Development and implementation of an interoperability tool across state public health agency's disease surveillance and immunization information systems

Lay Summary Many of the information systems currently used in public health have limited capabilities to exchange data electronically using nationally recommended standards (also called as interoperability). The Minnesota Department of Health, the state public health agency, uses the Minnesota Electronic Disease Surveillance System (MEDSS) to support disease surveillance, and the Minnesota Immunization Information Connection (MIIC) to support immunization practice and monitoring. The exchange of data between these systems was manual and hence a novel tool for standards-based data exchange was implemented in March 2022. The tool was developed by collecting user needs (n = 39) and mapping MIIC vaccine codes (n = 294) to corresponding MEDSS product codes (n = 48). Currently, 30 vaccination data elements including demographics from MIIC, vaccination history, and vaccine forecast are being imported into MEDSS. The tool was evaluated using quantitative and qualitative methods by assessing user time, clicks, and number of queries and by soliciting feedback from users. Comparison of key tasks demonstrated efficiencies in the access of vaccination data. It took 50 clicks and 5 h/week of staff effort before the tool was available and was decreased to 4 clicks and & SIM;17 min/week after the tool was implemented. This case study demonstrates the value of improving electronic data exchanges in public health with the goal of better decision-making using data and enhanced public health surveillance. Public health information systems have historically been siloed with limited interoperability. The State of Minnesota's disease surveillance system (Minnesota Electronic Disease Surveillance System: MEDSS, & SIM;12 million total reportable events) and immunization information system (Minnesota Immunization Information Connection: MIIC, & SIM;130 million total immunizations) lacked interoperability between them and data exchange was fully manual. An interoperability tool based on national standards (HL7 and SOAP/web services) for query and response was developed for electronic vaccination data exchange from MIIC into MEDSS by soliciting stakeholder requirements (n = 39) and mapping MIIC vaccine codes (n = 294) to corresponding MEDSS product codes (n = 48). The tool was implemented in March 2022 and incorporates MIIC data into a new vaccination form in MEDSS with mapping of 30 data elements including MIIC demographics, vaccination history, and vaccine forecast. The tool was evaluated using mixed methods (quantitative analysis of user time, clicks, queries; qualitative review with users). Comparison of key tasks demonstrated efficiencies including vaccination data access (before: 50 clicks, >2 min; after: 4 clicks, 8 s) which translated directly to staff effort (before: 5 h/week; after: & SIM;17 min/week). This case study demonstrates the contribution of improving public health systems interoperability, ultimately with the goal of enhanced data-driven decision-making and public health surveillance.