Primary care provider sends patient immunization data to public health

State: Draft

Story

Perspective: A Provider has a patient immunization event to report to Public Health

Context: The Provider has made the determination that it is clinically and legally appropriate to send the immunization message, and the Immunization service recognizes the Provider's address

Story: A child presents for a routine appointment at a Provider office. The Provider office staff searches the EHR for the patient's record. The Provider office staff notes that an immunization is due. (Note, standard protocol in the Provider office may require a separate query/response transaction to an external immunization registry to confirm exact immunization status of the patient, but such a query is a background detail that is out of scope for this user story.) The Provider, noting that there are no contraindications for the immunization, authorizes the immunization. After the vaccine is administered, the patient record in the Provider EHR is updated with the vaccine administered, the lot number of the vaccine, the dose of the vaccine, the route of administration, the body site of the injection (if an injection), and the time of the vaccine administration. When the vaccine record is saved, the EHR originates an unsolicited immunization update, which transmits the new immunization data to the state or local Immunization Information System (IIS) operated by Public Health.

Details

Actors

Actor	Details
Addressees	The Provider EHR and the State or local IIS
Source	The Provider EHR
Destination	The State or local IIS

1. At a minimum there is a single push message from the Provider EHR to the State or local IIS
2. There may be hidden actors, including potential HISPs for the Source and Destination

Data Exchanged (This section is non-normative)

The data transmitted in this case may vary. Some example cases are provided below.

1. The typical case will involve a structured document or message (e.g., HL7 VXU). An IFR compliant message will be "xxx".
2. A secondary case will involve immunization history messaging

User Acceptance Tests

Submit 500 IZ messages using NHIN Direct transport, then audit IZ registry to confirm correct receipt of the messages.