215014 Service-oriented Architecture: Enabling Data Sharing Between Immunization Information Systems and Clinical Care

Wednesday, November 10, 2010 : 12:30 PM - 12:50 PM

Noam Arzt, PhD , HLN Consulting, LLC, San Diego, CA
(1) Background: As the emphasis in supporting “meaningful use” shifts to provider-based electronic health record system (EHR-S), Service-oriented architectures (SOA) have provided a way for Immunization Information Systems (IIS) to remain viable and responsive to increasing demands for information and analysis. This paper offers two case studies of production IIS in different jurisdictions and the strategies used with SOA to enable new and important features to support data sharing with clinical systems. (2) Objective/purpose; To demonstrate how SOA can enable IIS to facilitate the achievement of “meaningful use” by provider EHR systems. (3) Methods; The New York City Citywide Immunization Registry (CIR) provides a consolidated database of all childhood and adolescent immunizations administered to City residents. In Rhode Island, KIDSNET is a computerized registry used to track children's use of preventive health services. Both of these existing systems were modified to provide new functionality for clinicians via SOA. (4) Results: Two services were developed in New York City: The first service allows an electronic health record system (EHR-S) to query the CIR and receive in response the immunization history and clinical decision support for the patient; the second service allows the EHR-S to report new immunizations to the CIR. After studying and testing several alternatives, Rhode Island integrated as a service an immunization algorithm from another state with minimal modification to KIDSNET itself. In the future, this service could be enabled to provide decision support to EHR systems via HL7 query. (5) Discussion/conclusions: Service-oriented architecture has moved into the mainstream of technical development strategies. This presentation demonstrates that it can be a useful tool to enable rich functionality within existing public health systems, while minimizing the cost and time to deploy these new features.

Learning Areas:
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Define the functions of an IIS best enabled by SOA Identify the ways in which IIS can support clinical needs Describe the technical standards used by IIS to enable information exchange with clinical systems

Keywords: Health Information Systems, Immunizations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in the design, development, and deployment of the systems described in this talk for many years. I am also involved in the technical standards development and harmonization organizations relevant to these activities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.