Dr. and Mr. Kressly Go To Washington

Sue and I went to a two-day conference in Washington, DC on February 7 and 8 to discuss how to increase physician usage of Immunization Information Systems (AKA Immunization Registries). Along with Stuart Weinberg of Vanderbilt University, Sue was the official AAP representative to the conference. Our task was to develop recommendations for the National Vaccine Advisory Council in three major areas. Sue spoke on physician incentives, Stu talked about regulatory issues, and there was a third panel about more stable funding for these services. I tagged along and ended up being the only representative of an EMR vendor who actually has to figure out how to make EMRs and IISs interoperable.

You may be surprised to learn that most registries offer web pages to enter and look up vaccination records, but almost none offer a service that allows these records to be imported directly into EMRs, the way OP can import insurance eligibility and benefits. That’s coming (slowly), but not as quickly as anyone would like. Over the next year, most of us would just settle for everyone agreeing to adopt a common set of standards, because OP now offers connectivity to almost 20 different registries, and no two are exactly alike (though some are close).

Also, there are numerous regulatory barriers to using these systems effectively on an interstate basis. For example, if a patient moved from, say, New Jersey to New York, there is no way to make their old NJ records available electronically to their selected NY doctor. Crazy, huh? Everyone cites Katrina as an IIS success story, but the truth is that it took special legislation to allow interconnectivity between LINKS (the LA registry) and the other states where the population scattered after the hurricane.

This meeting was a follow-on to the AAP/AIRA conference we attended last September. Sue hit all the summary points from that meeting, such as the need for uniform standards, bi-directional connectivity, and a customizable medical decision-making algorithm based on current ACIP standards. She also tried to emphasize that doctors care far more about the value of their time and workflows than small cash incentives to participate in registries (though cash is always nice!). “Pediatricians wholeheartedly support universal immunization, and we believe in sharing this information with each other… Build it right, and we will come,” was her basic mantra. I hope they were listening. When the final report comes out, I will summarize it here.

I made some good contacts with registries OP has not yet built interfaces for, like Rhode Island and Houston. I also made a commitment with one well-known registry to participate in some groundbreaking work that should bear fruit around the middle of this year. Watch this space…


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