The work of the American Immunization Registry Association (AIRA) with the Public Health Data Standards Consortium (PHDSC) to develop IHE profiles related to public health and immunization is finding reuse and incorporation by other Standards Development Organizations such as OMG and HSSP, and is wrapping back to HL7 itself in the form of harmonization of message and document specifications, of medication specifications, and of decision support specifications.  This ultimately will facilitate electronic exchange of immunization data with EMR systems by eliminating the need for EMR vendors to constantly translate from one “standard” to another.  Also, the consistent adoption of harmonized immunization standards by multiple SDOs will encourage federal bodies such as HITSP to promote those standards.

Overview

Public Health and Emergency Response (PHER)

PHER held its first series of immunization-related quarters, called Immunization Days.   A dialin line and gotomeeting was provided by HITSP, and speakerphone equipment by Lori Fourquet, so a number AIRA members were able to join by phone/web.   The final agenda is given at the end of this document.   

• Identified a PHER project to find a way to bind the Immunization DAM to specific HL7 messages, services and documents  
• Added PHER participation in Pharmacy project to define common product models (common to vaccination, medication, and other domains)
• Action items to harmonize CareRecord with POIZ: 
• PHER to comment on CareRecord Draft Standard for Trial Use (DSTU) and Clinical Statement DSTU to make compatible with the V3 immunization message (POIZ)
• PHER to collaborate with Clinical Decision Support (CDS) on CareRecord comments related to decision support
• PHER to develop POIZ template on CareRecord

As an AIRA representative to HL7 and PHER co-chair I have the duty of organizing Immunization Day.  See draft agenda at the end of this document.   Please forward agenda suggestions and comments to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it . 

Service-Oriented Architecture (SOA) and Healthcare Services Specification Project (HSSP)

The IIS use case has also worked its way into the activities of HSSP.  HSSP is a collaboration between HL7, the Object Management Group (OMG), and Open Health Foundation (OHF) for the purpose of defining web service and Service Oriented Architecture (SOA) standards.  It is the main international standards organization currently defining standards for SOA.  The HL7 SOA Work Group is the HL7 arm of HSSP.   

The stake of HL7 in HSSP may be changing.  HL7 has recently decided to pursue SOA as an important architectural and technical direction.  This was mentioned in SOA Work Group meetings (which are public) last week but has not yet even been announced formally yet by HL7.  Therefore, what this changes for HSSP is not yet clear.

HSSP initiated a formal relationship with Integrating the Healthcare Enterprise (IHE, www.ihe.net) in San Antonio in January 2008.  On Friday in Phoenix, HSSP hosted a face-to-face meeting between IHE and HSSP technical and planning co-chairs, and other interested parties.  This meeting was also available via dial-in and gotomeeting, courtesy of Lori Fourquet and HITSP. 

Attendance included Dr. Charles Jaffe, CEO of HL7, Audrey Dickerson of HIMSS, Didi Davis, Director of IHE (via phone), numerous IHE and HSSP co-chairs, and several HITSP representatives.    In all, about 25-30 people participated.

Outcomes included:

• Exchange materials and input on each group’s overview collateral on the subject of SOA

• Find a role for IHE in the shaping of HSSP service specifications related to Entity Identification Service (EIS, i.e., person identification).  These services are expected to follow along the lines of PIX and PDQ.  It seemed advantageous to include both IHE PIX and PDQ HL7 versions 2 and 3 in the platform-specific sections of the EIS specification.    Follow-up steps and contacts were identified.  PIX and PDQ include HL7 2.5 versions and have been discussed within AIRA as ways to cover the person identification portions of an HL7 2.5 implementation guide.

• Work together using the IHE Care Management and Immunization Registry Content profiles in the development of HSSP Retrieve, Locate and Update Service (RLUS) and Decision Support Service (DSS).  Care Management and Immunization Registry Content profiles are new this year and are the direct outcomes of the efforts of the Public Health Data Standards Consortium (PHDSC) and AIRA to promote public health use cases within IHE profiles.

Conclusion

The work of AIRA with PHDSC to develop IHE profiles related to public health and immunization is finding reuse and incorporation by other Standards Development Organizations such as OMG and HSSP, and is wrapping back to HL7 itself in the form of harmonization of message and document specifications, of medication specifications, and of decision support specifications.  This ultimately will facilitate electronic exchange of immunization data with EMR systems by eliminating the need for EMR vendors to constantly translate from one “standard” to another.  Also, the consistent adoption of harmonized immunization standards by multiple SDOs will encourage federal bodies such as HITSP to promote those standards.