Notes and Observations from the May 2004 PHIN Conference and its Relevance for Registries and AIRA

Approximately 900 public health professionals, consultants, students and vendors attended the three-day Second annual Public Health Information Network (PHIN) meeting in Atlanta Georgia

The PHIN meeting again generated much enthusiasm and high-level agreement for the standards based approach for electronic information exchange. However, there is less agreement on the best approach for implementing and adapting specifications to the community context. The meeting and level of progress reminds me of the development of immunization registries. As you recall, during the national meetings in the first years of immunization registries, the talks were often by a few sites that had pushed ahead and repeated their stores many times. At PHIN 2004, CDC, vendors and consultants, and others presented on the PHIN concepts and told “how” this could be done. The number of real stories of experiences with operating systems this year was very encouraging. The similar path towards system maturity was obvious, and many lessons learned by AIRA members and registries are relevant to PHIN.

The process of PHIN “certification” was presented in a plenary session and a subsequent breakout. CDC has chosen to use the less stringent “compatibility” approach to certification. This will provide greater latitude for registries and other programs. Compatibility is described as: the ability to perform all the required functionality and interact with other PHIN-compatible systems using appropriate technical and data standards; for instance, for exchanging data, using a different data model but mapping the vocabulary into a PHIN standard message structure.
The more stringent “Compliance” process would have required exact use of the PHIN specifications such as the exact logical data model and much less latitude.
CDC is attempting an ambitious and exciting project to create a standard public health vocabulary and a system (PHIN-VS) for making the vocabulary available via the internet. This is part of an effort to create a knowledge management framework, infrastructure and tools to support decision support.

Recommendations for AIRA:
· AIRA members should continue to engage in structured discussions of the PHIN meeting, and PHIN standards to get the full spectrum of views and target topics that will need action. AIRA members should participate in the PHIN-related workgroups and make sure registries are represented.
· AIRA should actively participate with the CDC certification process and create an AIRA process to define compatibility with PHIN standards and specifications. Work such as creating mapping tables and other specifications will be needed. A “road map” of action steps or similar tools may be useful.
· AIRA should make sure registry-related terms are identified and that standard definitions for the registry context are established and added to standard vocabulary is needed; e.g., reminder, recall, tracking and follow-up, vaccine inventory, and the like.

Although only noted briefly at PHIN, AIRA should make sure members are aware of NHII initiatives and safety connected with the news and information flow on NHII (http://aspe.hhs.gov/sp/nhii/index.html). This national issue has significant funding and policy implications associated with integration of a community based electronic health record. More on the July 2004 NHII conference in a future issue. ( Source: Martin LaVenture, MN)
Editor’s note: Martin LaVenture, Ph.D., (MN) served as an AIRA representative to the Second PHIN Conference, along with Sue Salkowitz. This is a condensed version of his complete summary. Conference materials are available on-line at http://www.cdc.gov/phin/.

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