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Immunization Data Exchange between State Registries and the Indian Health Service
The Indian Health Service (IHS) is the federal agency charged with providing health care to American Indians and Alaska Natives (AI/AN) who are members of federally-recognized tribes. There are 594 IHS and tribally-run facilities in 35 states providing health care to AI/AN people. All IHS sites and a majority of tribally-run sites use healthcare information software called the Resource Patient Management Software (RPMS). The RPMS is a suite of software programs designed to manage both clinical and administrative healthcare information and to provide an electronic health record for each patient. One of the components of RPMS is the Immunization Package. Like state immunization registries, the RPMS Immunization Package records and tracks immunization coverage, forecasts needed immunizations, generates reminder/recall letters, and provides vaccine accountability and immunization coverage reports for certain age groups. Unlike state immunization registries, however, information recorded in the RPMS Immunization Package is integrated into the patient's electronic health record. An individual's health summary generated by RPMS will include the patient's immunization history, as well as items such as medications, underlying health conditions and other pertinent health information.
Because of the success of the Vaccines for Children (VFC) program, AI/AN children can receive immunizations at any VFC provider, not just at an IHS or tribal facility. Although increasing the access to immunizations has been positive overall, it has made it more difficult for IHS and tribal facilities to maintain complete immunization histories on their patients and determine what they need. State immunization registries have helped providers obtain complete immunization histories, but in order to ensure immunization information is captured in both the RPMS and the state immunization registry so that it is immediately available at the point of care, IHS and tribal facilities need to enter the immunization information into each system– a time consuming process.
In order to facilitate the process and allow IHS and tribal sites to continue to use the RPMS Immunization Package as well as benefit from state immunization registries, IHS has embarked on an immunization data exchange project. The objective is to develop an automated, two-way exchange of immunization information (batch files or real time) between the RPMS and state immunization registries, using the HL7 standards set out by CDC in the "Implementation Guide for Immunization Data Transactions" using Version 2.3.1 of the HL7 Standard Protocol (www.cdc.gov/nip/registry/hl7/hl7guide.pdf)
Data exchange is currently being piloted in Wisconsin and Arizona, with plans to include South Dakota, Utah, Minnesota and Washington in the near future. To date, successful one-way HL7 exchanges from RPMS to the state registries have been completed in Wisconsin and Arizona, and a testing of the two-way exchange (from RPMS to the state registry, and from the state registry to RPMS) is underway in Wisconsin.
Source: Amy Groom IHS Immunization Consultant