Reporting immunization records to state agencies is a required core measure for Stage 2 meaningful use. For healthcare providers, that can sometimes be a time-consuming and arduous task.

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ADP AdvancedMD has recently teamed-up with Pittsburgh-based Iron Bridge Integration to enable end users to utilize IBIs cloud-based platform to manage the transmission of immunization records to state agencies.

Fundamentally, the cloud-based solution is designed to allow providers to meet meaningful use requirements more efficiently.

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The meaningful use measure requires participating providers to meet established public health criteria to receive electronic health record incentives. One of three possible public health components involves testing and establishing a connection from the provider site EHR to the appropriate Immunization Information System.

"Putting this objective in meaningful use helped to signal the technology community and providers that this will be a must do and therefore companies like Iron Bridge started building bridges to different registries," said Arman Samani, CTO at ADP Advanced MD.

Samani pointed out that larger organizations have had some success in connecting to registries and maintaining them but smaller private practices are lagging behind.

"The partnership between AdvancedMD and Iron Bridge is aimed at tackling this problem for small private practices without IT staff," he said. He added that collecting the data in a way that is discreet and then being able to report on those data and then being able to transmit those data, those are really the cornerstones of meaningful use.

According to the Centers for Medicare & Medicaid Services, among the significant provisions in Stage 2 are the endorsement of a single standard, HL7 2.5.1, for all immunization messages submitted from EHR systems to IIS, and the requirement for “ongoing submission” of production immunization data (as opposed to test data) to an IIS.

Samani said that despite the HL7 standard, the requirement has become more involved and every state registry is somewhat different.

"It has changed to be an ongoing submission of immunization data in the HL7 standard," said Samani. "The whole point here is that there are no required standard transmission methods and every registry has done it slightly differently making it difficult to build and maintain such solutions nationally," he said.

Samani added that as a national provider of electronic health records as well as practice management, ADP AdvancedMD had the challenge of connecting to all 50 states and some states that have more than two registries.

"With this condition we have to get into the business of starting to manage all these connections because some of the connections at times, might drop off, change in authentication method, or user name and passwords, these are in addition to slightly different HL7 requirements from every registry," he said.

The partnership between the two companies, according to Samani, will help to keep maintenance costs low because IBI provides seamless integration with AdvancedMD's EHR.

Samani said that the issue of connections is more challenging for some physician practices compared to others depending on how their practice is developed from an IT perspective. Hospitals, he said, often have to manage all this connectivity that they are not familiar with because the standards are not really usually the core competency of the IT personnel in the hospital.

According to AdvancedMD, the combined capability between the AdvancedMD EHR and IBI, also meets the needs of the Stage 2 program measures relating to immunization reporting, electronic laboratory reporting, cancer reporting and syndromic health reporting to public health agencies.  The integration of both products allows the user to stay within one system to achieve the goals of their practice.

Industry insiders point out that the process of applying to state registries in order to meet meaningful use 2 requirements for immunization records reporting is both tedious and time consuming from a providers perspective.

"We have gone through the process of applying to the state registries and from a provider's perspective, it would be considered a lengthy process," said Michael Fitzpatrick, enterprise integrations project manager at Hackensack University Medical Center. "It was very time consuming and if you don't have an IT department that is able to take on that task, it could be even more time-consuming and problematic and it could interfere with patient care."

Fitzpatrick noted that for providers that are using HUMCs EMR for their ambulatory or outpatient, they have contacted the state, have run through the testing with them and set up the necessary paper work and testing along with the state.

"The providers that are using HUMCs system have a seamless method. They use the clinical system to document that they're actually immunizing or administering the vaccines and behind the scenes due to the set up that we've completed, the correct information is being exchanged with New Jersey information systems."

Currently, HUMC is in the testing phase with New Jersey for its outpatients. Fitzpatrick said that there's a lengthy delay in acceptance for the state of New Jersey.

"They do enroll you based on the approximate volume of immunizations that your practice is giving," said Fitzpatrick. On the inpatient side, HUMC has just achieved ongoing submission with the state.

Fitzpatrick said that the integration of both AdvancedMD/IBI products that meets the needs of the meaningful use 2 program measures relating to immunization reporting, electronic laboratory reporting, cancer reporting and syndromic health reporting to public health agencies is "ground-breaking."

"Right now we are managing those projects separate and distinct from each other and if this one product is something that would be combining those, that is fantastic."