A Three-Step Approach for Creating Successful Electronic Immunization Record Exchanges between Clinical Practice and Public Health.
Population health and individual health are strengthened through proactive immunization programs. Clinicians refer to immunization records at the point of care about to decide which vaccinations their patients and families need to reduce the risk of contracting (and spreading) vaccine preventable disease (VPD). Understanding the earliest possible age intervals that are safe to administer vaccinations provides the youngest children with as much immunity as possible as early as possible. This is especially useful for children at highest risk as their visits to a medical provider may be sporadic. This- coupled with the continuous development of new and combined vaccines and complex vaccination schedules- challenges the provider to understand the appropriate vaccinations to order for their patients. Under-vaccinating increases patients' VPD risk/ over-vaccinating increases provider and consumer health care costs. Clinicians want to make the best clinical and economically responsible decisions - this is the challenge. The solution lies in providing clinicians timely and accurate vaccination data with decision support tools at the point of care. The use of Electronic Health Records (EHRs) alone cannot achieve this goal. It will take an accountable team made up of the clinician organization- their EHR vendor- and a public health agency to effectively manage immunization coverage for a patient population. This paper provides a three-step approach to establish and maintain EHR data exchanges- demonstrates the value of both clinical and technical testing prior to data exchange implementation- and discusses lessons learned. It illustrates the value of federal Meaningful Use criteria and considers how its objective to advance data exchange with public health systems increases providers' access to timely- accurate immunization histories and achieves desired mutual health outcomes for providers and public health programs.