The Wisconsin immunization registry experience: comparing real-time and batched file submissions from health care providers

CONTEXT: The Wisconsin Immunization Registry is a confidential- web-based system used since 1999 as a centralized repository of immunization information for Wisconsin residents. OBJECTIVE: Provide evidence based on Registry experiences with electronic data exchange- comparing the benefits and drawbacks of using the Health Level 7 standard- including the option for real time data exchange vs the flat file method. DESIGN: For data regarding vaccinations received by children aged 4 months through 6 years with Wisconsin addresses that were submitted to the Registry during 2010 and 2011- data timeliness (days from vaccine administration to date information was received) and completeness (percentage of records received that include core data elements for electronic storage) were compared by file submission method. RESULTS: Data submitted using Health Level 7 were substantially more timely than data submitted using the flat file method. Additionally- data submitted using Health Level 7 were substantially more complete for each of the core elements compared to flat file submission. CONCLUSIONS: Health care organizations that submit electronic data to immunization information systems should be aware that the technical decision to use the Health Level 7 format- particularly if real-time data exchange is employed- can result in more timely and accurate data. This will assist clinicians in adhering to the Advisory Committee on Immunization Practices schedule and reducing over-immunization.