Date: Sept 11 2023

Quarter: Q4

Minutes Approved as Presented 

This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."


Immunization Round Table

Discussion items

Updates- Chrissy Minor- CDCChrissy 
  • Digitize both implementation guides and will be using the Implication Guide Authoring management tool (IGAMT)
  • Starting pilot with first jurisdiction
  • Working on the next release of the v 2.5.1 which will be 2.0- put together an Implementation Guide Expert Group which will determine what should be include in the next release of the guide. Meets last Thursday of the month
  • The 2.8.2 updates will be reflected in the new 2.5.1 R2 version as well as new findings from implementation.

Eric Larson- AIRAEric 
  • Lasted RSV monoclonal antibody is keeping them busy, coded as a vaccine even though it isnt a vaccine. Working with EHRs policy, legal to ensure the communication of that data to IISs.
  • Often get temporary or baby names, the immunization integration program between CDC, AIRA and HIMSS and this is on their short list. May not get chosen. Could apply to people experiencing homelessness and addresses as well. IF the baby name gets selected may want to check with Vital Records and Newborn Screening programs. No standard currently exists for how those baby names are assigned across and within heath systems, problem is worse for multiples. With both the Hep B and the RSV it could cause further complexity in patient linkage.
  • The new monoclonal RSV antibodies are based on weight not age. May need to consider handling of weight in the 2.5.1 Imm IG to accommodate

Craig Newman- AltarumCraig
  • 5 open FHIR JIRA tickets on the base resources, see here:
    • Manufacturer is an example
  • FHIR is trying to clean up extensions and will be reaching out to workgroups to lean up extensions on the resources the work group owns. Will need to figure out where extensions are used and by whom, trying to gage impact and to resolve
  • Every other Friday morning we have an immunization focused workgroup call. Will be reviewing these sorts of things during that Friday call before bringing to the broader workgroup.
  • January Connectathon and WGM are both virtual, might be a good time to set up an immunization track
  • Bulk data for Imm (helios) bulk testing event in July. Now looking for a focused pilot. Also starting talk to CDC about IIS reporting to CDC. Will be focusing on an enumerated listed. DEX would be the entry point to CDC.

Daryl- HLNDaryl
  • Been thinking about forecasting issues
  • How an IIS needs to track the RSV dose with regards to forecasting
  • Should the forecaster try to ascertain the 8 month and 20 month dose for high risk.
  • There are no current age-based recommendation, but what if those guidelines change
  • For forecasting purses and clinical decision support- moving towards FHIR standards and incorporate and utilize FHIRs in forecaster. We already have a FHIR IG for forecasting, could work with NIST for some verification of connectivity. Would recommend using R4
  • Want to resurrect what was done and move it forward to FHIR and address high risk
  • May want to speak again to the CDS workgroup and CIMI 

John Stamm-EPICJohn
  • EHR community is talking about many of the same imm topics
Adjourned at 4:30pm (event time)Nathan Bunker- AIRANathan

Nathan Bunker (AIRA) GET SLIDES

  • International Vaccine code call next week. Contact Nathan if you want to attend.
    • Share what you are doing locally
    • Analysis on all the vaccine code sets
  • Vaccine Code Set Metrics
    • Working with a group from France to refine their metrics and translate into English
    • Looking at the following Metrics:
      • Complete
      • Precise
      • Informative
      • Non-specific
      • Historical
      • Mappable
      • Open Licensing (AIRA added)
      • Process (AIRA added)
    • Will be discussing on the next call Wednesday
    • Might want to invite the International Patient Summary – pharmacy group to this next or future call
  • Tracking Possible Future Standards for IIS Implementation
    • Where are we going with FHIR?
    • Not prescriptive, but descriptive to know the lay of the land
    • 4 areas/stages- for policy makers to show a staged process
      • Exploring
      • Draft
      • Pilot
      • Rollout
    • When we talk about future standards it doesn’t just mean FHIR. Topics are being documented
    • Topics are organized in neighborhoods for discussion
    • Topics may be at different points in the process/or different stage
    • Question about whether National should be nationwide vs more than 1 state. Rollout is more about being ready for nationwide rollout not simply only implemented in one or two places without everything needed in place
    • One example of a neighborhood is inventory. Currently decrement in v2 but it isnt sufficient for what is needed to reconcile lots. May want to look at reconcile lots between EHRs and IISs in the future. This might be a place where FHIR could be used
    • New topics neighborhood
      • School interoperability, schools have their own interoperability standard.
      • Lead blood updates and Lead blood queries – some IISs will capture lead or the IIS and lead may be in the same system

Action items