The Effect of Electronic Health Record and Immunization Information System Interoperability on Medical Practice...

Area of Science:

• Health Informatics
• Public Health
• Healthcare Systems Engineering

Background:

• Electronic health record (EHR) and immunization information system (IIS) interoperability can enhance data quality, impacting vaccination record timeliness, completeness, and accuracy.
• The specific influence of EHR/IIS interoperability on daily vaccination workflows and recordkeeping in medical practices remains largely unexamined.

Purpose of the Study:

• To assess the impact of EHR/IIS interoperability on vaccination workflows within medical practices.
• To identify how interoperability influences clinical and administrative activities related to vaccination.

Main Methods:

• Practices across various specialties and locations were selected based on HL7 interoperability levels with the Michigan Care Improvement Registry (MCIR).
• Semi-structured interviews were conducted to understand practice interactions with MCIR and EHRs throughout the vaccination process.
• Interview transcripts were analyzed to characterize technology use in vaccination workflows.

Main Results:

• All participating practices achieved at least unidirectional HL7 capability by study's end.
• Providers and staff heavily utilized both EHRs and MCIR for vaccination-related tasks.
• Practices primarily used MCIR for vaccination history but also relied on paper forms and other documentation.

Conclusions:

• Medical practices integrate EHRs and IIS into their vaccination workflows, often alongside paper-based methods.
• Reported benefits of EHR/IIS interoperability exist, but implementation necessitates learning new, potentially time-intensive, workflow processes and presents new challenges.