Learning Objectives for this Presentation:
By the end of this presentation participants will be able to:
1. Identify functional areas of immunization information systems (IIS) covered by best practice guidelines.
2. Understand how facilitation and business modeling techniques can be applied to analysis of IIS operations and development of best practice recommendations.
3. Describe the early impact of best practice recommendations on IIS.

Background:
The Modeling of Immunization Registry Operations Workgroup (MIROW) of the American Immunization Registry Association (AIRA) was formed to develop a “Best Practice” guidebook for various aspects of IIS functionality. The workgroup has developed several guidelines and has gathered preliminary information on the impact in IIS.

Objectives:
Provide guidelines that encourage common operational practices, improving quality, consistency, and usefulness of registry information.

Methods:
The MIROW Steering Committee conducted an assessment within the IIS community to determine which guideline components were problematic to deploy and could benefit from a collective guidance. For each topic subject matter experts with diverse backgrounds analyzed existing practices and developed consensus-based recommendations. The workgroup utilized modern business engineering and facilitation techniques. Web surveys designed to evaluate the usefulness and impact of the best practice guidelines are ongoing since January 2007.

Results:
Recommendations have been developed for the following topics: Management of patients' immunization status (2005), Vaccination level deduplication (2006), and Data quality validation checks (2007). Preliminary results based on 11 surveys returned to date suggest that opportunities and challenges remain. All of the respondents found the document at least somewhat useful in the work of their IIS, 7 have attempted to implement the guidelines and 3 more plan to implement.

Conclusions:
Use of facilitation and business modeling techniques enabled development of common consensus-based approaches that lead to support of immunization program activities with better IIS information. However implementation barriers related to limited resources and competing priorities has to be addressed.