Connecting Systems Lessons Learned

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Connecting SystemsLessons Learned
Questions Unanswered

• Michael Flynn
• NYS DOH Immunization Program
• NYSIIS Project Manager
• Presented NIC Denver 5/1/2002

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Give me the data!

• Data Sources
• Our own application
• Separate applications with same system
• Other DOH sources Vital records,
• Billing systems
• Medical record applications
• Medicaid

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Problems With Getting Data

• Can I communicating with other systems?
• Can they meet my security requirements?
• How do they handle consent?
• What are their business rules?
• Do they have the field I need?
• If they do, what codes are they using?
• How are the capturing the information?

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Background On NYSIIS

• New York State Immunization Information System
  (NYSIIS)
• Opt in consent has to be give to participate
• Regional approach
• General guidelines and core elements requirments
• Started with 8 projects and are down to 2
• Central HUB connecting applications, allowing
  for expansion to other systems

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NYSIIS Design

• All data is entered at the providers office

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NYSIIS Design

• Exchange between providers and application servers

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NYSIIS Design

• Exchange between application servers and state hub

NYSIIS HUB
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NYSIIS Design

• Future connections

NYSIIS HUB
MEDICAID WIC ETC
WEB Client Billing Med Rec Systems
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HL7 The Easy Part

• HL7 is the common language for registries
• Implementation Guide developed by CIRSET/CDC
• CDC developing a HL7 parser (translator) for
  projects

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Getting The Message

• HL7 is the common language for registries
• HL7 doesnt provide security/encryption
  HL7 is not what sends the data
• Transmission must meet projects security
  protocols
• Need to assess connections outside your system

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NYSIIS Design

• Future connections

NYSIIS HUB
MEDICAID WIC ETC
WEB Client Billing Med Rec Systems
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Consent

• NYS Opt In requires signed consent
• Providers need both consented and non-consented
• Regions differed on access/browsing
• Medical record/billing software/etc dont flag
  consent

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Coding Table

• How do you map values from different tables?
• Race code
• specific to general but not back
• single to multiple but not back
• Analysis
• If a source didnt have all the codes, you cant
  report the true frequency

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Field Consistency

• How is the field captured?
• Mothers Name, Mothers Maiden Name
• Birth or adoptive?
• VFC eligibility
• App1 captures per shot on immunization table
• App2 captures once on demographic table
• Responsible Person
• How is it filled out when seeded with birth data?
• App1 collects mother, father, and guardian

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Business Rules

• How systems use and disseminate data differ
• Medical home
• App1 primary medical home
• App2 shared medical home
• Updates to doses
• Some send just the new or updated event
• Some send complete record every time

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Summary

• Getting the data gets you half way
• Review systems completely prior to linking
• Prepare to be flexible.

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Contact Information

• Michael Flynn
• NYS DOH Immunization Program
• NYSIIS Project Manger
• mkf06_at_health.state.ny.us