2018-2020 Immunization Information System (IIS) Strategic Plan
The 2018-2020 CDC Immunization Information Systems Strategic Plan Cdc-pdf[8 pages] emphasizes the areas most important to CDC and the IIS community. The plan provides actions to move IISs toward their shared vision of real-time, consolidated immunization data and services for all ages that are available anytime and anywhere for authorized clinical, administrative, and public health users and consumers.
Immunization information systems (IISs) are confidential, population-based, computerized databases that record all immunization doses administered by participating providers to persons residing within a given geopolitical area.
- At the point of clinical care, IISs provide consolidated immunization histories for use by a vaccination provider in determining appropriate patient vaccinations.
- At the population level, IISs provide aggregate data on vaccinations for use in surveillance and program operations, and in guiding public health action with the goals of improving vaccination rates and reducing vaccine-preventable disease.
IIS Vision: Real-time, consolidated immunization data and services for all ages are available for authorized clinical, administrative, and public health users and consumers, anytime and anywhere.
IISSB Mission: Maximize protection against vaccine-preventable diseases by leading the advancement of immunization information systems (IISs).
Use of the Term IIS
Throughout this document, the term “IIS” is used to represent the information systems, the programs, the people, and the processes associated with the systems.
Figure 1: IIS Strategic Priorities
This strategic plan encompasses strategies for three fiscal years, 2018 through 2020, and aims to continue progress in the areas of IIS performance, standards, sustainability, and strengthening connections to the health IT environment. The plan builds upon the previous strategic plan that spanned Fiscal Years 2014 through 2017, carrying forward and enhancing many strategies already identified. This strategic plan, developed with guidance from the IIS community through the IIS Executive Board, focuses on a smaller set of priority areas and strategies intended to help the CDC prioritize investments and realize greater impact in key priority focus areas (see Figure 1).
Partnerships and Communication
IIS success is built on a strong foundation of partnerships and collaboration. While some priorities call out specific partnership and communications tactics to support strategic priority areas, CDC will renew focus on strengthening existing relationships, building new relationships to support IISs, and improving communications with IIS stakeholders across all of the priority areas. The strategies in this document require effective engagement with state and local IISs, partner organizations, and other stakeholders in order to meet the goals set forth below. Implementation of this plan will ensure that these stakeholders understand the value of IISs and work collaboratively to achieve success.
IISs have matured individually as immunization programs have recognized their value and invested in their systems to address point of clinical care and population level strategies in their jurisdictions. However, IISs are increasingly viewed as one national network of systems, rather than a collection of independent systems, so the success of each IIS depends, in part, on the successes of the IIS community as a whole. Performance disparities that currently exist in the IIS community must be resolved by ensuring all IISs contain robust functionalities and high data quality. Strategies in this plan help to advance all IISs to be high-performing systems that can support providers at point of clinical care by ensuring up-to-date vaccination histories are available to guide clinical decision support and reminder recall, and at a population level by providing accurate data that can inform strategic decisions to improve vaccination coverage and reduce vaccine-preventable diseases. Increasingly, state immunization programs rely on their IISs as critical infrastructure to support immunization ordering and inventory management, to serve as trusted sources of population coverage estimates, and to provide tools to support programmatic and policy decision making, such as near real-time immunization coverage estimates, identification of pockets of need, and AFIX assessments.
Goal 1.1: Elevate performance across all IISs to ensure their ability to improve and sustain immunization coverage levels for children, adolescents, and adults.
Strategies to support Goal 1.1:
- Develop mechanisms to assist state and local immunization program awardees (“awardees”) in prioritizing IIS efforts, defining IIS measures of success, and performing new and routine IIS activities.
- Create new and build upon existing partnerships and initiatives to address technical and nontechnical challenges to improving IIS performance.
- Provide proactive technical assistance to groups of awardees to solve common challenges.
- Measure progress of IISs toward achievement of this goal by establishing and tracking meaningful measures.
There is a movement toward increased standardization across a broad spectrum of health IT systems in the United States. The ability of IISs to demonstrate adherence to national standards increases the credibility and value of IISs, contributes to improved program sustainability, and advances performance. It is important for CDC and the IIS community to promote standardization, develop new IIS standards and best practices for high-priority needs, and reduce implementation variability across the community to ensure IISs remain relevant in an evolving health IT ecosystem. This requires investments in initiatives with direct and indirect impacts to IIS functions to ensure that IISs are able to achieve the standards.
Goal 2.1: Promote widespread use of IIS standards and best practices.
Strategies to support Goal 2.1:
- Develop, enhance, maintain, and disseminate IIS standards and best practices to awardees.
- Provide technical assistance to users of IIS standards to ensure accurate and consistent implementation.
- Develop, expand, implement, and maintain independent assessments of IIS functionality, data quality, and adherence to standards.
Many immunization stakeholders increasingly recognize the benefits of IISs, resulting in additional demands on IISs to develop and support new functions, such as supporting AFIX assessments, inter-jurisdictional data exchange, bi-directional data exchange with providers, consumer access to immunization records, and inclusion of adults in IISs. Sustainability of IISs nationwide depends on diversifying mechanisms of financial support for IISs, identifying new ways to reduce costs and use existing resources effectively, and ensuring access to a well-trained IIS workforce.
Goal 3.1: IISs have a diversified, stable resource base to meet program and system needs.
Strategies to support Goal 3.1:
- Identify opportunities to help awardees acquire more diverse means of sustaining their IIS.
- Develop tools to help awardees access diverse mechanisms and/or funding sources to support IIS sustainability.
Goal 3.2: Immunization program awardees have access to adequate workforce resources to fulfill all IIS activities and to manage and sustain robust systems and programs.
Strategies to support Goal 3.2:
- Maximize existing IIS resources by offering centralized training curriculum and workforce development services to the IIS community.
- Develop effective mechanisms to augment the IIS workforce at the state and local level.
Goal 3.3: IISs implement strategies to efficiently and effectively leverage existing and new resources.
Strategies to support Goal 3.3:
- Promote use of shared and centralized IIS services.
- Implement strategies in the IIS community that reduce variation in development and implementation of technical and nontechnical solutions.
State and local health departments and health care providers increasingly depend on technology to achieve and maintain high vaccination coverage, including IISs and electronic health record (EHR) systems. Standards development organizations (SDOs) as well as federal and industry organizations impact the delivery of immunization services by setting policies and strategies, and providing guidance and support, for these technologies. CDC works actively to engage immunization stakeholders to advance interoperability and use of immunization data and functions, thereby supporting high quality immunization services and ultimately improving immunization delivery.
Goal 4.1: Health IT systems support effective individual and population-level immunization services.
Strategies to support Goal 4.1:
- Develop system-neutral solutions and standards that support effective immunization services in diverse health IT systems.
- Establish initiatives to ensure effective implementation and use of IISs within the health IT environment.IISS
The 2018-2020 CDC Immunization Information Systems Strategic Plan Cdc-pdf[8 pages] is also available online.