Measurement & Improvement (M&I) Initiative

Overview

Launched in 2015, the Measurement and Improvement (M&I) initiative is a voluntary testing and recognition process that helps immunization information systems (IIS) align with national standards through independent testing, actionable data, and expert guidance. Led by AIRA in partnership with the CDC and the IIS community, M&I follows a three-stage process—Testing & Discovery, Assessment, and Validation—to measure system performance and provide clear steps for improvement. By participating, IIS programs align with IIS Functional Standards by enhancing data quality, interoperability, and overall system effectiveness, while also ensuring accurate immunization data supports public health efforts nationwide. For a high-level overview of the M&I initiative, please refer to the M&I One-Sheet.

M&I Stages

Prior to progressing through the three M&I stages, Pre-Measurement work takes place, during which AIRA explores testing and measurement approaches for a new content area, identifies potential data sources, and determines methodologies.

Testing & Discovery gathers preliminary information on community alignment with standards
Assessment involves more formal testing to measure individual IIS systems using IIS community-selected measures and tests
Validation is a summary stage to acknowledge and share results for IIS that are progressing toward or achieving alignment with community-selected measures and tests

Content Areas

Each content area represents a specific aspect of IIS functionality and capability that is evaluated through the three stages of the M&I process: Testing & Discovery, Assessment, and Validation. These stages and content areas were developed by the Measurement for Assessment and Certification Advisory Workgroup (MACAW), a panel of IIS community subject matter experts. To learn more about each of the following content areas, visit the M&I Content Areas page.

Benefits of Participation

Participating in M&I provides data-driven insights, technical support, and national recognition for IIS improvements. IIS receive customized reports to identify strengths and areas for growth, with successful participants earning digital badges for achieving national standards. Engaging in M&I strengthens collaboration across jurisdictions, improves data exchange, and enhances system credibility, making immunization data more reliable, efficient, and accessible for public health initiatives.

Recognition for IIS achieving at least the basic level of Validation in one or more measurable areas
Actionable data reports for each measurement area at the Testing and Discovery, Assessment, and Validation stages
Personalized technical assistance to support improved M&I results
Contribution to community alignment progress and enhanced overall IIS credibility

IIS Participation and Impact

M&I strengthens the IIS community by providing a standardized, community-driven framework for testing and improvement, enabling jurisdictional IIS to align with national standards, improve data quality, and enhance public health nationwide.

"Thanks to M&I, our IIS has demonstrated remarkable progress on closing the gap on standards alignment, especially with each new measurement area. It’s inspiring to be a part of the collective impact of our efforts towards a common goal.” – Arizona IIS staff

Independent Testing

To facilitate independent testing of IIS functionality and performance, AIRA developed the Aggregate Analysis Reporting Tool (AART) as part of the M&I initiative. AIRA conducts the independent testing using standardized measures and provides IIS jurisdictions with results through AART. This allows jurisdictions to review their system’s performance and identify areas for improvement. AIRA also oversees the development, support, and maintenance of AART as a resource for the IIS community. Users must register for AART and set up a free account to access the system.

At any time via AART, participating IIS can: