly every immunization registry in the country. After identifying those that are able to receive electronic data from practitioners, we have conducted testing and established an interface between our cloud-based servers and the IIS. Our single-instance, multi-tenant approach (meaning a single version of our software, on a single, shared cloud-based network, used and inhabited by tens of thousands) guarantees that every provider using our electronic health record service is on the exact same version of our Meaningful Use certified software. What does this mean to the IIS? Plenty. Once an interface is tested and deemed acceptable for any one of our clients, it is ready for every single client sending data to that registry. One well-tested interface for all that need it. This means more providers transmitting electronic data to the registries and a more complete and accurate vaccine database! Since we started building these interfaces four years ago, nearly eight million vaccination records have been delivered to the IIS via electronic interface.

And we don’t stop at immunization systems. We also actively test with 10 cancer registries to further support our providers and the public health system identify cancer trends, possible causes, and screening opportunities throughout the country. To support these efforts, we plan to build a cloud-based infrastructure for transmitting data to all state cancer registries, similar to what’s in place for immunization registries. So stay tuned!

Finally, I should mention that beefing up the public IIS data has delivered an added benefit for athenahealth providers – it’s helped them meet the public health Meaningful Use requirements. In fact, 99.6% of participating providers passed the immunizations measure for Meaningful Use Stage 2, a success rate we’re quite proud of.

Helping providers meet these exchange-related measures is important, of course, and in our dedication to helping them succeed, it’s part of what we do. But we also believe that making improvements at the population health level is an even greater vision, and will benefit larger public health needs.
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