Measurement & Improvement Initiative


The immunization information system (IIS) Measurement and Improvement (M&I) Initiative provides IIS with information and guidance to align with the IIS Functional Standards. The IIS Functional Standards are a set of specifications that describe the operations, data quality, and technology needed by IIS to support immunization programs, vaccination providers, and other immunization stakeholders.


M&I connects AIRA testing processes with IIS pre-production (or test) systems, and/or analyzes deidentified data, and shares results through the Aggregate Analysis Reporting Tool (AART). Participation in M&I is voluntary among IIS jurisdictions. AIRA continues to test with a growing number of IIS interfaces, with over 95% of IIS programs currently participating.


The data available help guide individual IIS enhancements to align with standards while acknowledging there will always be local law and policy and flexibility within the standard that can add additional requirements and contrasts between IIS. The initiative is demonstrating significant improvements in interoperability between IIS and electronic health record (EHR) systems across the community, as well as improvements in standards-based functionality.


M&I is a three-stage process for IIS to measure their alignment with current standards:

  1. Testing & Discovery gathers preliminary information on community alignment with standards.
  2. IIS Assessment involves more formal testing to measure individual IIS systems using IIS community-selected measures and tests.
  3. 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.

Each content area for measuring IIS functionality and capability progresses through all three stages of Testing & Discovery, IIS Assessment, and Validation. An additional preliminary stage, known as pre-measurement, precedes the M&I process during which AIRA explores how to test and measure a new content area, determines potential data sources, and identifies potential methodologies. The stages and content areas were developed by the Measurement for Assessment and Certification Advisory Workgroup (MACAW), a panel of IIS community subject matter experts.

Stages and content areas combine to provide a high-level roadmap for the M&I Initiative:

Please submit any questions via AIRA's technical assistance request form.

Additional Resources

Updated: 5/1/24