Observations Illustrating the Use of Health Informatics to Link Public Health Immunization Registries and Pharmacies to Increase Adult Immunization Rates and Improve Population Health Outcomes

Abstract

The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages health information exchange between clinical care and public health through Meaningful Use measures. Meaningful Use specifically identifies objectives to support a number of public health programs including immunizations, cancer registries, syndromic surveillance, and disease case reports. The objective is to improve public and population health. Stage 2 of Meaningful Use focused on the sending of information to public health. The Stage 3 information exchange supports the flow of information from public health back to the provider.The HITECH Act Stage 2 initiative provided incentive and motivation for the healthcare providers to encourage their Electronic Medical Record (EMR) vendors to implement data exchanges with public health, resulting in timelier awareness of population health risk. However, the real empowerment in the HITECH Act is not in the reporting of information to public health but in the ability for a provider to receive relevant information back, the Stage 3 model. There is no better example of the Stage 3 empowerment than an immunization record data exchange.The ability for public health to retain current immunization records of individuals from a variety of providers supports their program goals to increase immunization rates and mitigate the risk of vaccine-preventable disease (VPD). The ability for providers to receive at the point of service more complete immunization histories integrated with decision support supports their delivery of care and reduces the risk of their patients to VPD. Indirectly payers benefit through healthcare cost savings and when the focus is expanded from a health model to a business model, there are significant return on investment (ROI) opportunities that exponentially increase the value of a bi-directional immunization data exchange. This paper will provide descriptions of case examples to demonstrate the value added benefit of electronic data exchanges when immunization providers, specifically pharmacists, and public health work together.