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). AIRA continues to test with a growing number of IIS interfaces, with over 90% 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. The stages and content areas were developed by the Measurement for Assessment and Certification Advisory Workgroup (MACAW), a panel of IIS subject matter experts.

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


For questions regarding this initiative, please contact [email protected].

Additional Resources