American Immunization Registry Association (AIRA) collaborates with the Public Health Data Standards Consortium (PHDSC) and the Health Information Security and Privacy Collaboration (HISPC) to develop a standard Inter-Organizational Agreement (IOA) for interstate exchange of immunization histories between Immunization Information Systems (IIS)

Background: Public health jurisdictions across the U.S. have developed standards-based Immunization Information Systems (IIS), (formerly known as Registries) to capture immunization histories, monitor immunization rates and status, and enable providers to access immunization histories for their patients. IIS lack records of immunizations residents received in other jurisdictions, and thus cannot effectively measure immunization rates or coverage in the event of an outbreak. However, it is burdensome to create individual IOAs for each exchange. An AIRA Northeast Regional Forum focused on inter-jurisdictional exchange between IIS.

Objective: Collaborate to create a universally accepted standard data exchange agreement that can be used to securely share immunization information between jurisdictions.

Methods: An AIRA ad-hoc work group drafted and refined an IOA based on a compilation of existing interstate IIS agreements and on an MOU developed for newborn screening. AIRA harmonized their draft with the Health Information Security and Privacy Collaborative (HISPC), Inter-Organizational Agreement (IOA) Collaborative, which had already drafted an IOA to formalize IIS exchange between NJ and NY following a pilot exchange project which could not be implemented routinely without an agreement. HISPC-IOA endorsed the AIRA changes. AIRA solicited additional endorsement by the Public Health Data Standards Consortium (PHDSC).

Results: AIRA expertise in immunization data and its standards-based approach contributed to the development of an IOA to increase exchanges between IIS and providers and between jurisdictions that share providers and population.

Conclusions: Collaboration of AIRA, PHDSC, and HISPC-IOA, resulted in a harmonized IOA, conforming with national HIT initiatives, which can be used across health information exchanges (including bi-directional public-to-public and public-to-private exchanges) for IIS and as a template for other public health data.