Leverage Immunization Information System (IIS) Functionality

Improved IIS immunization practice

On-time vaccination depends on knowing what vaccines a patient is due for and when. High-quality data in the IIS can support providers by:

• Providing consolidated vaccination records for each patient
• Generating lists of patients due for vaccines
• Forecasting future dose due dates to assist with scheduling
• Delivering reminders for upcoming appointments
• Providing practice-based coverage assessments

Evidence base and justification

A functional IIS populated with timely and accurate data improves the efficiency of provider locations by giving them tools to ensure on-time vaccination, engage patients and their families, and monitor vaccine uptake. Providers can use this strategy to improve IIS data quality and to make use of features available within the IIS.

• A 2014 review of IIS-focused studies describes the wide variety of features IISs offer to improve provider workflow and vaccine uptake. For instance, providers can use the IIS to measure—and monitor trends over time in—vaccination coverage, and they can use this information to target areas for vaccination workflow improvement in general or for specific vaccines with lower uptake.
• Timely and complete IIS data also prevent over-immunization, as demonstrated by a 2015 study of influenza vaccination in children.
• Many IISs include provider reminder functions (also known as clinical decision support systems for immunizations, or CDSi), which generate notes and reminders alerting providers when patients are due or overdue for vaccination and forecasting upcoming vaccine due dates to assist with scheduling. The value of these features increases with the quality of IIS data.
• A 2021 review of studies on patient reminder and recall—which many IISs facilitate—concluded that reminder and recall is one of the most effective and cost-effective tools for both childhood and adolescent vaccine delivery.
• Another 2021 study highlighted the potential for centralized IIS-based reminder and recall to increase immunization rates nationally. Given the demonstrated success and low cost of this approach, this study concluded that wider dissemination should optimally involve state and regional IIS, especially given the willingness of IIS managers to engage in this effort.

Examples of strategy implementation activities

• Identify workflow points where procedures will be revised for looking up patient vaccination histories, vaccine forecasts, or generating patient lists.
• Enter new patients' historical vaccination data into the IIS to more accurately determine which doses are due.
• Promptly enter all vaccine doses administered into the IIS, set up routine electronic reporting to the IIS, or work with the jurisdiction's IIS team to improve existing EHR-IIS integration.
• Set up or fine-tune the IIS's reminder and recall settings for vaccination appointments.
• Update patients' active/inactive status in the IIS on a routine basis.
• Designate staff person to routinely run IIS-based coverage assessments to monitor provider immunization performance.
• Use information in IIS coverage reports during staff meetings and team huddles to identify opportunities for improving vaccination performance.
• Verify/update patient contact information for reminders, recall, and follow-up.
• Provide the parent with their child's updated vaccination record and/or share information about the IIS's public access portal (if applicable).