Clinical Decision Support for Immunization (CDSi)

Immunization clinical decision support (CDS), more commonly referred to as evaluation and forecasting, is an automated process that determines the recommended immunizations needed for a patient and delivers these recommendations to the healthcare provider. Health Information Systems (HIS) – which can include Health Information Exchanges (HIEs), Immunization Information Systems (IIS) and Electronic Health Records (EHRs) – provide healthcare providers with immunization evaluation and forecasting tools designed to automatically determine the recommended immunizations needed when a patient presents for vaccination. These recommendations are developed by the Advisory Committee on Immunization Practices (ACIP). ACIP is a federal advisory committee responsible for providing expert external advice and guidance to the Director of the Centers for Disease Control and Prevention (CDC) and the Secretary of the U.S. Department of Health and Human Services (DHHS) on use of vaccines and related agents for control of vaccine-preventable disease in the United States. Recommendations include age for vaccine administration, number of doses, dosing interval, and precautions and contraindications.

After ACIP recommendations are published, technical and clinical subject matter experts (SMEs) work to interpret and integrate them into their evaluation and forecasting engines. New ACIP schedule changes are currently communicated only through clinical language, in publications like the Morbidity and Mortality Weekly Report (MMWR) and the Epidemiology and Prevention of Vaccine-Preventable Diseases (\"The Pink Book\"). The translation of that clinical language into technical logic that can be processed within evaluation and forecasting engines is a time-consuming and complex process that happens mostly independently within the different HIS. Due to the challenge of interpreting clinically-written ACIP recommendations, CDS engine outputs often vary and do not always match the expectations of clinical SMEs.