PH+Reporting+User+Story+-+Health+Information+Exchanges+(HIEs)+and+Immunizations

include component="page" wikiName="siframework" page="PHRI Header" =User Story: Health Information Exchanges (HIEs) and Immunizations=

Contact Info:
Alean Kirnak (akirnak@swpartners.com, phone: 760.419.8436) -- President, Software Partners LLC

Date Received:
11/18/2011

This HIEs and Immunizations User Story describes immunization registry reporting and data retrieval when a Health Information Exchange (HIE) serves as an intermediary between the provider system and the immunization registry (also called an Immunization Information System, or IIS). The HIE contains a Public Health Gateway component of the HIE which is identified as having a special function. It serves as an intermediary between providers and public health. It may simply pass messages through, or it may perform such services as routing, data caching, parsing, transformation, translation, and data quality checks.
 * 1.1 Introduction **

In this user story, nothing is said about how the HIE assembles the information it uses to respond to provider queries. The HIE may query the IIS to obtain this information; alternatively it may cache immunization records in a document repository or other data store which it uses to respond to queries. Multiple HIEs or multiple IISs may also be involved. A submission or query may be routed or cascaded by the HIE as appropriate. For example, a regional HIE, failing to find a record locally, may query a state-wide HIE; a state-wide HIE may query an HIE in a neighboring state. These details and special cases are beyond the scope of this user story.

Because this user story allows senders to submit in CCD format, reporting to the IIS according to this storyboard may be easily combined with other public health reporting. For example, by adding height and weight measurements to the Vital Signs section of an Immunization Content CCD, EHRs can report Body Mass Index (BMI) to public health childhood obesity projects at the same time. The Public Health Gateway may separate the BMI data from the immunization data, reporting to different public health systems if needed.

T his user story allows for more efficient interaction with IISs by combining reporting efforts using single connections to the HIE, and common data formats such as CCD. It compensates for mismatches in sender/receiver capabilities and/or preferred methods of reporting. It facilitates multiple public health objectives simultaneously since the reporting sources – primarily EHRs – can use the single CCD format for multiple types of data; while the HIE provides the service of interacting with separate public health legacy systems. This begins to bring together the existing public health silos through the vehicle of the HIE.
 * 1.2 User Story Narrative **
 * 1.2.1 Goal **

This user story focuses on immunizations; however, as pointed out, additional public health use cases can easily be added to the model using common data sources and HIE infrastructure.

This user story complements user stories submitted by the American Immunization Registry Association (AIRA) and other immunization registry stakeholders by showing an emerging model for interacting with immunization registries. Thus the public health clinical purposes are the same as for traditional immunization registries: to manage vaccine-preventable disease. Since multiple stakeholders must cooperate to effectively achieve this, individual stakeholders may have slightly different clinical purposes. Providers wish to keep their particular patients healthy. HIEs wish to provide complete information to multiple stakeholders. Individual patients accessing Personal Health Records may also participate; their objective is to manage the health of themselves and their dependents. Here is an example scenario:
 * 1.2.2 Description of Data Reporting Events, Actors and Triggers **

__//Step 1: An EHR queries the HIE for immunization information //__
The 4-year-old patient and the parent visit the provider, who uses an Electronic Health Record (EHR) system. Although the provider may have immunization records for the patient, his EHR nevertheless queries the Health Information Exchange (HIE) for the most up-to-date information. The HIE finds that the patient’s records are available and returns the immunization history and care plan (sometimes called “vaccine forecast”) to the EHR. The response may be in the form of a CDA, of an HL7 Version 2 message, or another format. The provider reviews the immunizations and the vaccine recommendation. The provider administers vaccines and enters the records in his EHR.

__//Step 2: The provider submits immunization records to the IIS via the HIE //__
The EHR submits the newly entered immunization records to the IIS via the HIE Public Health Gatewayt. The submission may be in the form of a CDA, an HL7 Version 2 message, or another format. The Public Health Gateway transforms the submission into HL7 Version 2 and updates the IIS.

__//<span style="font-family: 'Arial','sans-serif';">Step 3: Another EHR queries the HIE for immunization information //__
<span style="font-family: 'Arial','sans-serif';">In getting the child ready for school, the parent uses notices from his Personal Health Record (PHR) that one vaccine is missing. In a rush, the parent makes an appointment at a different clinic. The patient is new to this provider. The EHR queries the Health Information Exchange (HIE) for the patient’s immunization history and care plan. The HIE returns the immunization history and care plan to the EHR. The response may be in the form of a CDA, of an HL7 Version 2 message, or another format. The provider reviews the immunizations and the vaccine recommendation. The provider administers vaccines and enters the records in his EHR. Step 2 now repeats.

<span style="font-family: 'Arial','sans-serif';">Actors:

 * <span style="font-family: 'Arial','sans-serif';">Provider
 * <span style="font-family: 'Arial','sans-serif';">Patient
 * <span style="font-family: 'Arial','sans-serif';">Parent
 * <span style="font-family: 'Arial','sans-serif';">EHR system
 * <span style="font-family: 'Arial','sans-serif';">PHR
 * <span style="font-family: 'Arial','sans-serif';">HIE
 * <span style="font-family: 'Arial','sans-serif';">HIE Public Health Gateway
 * <span style="font-family: 'Arial','sans-serif';">IIS

<span style="font-family: 'Arial','sans-serif';">Actions/Interactions:

 * <span style="font-family: 'Arial','sans-serif';">Request immunization history
 * <span style="font-family: 'Arial','sans-serif';">Return immunization history
 * <span style="font-family: 'Arial','sans-serif';">Request care plan
 * <span style="font-family: 'Arial','sans-serif';">Return care plan
 * <span style="font-family: 'Arial','sans-serif';">Submit immunizations to IIS

<span style="color: #000000; font-family: 'Arial','sans-serif';">This user story may involve the reporting of any data elements that are allowed in a CCD, specifically, any discussed in the IHE Patient Care Coordination (PCC) Immunization Content profile. Data elements reported to IISs include only those allowed to be retained by IISs, specifically the data elements captured by the HL7 Version 2.3.1 and Version 2.5.1 implementation guides for immunization messaging<span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 14.6667px;">[1]. Data elements included in Immunization Content but not allowed to be stored by IISs may be used as policy allows by the HIE as appropriate, but not forwarded to IISs.
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">1.2.3 Data **

<span style="color: #000000; font-family: 'Arial','sans-serif';">Of primary interest are demographic data, immunization history, and immunization care plan (also known as a “vaccine forecast”).

<span style="color: #000000; font-family: 'Arial','sans-serif';">An example Immunization Content document, generated at the HIMSS 2011 Interoperability Showcase by participating EHR, public health and infrastructure vendor demos, is given here.

|| **<span style="color: #051f2e; font-family: 'Arial','sans-serif';">Software Partners LLC Immunization Registry ** ||
 * <span style="display: block; font-family: 'Arial','sans-serif'; text-align: center;">MARK MAROSTICA - Immunization Content ||
 * |||| **<span style="color: #ffffff; font-family: 'Arial','sans-serif';">Document Information ** ||  ||   ||
 * |||| **<span style="color: #ffffff; font-family: 'Arial','sans-serif';">Detail: ** ||
 * **<span style="font-family: 'Arial','sans-serif';">Title: ** || <span style="font-family: 'Arial','sans-serif';">Immunization Content ||
 * **<span style="font-family: 'Arial','sans-serif';">Description: ** || <span style="font-family: 'Arial','sans-serif';">History of immunization //(11369-6 LOINC)// ||
 * **<span style="font-family: 'Arial','sans-serif';">Effective Date: ** || <span style="font-family: 'Arial','sans-serif';">Tuesday, February 22, 2011 at 10:17 :33 am ||
 * |||||| **<span style="color: #ffffff; font-family: 'Arial','sans-serif';">Patient Information ** ||
 * |||||| **<span style="color: #ffffff; font-family: 'Arial','sans-serif';">Patient Detail ** ||
 * || **<span style="font-family: 'Arial','sans-serif';">Name: ** || <span style="font-family: 'Arial','sans-serif';">MARK MAROSTICA ||
 * **<span style="font-family: 'Arial','sans-serif';">Address: ** || <span style="font-family: 'Arial','sans-serif';">216 Woodland Ave
 * **<span style="font-family: 'Arial','sans-serif';">Address: ** || <span style="font-family: 'Arial','sans-serif';">216 Woodland Ave

<span style="font-family: 'Arial','sans-serif';"> Atlanta, GA 31146

<span style="font-family: 'Arial','sans-serif';"> USA ||
 * **<span style="font-family: 'Arial','sans-serif';">Home : ** ||  ||   ||   || **<span style="font-family: 'Arial','sans-serif';">Patient Number: ** || <span style="font-family: 'Arial','sans-serif';">12342234 ||
 * **<span style="font-family: 'Arial','sans-serif';">Date of Birth: ** || <span style="font-family: 'Arial','sans-serif';">Tuesday, February 21, 2006 at 12:00 :00 am ||
 * **<span style="font-family: 'Arial','sans-serif';">Gender: ** || <span style="font-family: 'Arial','sans-serif';">Male ||
 * **<span style="font-family: 'Arial','sans-serif';">Language: ** ||  ||   ||   ||   ||   ||   ||   ||   ||   ||
 * || **<span style="color: #ffffff; font-family: 'Arial','sans-serif';">Vital Signs ** ||  ||
 * || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Date / Time: ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Feb 21, 2008 ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Feb 21, 2009 ** ||
 * **<span style="color: #000000; font-family: 'Arial','sans-serif';">Height ** || <span style="color: #000000; font-family: 'Arial','sans-serif';">31 in || <span style="color: #000000; font-family: 'Arial','sans-serif';">33 in ||
 * **<span style="color: #000000; font-family: 'Arial','sans-serif';">Weight ** || <span style="color: #000000; font-family: 'Arial','sans-serif';">29 lbs || <span style="color: #000000; font-family: 'Arial','sans-serif';">33 lbs ||  ||   ||
 * || **<span style="color: #ffffff; font-family: 'Arial','sans-serif';">Immunizations ** ||  ||
 * || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Name ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">CVX Code ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Date Admin ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Dose # ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Mfg Code ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Lot Number ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Route ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Site ** ||
 * <span style="color: #000000; display: block; font-family: 'Arial','sans-serif'; text-align: center;">POLIO ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">IPV || <span style="color: #000000; font-family: 'Arial','sans-serif';">10 || <span style="color: #000000; font-family: 'Arial','sans-serif';">04/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 || <span style="color: #000000; font-family: 'Arial','sans-serif';">PMC || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc10PMCswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">SC || <span style="color: #000000; font-family: 'Arial','sans-serif';">LA ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">IPV || <span style="color: #000000; font-family: 'Arial','sans-serif';">10 || <span style="color: #000000; font-family: 'Arial','sans-serif';">06/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">2 || <span style="color: #000000; font-family: 'Arial','sans-serif';">PMC || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc10PMCswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">SC || <span style="color: #000000; font-family: 'Arial','sans-serif';">LA ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">IPV || <span style="color: #000000; font-family: 'Arial','sans-serif';">10 || <span style="color: #000000; font-family: 'Arial','sans-serif';">08/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">3 || <span style="color: #000000; font-family: 'Arial','sans-serif';">PMC || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc10PMCswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">SC || <span style="color: #000000; font-family: 'Arial','sans-serif';">LA ||
 * <span style="color: #000000; display: block; font-family: 'Arial','sans-serif'; text-align: center;">DTP ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">DTaP || <span style="color: #000000; font-family: 'Arial','sans-serif';">20 || <span style="color: #000000; font-family: 'Arial','sans-serif';">04/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 || <span style="color: #000000; font-family: 'Arial','sans-serif';">SKB || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc20SKBswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">LD ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">DTaP || <span style="color: #000000; font-family: 'Arial','sans-serif';">20 || <span style="color: #000000; font-family: 'Arial','sans-serif';">06/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">2 || <span style="color: #000000; font-family: 'Arial','sans-serif';">SKB || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc20SKBswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">LD ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">DTaP || <span style="color: #000000; font-family: 'Arial','sans-serif';">20 || <span style="color: #000000; font-family: 'Arial','sans-serif';">08/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">3 || <span style="color: #000000; font-family: 'Arial','sans-serif';">SKB || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc20SKBswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">LD ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">DTaP || <span style="color: #000000; font-family: 'Arial','sans-serif';">20 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2007 || <span style="color: #000000; font-family: 'Arial','sans-serif';">4 || <span style="color: #000000; font-family: 'Arial','sans-serif';">SKB || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc20SKBswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">LD ||
 * <span style="color: #000000; display: block; font-family: 'Arial','sans-serif'; text-align: center;">MMR ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">MMR || <span style="color: #000000; font-family: 'Arial','sans-serif';">3 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2007 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 || <span style="color: #000000; font-family: 'Arial','sans-serif';">MSD || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc3MSDswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">SC || <span style="color: #000000; font-family: 'Arial','sans-serif';">RA ||
 * <span style="color: #000000; display: block; font-family: 'Arial','sans-serif'; text-align: center;">HIB ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Hib || <span style="color: #000000; font-family: 'Arial','sans-serif';">17 || <span style="color: #000000; font-family: 'Arial','sans-serif';">04/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 || <span style="color: #000000; font-family: 'Arial','sans-serif';">PMC || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc17PMCswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">RVL ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Hib || <span style="color: #000000; font-family: 'Arial','sans-serif';">17 || <span style="color: #000000; font-family: 'Arial','sans-serif';">06/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">2 || <span style="color: #000000; font-family: 'Arial','sans-serif';">PMC || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc17PMCswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">RVL ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Hib || <span style="color: #000000; font-family: 'Arial','sans-serif';">17 || <span style="color: #000000; font-family: 'Arial','sans-serif';">08/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">3 || <span style="color: #000000; font-family: 'Arial','sans-serif';">PMC || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc17PMCswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">RVL ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Hib || <span style="color: #000000; font-family: 'Arial','sans-serif';">17 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2007 || <span style="color: #000000; font-family: 'Arial','sans-serif';">4 || <span style="color: #000000; font-family: 'Arial','sans-serif';">PMC || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc17PMCswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">RVL ||
 * <span style="color: #000000; display: block; font-family: 'Arial','sans-serif'; text-align: center;">HEP B ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Hep B-adol or ped || <span style="color: #000000; font-family: 'Arial','sans-serif';">8 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 || <span style="color: #000000; font-family: 'Arial','sans-serif';">SKB || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc8SKBswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">LD ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Hep B-adol or ped || <span style="color: #000000; font-family: 'Arial','sans-serif';">8 || <span style="color: #000000; font-family: 'Arial','sans-serif';">03/21/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">2 || <span style="color: #000000; font-family: 'Arial','sans-serif';">SKB || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc8SKBswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">LD ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Hep B-adol or ped || <span style="color: #000000; font-family: 'Arial','sans-serif';">8 || <span style="color: #000000; font-family: 'Arial','sans-serif';">08/08/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">3 || <span style="color: #000000; font-family: 'Arial','sans-serif';">SKB || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc8SKBswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">LD ||
 * <span style="color: #000000; display: block; font-family: 'Arial','sans-serif'; text-align: center;">VARIC ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Varicella || <span style="color: #000000; font-family: 'Arial','sans-serif';">21 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2007 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 || <span style="color: #000000; font-family: 'Arial','sans-serif';">MSD || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc21MSDswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">SC || <span style="color: #000000; font-family: 'Arial','sans-serif';">LA ||
 * <span style="color: #000000; display: block; font-family: 'Arial','sans-serif'; text-align: center;">HEP A ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Hep A-child || <span style="color: #000000; font-family: 'Arial','sans-serif';">31 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2007 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 || <span style="color: #000000; font-family: 'Arial','sans-serif';">MSD || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc31MSDswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">LD ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Hep A-child || <span style="color: #000000; font-family: 'Arial','sans-serif';">31 || <span style="color: #000000; font-family: 'Arial','sans-serif';">08/21/2007 || <span style="color: #000000; font-family: 'Arial','sans-serif';">2 || <span style="color: #000000; font-family: 'Arial','sans-serif';">MSD || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc31MSDswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">LD ||
 * <span style="color: #000000; display: block; font-family: 'Arial','sans-serif'; text-align: center;">PNEUMO ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">PCV 7 || <span style="color: #000000; font-family: 'Arial','sans-serif';">100 || <span style="color: #000000; font-family: 'Arial','sans-serif';">04/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 || <span style="color: #000000; font-family: 'Arial','sans-serif';">WAL || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc37WALswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">RVL ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">PCV 7 || <span style="color: #000000; font-family: 'Arial','sans-serif';">100 || <span style="color: #000000; font-family: 'Arial','sans-serif';">06/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">2 || <span style="color: #000000; font-family: 'Arial','sans-serif';">WAL || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc37WALswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">RVL ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">PCV 7 || <span style="color: #000000; font-family: 'Arial','sans-serif';">100 || <span style="color: #000000; font-family: 'Arial','sans-serif';">08/04/2006 || <span style="color: #000000; font-family: 'Arial','sans-serif';">3 || <span style="color: #000000; font-family: 'Arial','sans-serif';">WAL || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc37WALswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">RVL ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">PCV 7 || <span style="color: #000000; font-family: 'Arial','sans-serif';">100 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2007 || <span style="color: #000000; font-family: 'Arial','sans-serif';">4 || <span style="color: #000000; font-family: 'Arial','sans-serif';">WAL || <span style="color: #000000; font-family: 'Arial','sans-serif';">abc37WALswp || <span style="color: #000000; font-family: 'Arial','sans-serif';">IM || <span style="color: #000000; font-family: 'Arial','sans-serif';">RVL ||  ||   ||
 * || **<span style="color: #ffffff; font-family: 'Arial','sans-serif';">Care Plan ** ||  ||
 * || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Name ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">CVX Code ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Min Date ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Max Date ** || **<span style="color: #000033; font-family: 'Arial','sans-serif';">Dose # ** ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">IPV || <span style="color: #000000; font-family: 'Arial','sans-serif';">10 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2010 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/20/2024 || <span style="color: #000000; font-family: 'Arial','sans-serif';">4 ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">DTaP || <span style="color: #000000; font-family: 'Arial','sans-serif';">20 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2010 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/28/2013 || <span style="color: #000000; font-family: 'Arial','sans-serif';">5 ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">MMR || <span style="color: #000000; font-family: 'Arial','sans-serif';">3 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2010 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2106 || <span style="color: #000000; font-family: 'Arial','sans-serif';">2 ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Varicella || <span style="color: #000000; font-family: 'Arial','sans-serif';">21 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2010 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/20/2066 || <span style="color: #000000; font-family: 'Arial','sans-serif';">2 ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Tdap || <span style="color: #000000; font-family: 'Arial','sans-serif';">115 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2017 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/20/2071 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">MCV4 || <span style="color: #000000; font-family: 'Arial','sans-serif';">114 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2017 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/20/2025 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 ||
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">Zoster (shingles) || <span style="color: #000000; font-family: 'Arial','sans-serif';">121 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2066 || <span style="color: #000000; font-family: 'Arial','sans-serif';">02/21/2106 || <span style="color: #000000; font-family: 'Arial','sans-serif';">1 ||  ||   ||

<span style="font-family: 'Arial','sans-serif';">The HL7 Service Oriented Architecture (SOA) workgroup is currently developing a Project Scope Statement for an architectural implementation guide project for the immunization domain. This project will tie together the various existing relevant standards (CCD, HL7 V2, IHE profiles, service specifications, etc.) from multiple Standards Development Organizations (SDOs) to show how they can be used in combination by a set of interoperating stakeholder systems. The first draft of this project is expected in May of 2012.
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">1.2.4 Other information **

<span style="color: #000000; font-family: 'Arial','sans-serif';">Some EHR vendors such as Greenway Technologies have implemented immunization registry using Immunization Content CCD in the field in some installation. It has been confirmed that stakeholders doing so will receive module credit for Meaningful Use Stage I provided that the software used by the intermediary HIE is certified for immunization reporting. At least one HIE is planning to use this model. Permission to publicize is pending.
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">1.3 Stakeholder Commitment **

<span style="font-family: 'Arial','sans-serif';">Alean Kirnak, President, Software Partners LLC 760-419-8436 akirnak@swpartners.com
 * <span style="color: #000000; font-family: 'Arial','sans-serif';">1.4 Contact Information **

References: <span style="font-family: 'Calibri','sans-serif'; font-size: 13.3333px;">[1] [], []

Supporting Files:

 * **Description** || **File** ||
 * This document contains the initial draft user story submission. || [[file:Initial Draft Submission - HIE and Immunization - November 18 2011.docx]] ||  ||

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