A Comparative Analysis of Immunization Data to Gauge Interoperability and Data Quality Open Access

Hauser-Saslo, Dannelle G. (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/6969z100q?locale=en
Published

Abstract

CONTEXT: Immunization information systems are used by most states to maintain registries of immunization data for monitoring population-level adherence as well as for use in clinical practice and research. Data exchange between said systems and electronic health record systems presents an opportunity to improve the completeness and quality of information available using appropriate messaging technology to enhance interoperability and data quality.

OBJECTIVE: The goal of this study is to evaluate and compare HL7 messaging versions 2.4; 2.5.1 and FHIR to determine if interoperability and data quality improve with version enhancements in an effort to contribute to the discussion of standards and interoperability of state-run immunization information systems and data exchange with electronic health record systems.

DESIGN: Sample immunization data from version 2.4 and 2.5.1 were collected from the Washington State Immunization Information System, analyzed and compared to FHIR based on literature review and tests completed in Grahame Grieves test server environment. Personal health information found in immunization messages were removed using HL7Scrubber, a Scientific Technologies Corporation (STC) product, to remove all personal identifiers.

RESULTS: Data quality analysis of sample immunization data determined that poor semantic interoperability of standardized concepts were the primary reason for data fields in both HL7 v2.4 and v2.5.1 to fall below the required 95% threshold expected at the state level for what is considered high data quality. Improvement in v2.5.1 was found in select fields but is not a significant improvement from v2.4. Literature review and testing of HL7 FHIR and its capacity for immunization data suggests that platform specification Structured Data Capture would resolve provider barriers to semantic interoperability by pre-defining data element definitions to which providers can map.

CONCLUSION: This study highlights issues related to data exchange, data quality, and interoperability of immunization information to state registries and suggests that there is some degree of deficiency in data quality in immunization data submitted using earlier versions of HL7 due to issues providers face in maintaining updated concept codes. This study indicates that there is a need to strengthen messaging requirements while maintaining flexibility between electronic health record systems and immunization information systems.

Table of Contents

CHAPTER 1: INTRODUCTION

INTRODUCTION AND RATIONALE

PROBLEM STATEMENT

SPECIFIC AIMS

PURPOSE STATEMENT

CHAPTER 2: LITERATURE REVIEW

INTRODUCTION

CURRENT DATA STANDARDS

VERSION REVIEW

HL7 FHIR

CHAPTER 3: METHODS

INTRODUCTION

RESEARCH DESIGN

INSTRUMENTS & ANALYSIS

Stage 1: Version Analysis Stage

2: HL7 FHIR Evaluation Stage

3: Comparative Data Quality Analysis

BARRIERS & LIMITATIONS

CHAPTER 4: RESULTS

INTRODUCTION

FINDINGS

Stage 1: Version Analysis Results

Stage 2: Comparative Data Quality Analysis Results

Stage 3: HL7 Version Recommendations

CHAPTER 5: CONCLUSION

SUMMARY OF STUDY

CONCLUSION

RECOMMENDATION

Appendix A

Appendix B

Appendix C

REFERENCES

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