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How can immunization registries be linked to other health information including electronic health records (EHRs) and personal health records (PHRs)?

Since immunization registries have demonstrated their value to a child's health and they are relatively well developed, it is reasonable to think they could form the backbone of an integrated system that links with other health information including EHRs and PHRs.

There are a few States and regional health information organizations (RHIOs) that are developing systems to allow immunization registries to be linked with other health information. For example, the Utah Department of Health created a Child Health Advanced Records Management (CHARM) system that acts as electronic "middle ware." Middleware is software that connects two or more software applications, allowing them to exchange data. CHARM provides access to information stored in specific State program databases to track and monitor a child's health status, such as screening results, immunization status, referrals, assessment, treatment and outcomes.

The Colorado Regional Health Information Organization (CORHIO) developed a secure and confidential health information exchange collecting data from both public and private partners: The Children's Hospital, Denver Health & Hospital Authority, Kaiser Permanente Colorado and the University of Colorado Hospital. These organizations provide information on laboratory test results, medication history, immunization status, radiology reports, and a "problem list" based on diagnostic codes. The Colorado Immunization Information System (CIIS) will utilize the interface between CORHIO and its data sharing partners to allow data to flow to clinicians either through a web browser or to their electronic medical record (EMR).

The Whatcom County health information exchange in Washington State, part of a Health Record Bank pilot, is developing a system to load immunization data from the State immunization registry into the Shared Care Plan PHR by using the Microsoft HealthVault platform. This project is funded by the Washington Healthcare Authority and Microsoft Be Well Funds. The HealthVault platform is a database that sends immunization information into an EHR or a PHR. The Washington State Healthcare Authority is expanding this program to three additional pilot sites (PDF - 128KB) (Spokane, Cashmere, and Bellingham) during early 2009.