Overview of Scenario
The EHR or other clinical software system directly or indirectly through an intermediary creates and transmits a report of a patient’s immunization history to public health immunization registries.
Example of Scenario
The nurse administering vaccines to Juana Maria Gonzales Morales completes the session by submitting a report to the public health immunization registry. The EHR system formats all of the information in the report consistent with HL7 version 2.5.1, Implementation Guide for Immunization Messaging Release 1.5.
Guidance
All products evaluated provide an HL7 2.5.1 patient immunization report to the immunization registry. Vendors should take care to avoid conformance errors with respect to HL7 Implementation Guide for Immunization Messaging version 1.4 (used for Meaningful Use 2) and the newer version 1.5. Here are some potential conformance errors seen in pilot testing of the available tests:
- Syntax (formatting) errors in the message.
- Content errors:
- Failure to include content provided in the test script for some elements required by the standard if content exists (RE); and
- Use of a value or value set different from the one expected by the standard and the NIST test tool.
The HL7 V2.5.1 Implementation Guide for Immunization Messaging version 1.5 requires NCIT body site codes rather than the HL7 Table 0162 allowed by the version 1.4.
The implementation guide version 1.5 requires the code ER (return only on error) for the field “Accept Acknowledgement Type” (MSH.15). The test tool does not accept ACK (acknowledgement).
Greater collaboration among the public health registries, vendor, and providers should help to address areas of workflow conflicts and lead to more efficient standards development.
Some registries require more “RE” elements in the vaccine report than others. Enabling the EHR report to transmit any of the data elements listed in the standard, or the “super set” should decrease the need for local configuration at customer sites.
- Vendor Perspectives. Due to state statutory requirements and local variation, some public health immunization registries require more data elements in immunization reports. The ability to capture and submit all potential data elements listed in the HL7 implementation guide assure the product can capture the superset of data to support the variation, though it does not address custom local requirements that may be imposed beyond those defined in the standard.
- Provider and Implementer Perspectives. Customization requirements for non-standard localization can be costly and cause implementation delays.
Tests
Click here for test script scenarios that include the capability, Transmit Standard Patient Immunization History Report. The script also indicates successful performance for each of the test sections.
Data Elements
Click here for data elements for the capability, Transmit Standard Patient Immunization History Report.