The system sends a request to the public health immunization registry “on demand” (e.g., those without scheduled appointments). The request includes the identifying information the immunization registry needs to match each patient with those in the registry including, if present, the mother’s maiden name, a multiple birth indicator, and the birth order. The request also is sent in a pre-determined format the registry can read and interpret (Query Response Grammar (RSP) – HL7 version 2.5.1 Implementation Guide for Immunization Messaging Release 1.5).
On Wednesday, Dr. Smith’s office manager uses the EHR to select Juana Mariana Gonzales (age 6), who is a late addition to the appointment schedule for the same day. The EHR allows the office manager to create a query to the public health immunization registry (IIS) requesting the patient’s immunization history. The EHR formats the request, including the patient’s information, into a format that can be read and processed by the registry. The registry returns a response in real-time that includes Juana’s latest vaccine history and forecast in a standard format that the EHR can be process and present to Dr. Smith when she sees the patient.
Information required for matching patients with those known to the immunization registry is identical to capability 1.1. The immunization history that the registry returns to the provider may include some or all of the data elements listed here. Most of the vendors evaluated had fields for historical vaccine information for all except the fields: ordering provider, entering organization, administering provider and entered by. Specifically valuable for reconciling the vaccine history with the information in the EHR were date/time of administration, vaccine administered, lot number, substance manufacturer name. The additional fields listed here may also provide benefit for patient follow up. Further feedback is invited regarding which additional elements to address.
- Vendor, Provider and Implementer Perspectives. Products with the ability to store additional data elements about historical vaccines may assist providers to perform reconciliation. Additional data (such as administered at location) may also allow providers to obtain additional information as needed for vaccine recalls.
Click here for test plans that include the capability, Real Time Request/Receipt of Patient Immunization History. The scripts indicate successful performance for each of the test sections.
Click here for data elements associated with the capability Real Time Request/Receipt of Patient Immunization History.