HL7 Immunization User Group Monthly Meeting June 11, 2020 2:00 PM ET
Agenda • Welcome - Which perspective do you primarily identify yourself with? • Updates • SISC • FHIR • COVID-19 • AIRA Technical Responses • Report back on Immunity Codes • Questions IIS need answered • Integration of IIS with other public health systems
SISC Update Mary Woinarowicz
FHIR Update Nathan Bunker
FHIR Update • Virtual FHIR Meetings • June 15-18, 2020 HL7 FHIR Dev-Days • Immunization DS Connectathon: Scheduled for July • September HL7 WGM & Connectathon will be virtual • FHIR releases • Looking to do interim release of R4 – Q2 2021
Preparing for COVID-19 Nathan Bunker
Preparing for COVID-19 • IIS need to ensure they are ready • PBS Frontline Coronavirus Pandemic, April 21, 2020 • Lesson Learned: Preparation is key to an effective response • https://www.pbs.org/wgbh/frontline/film/coronavirus-pandemic/ • Preparing for COVID-19 Vaccine One Sheet • Interim suggestions for IIS to prepare now • https://repository.immregistries.org/resource/preparing-for-a-covid- 19-vaccine-one-sheet/
1) Onboard Immunizing Partners • Swiftly onboard any providers waiting in a testing queue. • Identify and contact potential immunizing providers to initiate onboarding now . • Automate and streamline onboarding functions. • Review and implement AIRA’s Onboarding Consensus-Based Recommendations. • https://repository.immregistries.org/resource/onboarding-consensus-based- recommendations/ • Allow for online registration and electronic signatures; auto- generate provider site IDs or PINs.
2) Align With Standards • Verify that all messaging practices are standards-based • HL7 Messaging • SOAP/Web Services and the CDC WSDL • Clinical Decision Support (CDS) • Use the Aggregate Analysis Reporting Tool (AART) to assess your IIS alignment with standards
3) Eliminate Data Exchange Limitations • Familiarize yourself with local laws or policies impacting IIS: • Consent (opt-in vs. opt-out) • Vaccine reporting mandates • Data sharing (across borders and with federal agencies) • Provider types permitted to administer vaccines • Explore jurisdictional emergency orders to relax laws and/or policies, as needed. • Ensure that interjurisdictional data exchange is possible: • Advocate for signing of the Memorandum of Understanding for IIS Interjurisdictional Exchange. • Connect with the Immunization (IZ) Gateway to support IIS to IIS exchange
4) Expand Consumer Access • If IIS web access is available to consumers, test and validate process for authentication • Expand query/response capabilities with EHRs to enable consumers to access immunization records in EHR portals • If records are only available through Help Desks or provider offices, develop a strategy for adequate staffing to manage increased volume of record requests
IIS Support for COVID-19 Related Concepts Nathan Bunker
IIS Support for History of Disease MSH|^~\&|||||20200219102500-0600||VXU^V04^VXU_V04 |rhB-SA.9.2.1-D|P|2.5.1|||ER|AL|||||Z22^CDCPHINVS PID|1||X48O3469^^^AIRA^MR||LinnAIRA^MatsuAIRA^Charley^^^^L|WaschingAIRA^Pol onaAIRA^^^^^M|20190207|F||2106-3^White^CDCREC|1088 Bisterwijk Pl^^Ellsworth^MI^49729^USA^P||^PRN^PH^^^231^5703745|||||||||2186-5^not Hispanic or Latino^CDCREC||N||||||N PD1|||||||||||02^Reminder/Recall - any method^HL70215|N|20200219|||A|20200219|20200219 NK1|1|LinnAIRA^WaschingAIRA^Marion^^^^L|MTH^Mother^HL70063|1088 Bisterwijk Pl^^Ellsworth^MI^49729^USA^P|^PRN^PH^^^231^5703745 ORC|RE||9999^AIRA| RXA|0|1|20200219||998^No Vaccine Administered^CVX|999|||||^^^SIISCLIENT10543|||||||||NA|A RXR|C28161^Intramuscular^NCIT| OBX|1|CE|59784-9^Disease with presumed immunity^LN|1|38907003^History of Varicella infection^SCT||||||F|||20200219
IIS Support for History of Disease 45 40 35 30 25 20 15 10 5 0 Accepted Not Accepted Unknown IIS Response
IIS Support for Evidence of Immunity MSH|^~\&|||||20200219102500-0600||VXU^V04^VXU_V04|rhB-SA.9.3.1- D|P|2.5.1|||ER|AL|||||Z22^CDCPHINVS PID|1||T83Y3477^^^AIRA^MR||BonnevilleAIRA^FairleyAIRA^Ames^^^^L|AlpineAIRA^ AnnAIRA^^^^^M|20190207|F||2106-3^White^CDCREC|1111 Goerden Ln^^Riga^MI^49276^USA^P||^PRN^PH^^^517^5557615|||||||||2186-5^not Hispanic or Latino^CDCREC||N||||||N PD1|||||||||||02^Reminder/Recall - any method^HL70215|N|20200219|||A|20200219|20200219 NK1|1|BonnevilleAIRA^AlpineAIRA^Marion^^^^L|MTH^Mother^HL70063|1111 Goerden Ln^^Riga^MI^49276^USA^P|^PRN^PH^^^517^5557615 ORC|RE||9999^AIRA| RXA|0|1|20200219||998^No Vaccine Administered^CVX|999|||||^^^SIISCLIENT10543|||||||||NA|A RXR|C28161^Intramuscular^NCIT| OBX|1|CE|75505-8^Disease with serological evidence of immunity^LN|1|271511000^Serology confirmed Hepatitis B^SCT||||||F|||20200219
IIS Support for Evidence of Immunity 45 40 35 30 25 20 15 10 5 0 Accepted Not Accepted Unknown IIS Response
IIS Support for Adverse Event MSH|^~\&|||||20200219102500-0600||VXU^V04^VXU_V04|rhB-SA.8.1.2- D|P|2.5.1|||ER|AL|||||Z22^CDCPHINVS PID|1||J52S3444^^^AIRA^MR||ConnorAIRA^GaiAIRA^Keara^^^^L|OlsonAIRA^ArashelA IRA^^^^^M|20160208|F||2106-3^White^CDCREC|1058 Oinsum Ave^^Saint Clr Shores^MI^48081^USA^P||^PRN^PH^^^586^8222890|||||||||2186-5^not Hispanic or Latino^CDCREC||N||||||N PD1|||||||||||02^Reminder/Recall - any method^HL70215|N|20200219|||A|20200219|20200219 NK1|1|ConnorAIRA^OlsonAIRA^Marion^^^^L|MTH^Mother^HL70063|1058 Oinsum Ave^^Saint Clr Shores^MI^48081^USA^P|^PRN^PH^^^586^8222890 ORC|RE||9999^AIRA| RXA|0|1|20170218||998^No Vaccine Administered^CVX|999|||||^^^SIISCLIENT10543|||||||||NA|A RXR|C28161^Intramuscular^NCIT| OBX|1|CE|31044-1^Reaction^LN|1|39579001^Anaphylaxis^SCT||||||F|||20170218|
IIS Support for Adverse Event 45 40 35 30 25 20 15 10 5 0 Accepted Not Accepted Unknown IIS Response
IIS Support for Contraindication MSH|^~\&|||||20200219102500-0600||VXU^V04^VXU_V04|rhB-SA.9.1.1- D|P|2.5.1|||ER|AL|||||Z22^CDCPHINVS PID|1||N45O3461^^^AIRA^MR||NorthumberlandAIRA^SunAIRA^Pier^^^^L|CruzAIRA^Ce rdwinAIRA^^^^^M|19940207|F||2106-3^White^CDCREC|1850 Ptichtse Vecht Ave^^Cross Village^MI^49723^USA^P||^PRN^PH^^^616^6748817|||||||||2186- 5^not Hispanic or Latino^CDCREC||N||||||N NK1|1|NorthumberlandAIRA^CruzAIRA^Marion^^^^L|MTH^Mother^HL70063|1850 Ptichtse Vecht Ave^^Cross Village^MI^49723^USA^P|^PRN^PH^^^616^6748817 ORC|RE||9999^AIRA| RXA|0|1|20200219||998^No Vaccine Administered^CVX|999|||||^^^SIISCLIENT10543|||||||||NA|A RXR|C28161^Intramuscular^NCIT| OBX|1|CE|30945-0^Vaccination contraindication^LN|1|77386006^Patient Currently Pregnant^SCT||||||F|||20200219 OBX|2|DT|30946-8^Vaccination contraindication effective date^LN|1|20160605||||||F|||20200219
IIS Support for Contraindication 40 35 30 25 20 15 10 5 0 Accepted Not Accepted Unknown IIS Response
IIS Support for Immune Globulin (IgIV) MSH|^~\&||GU2017||GU0000|20190728140619-0400||VXU^V04^VXU_V04|Q5u-CV-CVX- 87|P|2.5.1|||ER|AL|||||Z22^CDCPHINVS PID|1||R81Q34752^^^AIRA- TEST^MR||Barry^Anitra^Mamta^^^^L|Westport^Eva^^^^^M|20190328|F||2106- 3^White^CDCREC|42 Peterson Pl^^Saint Heights^MI^48312^USA^P||^PRN^PH^^^586^4549852|||||||||2186-5^not Hispanic or Latino^HL70005 PD1|||||||||||02^Reminder/Recall - any method^HL70215|||||A|20190728|20190728 NK1|1|Barry^Westport^^^^^L|MTH^Mother^HL70063|42 Peterson Pl^^Saint Heights^MI^48312^USA^P|^PRN^PH^^^586^4549852 ORC|RE||BR81Q34752.1^AIRA|||||||I-23432^Burden^Donna^A^^^^^NIST-AA-1 RXA|0|1|20190528||87^IGIV^CVX|999|||01^Historical information - source unspecified^NIP001|||||||||||CP|A
IIS Support for Immune Globulin (IgIV) 50 45 40 35 30 25 20 15 10 5 0 Accepted Not Accepted Unknown IIS Response
Next Meeting July 9, 2020 2:00 pm ET / 11:00 am PT
More Information • Web Links • Subscribe to immunization group http://www.hl7.org/participate/UserGroups.cfm?UserGroup=Immunization • Public User Group Wiki http://www.hl7.org/special/committees/iug/index.cfm • Private User Group Wiki http://iugwiki.hl7.org/ • HL7 Press Release http://www.hl7.org/documentcenter/public_temp_F760602A-1C23-BA17- 0C0D326E635471F9/pressreleases/HL7_PRESS_20140402.pdf • AIRA Press Release http://www.immregistries.org/events/2014/04/10/hl7-immunization-user-group
Contact Information If you have any questions or comments: • Kim Salisbury-Keith Kim.SalisburyKeith@health.ri.gov • Nathan Bunker nbunker@immregistries.org • Kevin Snow ksnow@envisiontechnology.com • Danny Wise Danny.Wise@allscripts.com Thank you!
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