The public health immunization registry has returned the requested immunization history for a patient. The EHR is able to display the immunization history received from the registry as well as the immunization history already present in the EHR so that a user can compare them. The EHR provides a way for the provider to view both histories, determine what is different (if anything), and update the existing EHR immunization history with new information from the public health registry if he or she chooses to do so. The system must store the new information as structured data as part of the patient’s local immunization history and include the time of the update and the source of the new information.
Dr. Smith’s EHR system receives immunization information from the registry for the existing patient, Juana Mariana Gonzales. The immunization history in the EHR indicates that the patient has not received any doses of MMR vaccine. The history received from the registry indicates that Juana was given an MMR vaccine at age 15 months by another provider. The EHR allows Dr. Smith to accept the history received from the registry, save it in Juana’s record, and indicate that the source of the information is the public health registry.
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 here may also provide benefit for patient follow up. Further feedback is invited regarding which additional elements to address. Usability evaluation such as User Centered Design should inform effective and safe methods for managing immunization reconciliation.
- Vendor, Provider and Implementer Perspectives. Products with the ability to store additional data elements about historical vaccines may assist providers 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, Compare Public Health IIS Immunization History to EHR Immunization History. The scripts indicate successful performance for each of the test sections.
Click here for data elements associated with the capability Compare IIS Immunization History to EHR Immunization History.