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Thursday, March 24, 2005 - 9:05 AM
87

Evolution of Data Exchange with the New York Citywide Immunization Registry (CIR): From Paper to Electronic Messaging

Noam H. Arzt1, Angel R. Aponte2, Amy Metroka3, Paul S. Schaeffer4, Vikki Papadouka3, Susan M. Salkowitz5, and Fred Pytlak6. (1) HLN Consulting, LLC, 7072 Santa Fe Canyon Place, San Diego, CA, USA, (2) Citywide Immunization Registry, New York City Department of Health, 2 Lafayette St., 19th Floor, New York, NY, USA, (3) Citywide Immunization Registry, Bureau of Immunization, NYC Department of Health and Mental Hygiene, 2 Lafayette Street, 19th floor - CN21, New York, NY, USA, (4) NYC DOHMH, 2 Lafayette St. 19th Floor, new york, NY, USA, (5) Salkowitz Associates, LLC, Two Independence Place, Unit 1601, 233 S. 6th Street, Philadelphia, PA, USA, (6) Visual Data, LLC, 148 W 24th Street, New York, NY, USA


BACKGROUND:
The CIR has been in production since 1997. Various methods have been supported over the years for both electronic submission of information and for extracting and returning data to authorized participants, typically health care providers and Managed Care Organizations (MCOs).

OBJECTIVE:
To describe methods for data exchange and how changing requirements and capabilities of providers and MCOs have necessitated changes in strategy. In particular, the Electronic Health Record (EHR) initiative has required more sophisticated options and focused CIR on enabling more dynamic, real-time, two-way communication to supplement existing techniques.

METHOD:
Because reporting of immunizations is mandatory in NYC, a variety of data submission options are offered, including submission of a standard ASCII data file via Web-based upload, online entry through a Web client, and submission of paper forms. Data may be viewed using the Web client, and extracts may be requested via submission of a standard file for matching against the database and return of data in a standard ASCII file format. Demands for tighter integration with provider electronic medical records (EMR) systems have resulted in a pilot project to provide bi-directional HL7 messaging with CIR.

RESULT:
Use of all data access methods has increased steadily. Lookups through the Web client increased by 274% from September 2002 (4,293 per month) to September 2004 (16,058 per month), and immunizations reported over the Web increased by 414% in the same period (from 3,498 to 17,965 per month). Records requested by providers, MCOs, and schools in batch increased by 140% from 2002 (75,000) to 2004 (180,000). As the HL7 pilot moves into full production, this rate of data exchange is expected to increase dramatically.

CONCLUSION:
Changes in the health care systems environment, including demands for more data and more timely data, have required CIR to develop more sophisticated mechanisms to receive and supply data to partners.

LEARNING OBJECTIVES:
Understanding how a registry can keep pace with changing data exchange requirements of external users.

See more of Immunization Registries Track: Data Standards: Meeting the Demand for High Quality Data
See more of The 39th National Immunization Conference (NIC)