Overview

After reconciling immunization history maintained in a provider’s EHR and with immunization history from the public health registry, a provider may determine that some EHR-maintained information may be more correct than what is in the registry’s history. The EHR should provide a report to the public health registry listing such inconsistencies (e.g., past immunizations missing from the registry report, incorrect CVX codes, and incorrect vaccine administration dates).

Example

The immunization history maintained in Dr. Smith’s EHR for Juana Mariana Gonzales, age 6, includes the three-dose meningococcal vaccine (CVX code 163). The public health immunization registry history shows the two-dose meningococcal vaccine (CVX code 162). Dr. Smith’s staff confirms they provided the vaccine with a three-dose schedule. The EHR then prepares and submits a report to the public health registry that lists the discrepancy and indicates that the CVX code 163 is the correct information.

Guidance

Experience reported by some EHR vendors and providers suggests that immunization registries may not routinely accept updated information from the provider’s office. Examples include:

1. Some registries reportedly accept updated information only from the provider that administered the vaccine. Thus a registry may refuse an update from another provider who recognizes an error in the registry data by comparing it with a copy of historical record received from the administering provider.
2. Some providers indicate receiving documentation of historical vaccines that include inexact dates, indicating registries will not accept such information without an exact date.
3. Some providers indicate discrepancies between the specific CVX codes they record for vaccines they administer and the CVX code recorded by the registry (the registry using a more generic CVX code). These providers report that registries may not accept the update with the correct code. The result is the discrepancy shows up every time the patient has an appointment and a new query is sent to the registry.

Feedback is invited about the value of this capability.  Further, collaboration among providers, software vendors, and public health registries may help identify the source of the discrepancies and recommend solutions.

• Vendor Perspective. Vendors should collaborate with providers and public health immunization registries to harmonize capabilities and determine workflow.
• Provider and Implementer Perspective. Providers should collaborate with public health immunization registries and EHR vendors to harmonize capabilities and determine workflow.

Test

There are no tests for this capability.

Data Elements

There are no data elements for this capability.