Learning Objectives for this Presentation:
By the end of the presentation participants will be able to understand the current state of immunization information system (IIS) data exchange and identify emerging technologies that may address communication challenges.

Background:
In May 2006, the American Immunization Registry Association undertook the first comprehensive analysis of immunization registry data exchange.

Objectives:
Assess the percentage of immunization registries capable of performing standardized electronic data exchange with healthcare facilities and with each other. This communication would lead to more complete immunization records for patients who move or are cared for at multiple healthcare facilities in more than one jurisdiction.

Methods:
An online survey was sent to 72 sites (50 states, 13 regional, 4 territories, 4 cities, and IHS) that have an active IIS. Questions were asked about IIS data exchange with other IISs, use of nationally standardized messages for electronic communication, communication protocols used by IISs, use of encrypted communication, and barriers faced by IISs when performing electronic communication.

Results:
Thirty-two of seventy-two IISs responded (44%). Most IISs do not exchange data with other IISs and do not use the national standard HL7 message format. Of the thirteen that use standardized messages, seven use it for batch communication, one uses it for real-time communication, and five use HL7 for batch and real-time communication. Respondents use or plan to implement the HTTPS protocol, ebXML, and SOAP to deliver electronic messages. Six respondents do not encrypt immunization information exchange. The most common barriers to electronic communication identified by respondents are funding, technical/development issues, and network issues.

Conclusions:
To improve data exchange, electronic communication of immunization information needs to be simplified and standardized. Encryption should be used for all confidential health communication. Evaluation of emerging technologies, such as Web Services, should be performed.