The American Immunization Registry Association Collaborates to Develop a Standard IOA for Interstate Exchange of Immunization Histories Between IIS

States, local health jurisdictions and territories have developed standards-based Immunization Information Systems (IIS) to capture immunization records for their residents. Currently, public health officials cannot fully monitor the immunization status of their residents who receive health care in other jurisdictions because data is not routinely shared and each jurisdiction has tried to develop its own data sharing agreement. Last September, the American Immunization Registry Association (AIRA) held a regional forum of the Northeast IIS grantees, VT, ME, RI, CT, NYC, NYS, NJ, PA and Philadelphia, focused on Interstate Data Sharing, and building on a successful pilot exchange between NYC and NJ. The agenda focused on development of a standard agreement addressing privacy and confidentiality, a minimum data set, and parameters for data quality, that all jurisdictions could use. Although the primary objective was to enable IIS to IIS exchange, many of the same issues affect IIS exchange with EHRs, and within HIEs. An AIRA ad-hoc work group drafted and refined an MOU, based on compilation of interstate IIS agreements developed by states outside of the region, and on an MOU developed for newborn screening. AIRA harmonized their proposed agreement with the Health Information Security and Privacy Collaborative (HISPC), Inter-Organizational Agreement (IOA) Collaborative, one of whose objectives is to create a standard agreement that can be used across health information exchanges (including bi-directional public-to-public exchanges and public-to-private exchanges). By collaborating with relevant partners, AIRA obtained widespread endorsement and has published a health information exchange agreement which will first be used to exchange information between the Philadelphia KIDS IIS and the NJIIS. AIRA continues to develop and support the use of standards through its own members and membership in PHDSC to enhance use of immunization information by increasing data exchanges between IIS and providers and between jurisdictions that share providers and population.