Now, this care includes coronavirus vaccinations. As these vaccines are still so new, providers are being asked to implement unprecedented processes and procedures for their administration—and they have to do so quickly, as the industry collectively works to inoculate millions of people in as short a time as possible.
Because the decisions around vaccine administration are so fluid, some providers are currently having to rely on spreadsheets or external databases to log data, document vaccines and report to state immunization registries while their health IT partners race to develop and configure supportive functionality. In other cases, healthcare professionals using certain EHR systems have access to tools that document and report on vaccines, facilitating both Federal and State-required reporting as necessary. Allscripts, for one, has offered immunization reporting in its solutions for many years, and this functionality has now been updated to meet the unique needs called for today.
COVID-19-specific vaccine reporting functionality varies slightly from other immunization requirements, including the need to log first- and second-dose administration specifics, set time-sensitive patient appointments and reminders and more acutely track potential adverse events for patients, given the Emergency Use Authorization status of the various FDA-approved doses. Specialized functions for orders, billing and reporting is also usually included, and efforts continue to be made to ensure that providers are compliant with the latest updates and changing requirements.
There are several factors that complicate the COVID-19 vaccine effort. For example, while vaccine distribution normally takes place largely in ambulatory settings, the COVID-19 administration is predominantly happening, to date, in acute settings or in public health departments that lack any EHR at all. The industry is tackling the need for unusual IT infrastructure to support drive-up appointments, as another example, so health IT developers are actively partnering with clients to identify how they can optimize their unique vaccine delivery programs and support them with minimal implementation or disruption.
However, while certified EHRs already meet the present ONC standards required for connectivity to immunization registries, Allscripts and other health IT companies are continuing to work closely with public health organizations such as HHS, the CDC, Operation Warp Speed, and several state governments because the effort is not as straight-forward as it could be, or even should be. The question is, what can be done to simplify and streamline any similar epidemic emergency use case that occurs in the future?
First and foremost, the Biden Administration should take steps to build on the work already done by Congress to fund and promulgate requirements for states to invest in modernizing their public health registries and interoperability capabilities, or even to establish these where they don’t yet exist. Many of the state-by-state development efforts that health IT developers are forced to make is due to existing registries taking fragmented and outdated approaches to the formats they require for reporting. Because of this, very few are able to return information back to the providers so that knowledge dissemination is broadened beyond the public health walls.
Further, stronger guidance from the federal government and the CDC as to what types of data should be reported, the data’s format and implementation specifications would be helpful. Currently, states from New York to Texas have decided in isolation to require different classifications of data to be collected and transmitted, frequently in ways that do not align with the work vendors have done previously to implement HL7 connectivity.
None of these issues are new. In fact, they are challenges that have been brought to the attention of Congressional committees and ONC for many years. The COVID-19 pandemic is simply the most stressed test of the immunization reporting use case in the history of our digitized health system. However, with appropriate attention from policymakers and input from industrywide subject matter experts, the next time a pandemic comes through, this can be much more straightforward for everyone.
