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Bilateral Communication With the New York Citywide Immunization Registry

Bilateral Communication With the New York Citywide Immunization Registry. Angel Aponte Computer Specialist (Software) Contact: aaponte@health.nyc.gov. Outline. New York Citywide Immunization Registry (CIR) introduction Open Source technologies used at CIR CIR electronic data exchange

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Bilateral Communication With the New York Citywide Immunization Registry

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  1. Bilateral Communication With the New York Citywide Immunization Registry Angel Aponte Computer Specialist (Software) Contact: aaponte@health.nyc.gov

  2. Outline • New York Citywide Immunization Registry (CIR) introduction • Open Source technologies used at CIR • CIR electronic data exchange • Immunization reporting • Immunization information sharing • Decision support for immunization schedule • Current methods • Emerging solutions

  3. New YorkCitywide Immunization Registry • Immunization Information System for the New York City area • Implemented in 1997 • NYC has mandatory reporting of vaccinations of children 0-18 years of age • Birth to < 8 years old since January 1, 1997 • Birth to < 19 years old since August 18, 2005 • Over 3.4 million records with over 36 million immunizations • >90% of pediatric providers in NYC participate in CIR • Population-based

  4. Open Source TechnologiesUsed at CIR • Red Hat Enterprise Linux (RHEL) 5 operating system • Apache Web Server, Tomcat Application Server, and Axis for Web Services/SOAP/XMLP • MySQL database • Java, C/C++ (gcc), Python, Perl, Eclipse for development • nagios service outage alerting system • Security: iptables firewall, nmap port scanner, wireshark packet sniffer

  5. CIR ApplicationLogical Architecture

  6. Current Methods of Reporting • Web File Repository (WFR) for batch electronic submission, data quality feedback, and retrieval • Reporting: • Paper: 27,130forms per month are key entered and an electronic file is created and submitted through WFR • Electronic file: Facilities also perform extracts from their information systems and submit a text file to CIR • Web: Online Registry for additions of current and historical immunizations in real-time

  7. CIR Reporting VolumeImmunizations added to CIR for children < 8 years

  8. Shift to electronic methods of reporting

  9. Current Methods of Data Access • Batch data exchange interface • Online Registry for viewing immunization history and immunization schedule recommendations • Issue immunization records in response to requests via phone, fax, mail

  10. Current Methods of Data AccessFY 2008

  11. Online Registry use: 2004-to date

  12. Provide current information to doctors through their healthcare facility’s electronic system Provide decision support services Enable real-time reporting from doctor’s system Can also be used by other CIR partners New York State Other immunization registries (e.g. ~47,000 patients < 19 years old with a New Jersey address reported to NYC CIR) Immunization clinics Regional Health Information Organizations (RHIOs) Emerging Data Exchange:Real-Time EHR Integration With CIR

  13. CIR Web ServiceLogical Architecture

  14. Conclusions • CIR is a successful system in NYC that uses Open Source technologies • CIR Web application currently provides real-time reporting and access to immunization histories and decision support • CIR Web Services will provide these immunization information services to providers with EHRs and other partners • Existing batch data exchange mechanisms will be maintained as a fallback solution

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