BACKGROUND:
There are a number of critical barriers, particularly double data entry and inadequacies of claims data, to populating immunization registries, especially from the private provider community. Use of electronic medical records systems is increasing in ambulatory care and shows great promise as a direct source of data for this and other public health systems.

OBJECTIVE:
To describe the evolution of electronic health records systems (EHR) and the opportunity they present to improve data quality and ease of submission to immunization registries.

METHOD:
A retrospective review of computer-based patient records, and their evolution to electronic medical records and (now) to electronic health records was conducted. A range of possible strategies to integrate these systems with immunization registries was then developed, drawing upon examples in production around the country. The current HL7/EHR initiative was also examined.

RESULT:
Registry projects have a number of alternatives with respect to provider systems integration. Tradeoffs exist between these alternatives.

CONCLUSION:
The current HL7/EHR initiative is expected to promote increased standards-based records exchange capabilities of EMR-systems and their ability to interact or integrate with registries, PHIN and other public health systems. It is important for program managers and registry managers to understand, be aware of and participate in these developments.

LEARNING OBJECTIVES:
To understand current EHR initiatives and how to leverage them for registry projects.