The IHS Immunization Survey: IIS and Electronic Interface Participation by Indian Health Providers in Various States

Background:
The Indian Health Service (IHS) immunization data exchange initiative encourages IHS, tribal and urban (I/T/U) Indian health sites to participate in immunization information systems (IIS). IHS developed software to facilitate provider participation in an automated, two-way batch ITU/IIS interface.

Objectives:
To characterize participation by ITU providers in 35 state IIS. To track participation over time, sites will receive a survey annually as both IIS capabilities and interface software evolve.

Methods:
In 2008, a 25 question survey was distributed to the 233 ITU sites reporting to the IHS National Immunization Reporting System. Responses were analyzed using Epi Info. The survey will be re-administered in 2009, and results will be compared to 2008 results.

Results:
For 2008, we received responses from 113 of 233 (48%) sites in 18 states. Of those, 81% were familiar with their IIS; 69% reported sharing information with the IIS, and 49% reported using IIS look-up capability. Twenty-four (21%) sites reported using the ITU/IIS interface to send information one-way to the IIS, and 7% report bidirectional information sharing. Others report direct data entry into the IIS (36%), sending hard copy documentation to the state for entry into the IIS (4%), or sending a flat file (3%). Comments from the survey indicated barriers to IIS participation such as: no time or personnel for double data entry, waiting for IIS capability to exchange data through the interface, and lack of technical support for interface issues.

Conclusions:
While most respondents are aware of the IIS, not all share information with their IIS or use look-up capability. Although ITU providers would prefer IIS participation through an electronic interface, educating them on the value of using IIS look up capability while establishing an interface may help to engage them. Continued support to establish ITU/IIS interfaces is critical for increasing ITU site participation.