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The Importance of Liberating Immunization Data

As James Daniel prepares to leave HHS, he reflects on the power of the Immunization Gateway, a system that enables the exchange and access of immunization data across the U.S.

Dad on working on the computer with child looking on.

Of all of the public health initiatives I have worked on, the Immunization Gateway, IZ (‘eye-zee’) Gateway for short, has proven to be the most innovative project to improve public health. Indeed, this project won the Technology Trailblazer - InnovateIT award from the AFCEA Bethesda chapter in 2016. The IZ Gateway enables the exchange and access of immunization data for health providers and consumers across the country’s 64 siloed immunization registries run by state, territorial, and local health departments.

Why the IZ Gateway?

The IZ Gateway builds upon the successes of immunization registries. Prior to the age of electronic health records, or EHRs, paper records spread across multiple providers and “yellow cards” held by parents were the only way to keep track of a child’s immunization history. This system got a much-needed computerized update in the early 1990s with funding from the Robert Wood Johnson Foundation. Run by state and local health departments, these systems migrated to web-based applications by the early 2000s. With the widespread adoption of EHRs around ten years ago, immunization registries began electronically exchanging data with EHRs to minimize data entry burden. Standard data exchange protocols now enable real time, bi-directional exchange of data with EHRs in almost every state.

IZ Gateway Solves Continuing Challenges 

Three issues still prevent immunization data in registries from being widely available:

  1. Immunization registries are run by state and local health departments, and the regulations for their use are set by these same health departments. Reporting to immunization registries is based on the geographic location of the provider. However, many patients cross jurisdictional boundaries to seek care and often move across the country, resulting in fractured and incomplete immunization records.
  2. Large provider organizations often have multiple locations across jurisdictional boundaries; this forces them to connect to multiple immunization registries, costing significant time and resources.
  3. Consumers have historically not been able to access the rich data and clinical guidance within the immunization registries.

To solve these issues, I created the IZ Gateway. The IZ Gateway is a data exchange hub that offers an efficient solution to connect immunization registries with each other, large national organizations, and consumer applications. Without the IZ Gateway’s infrastructure, countless connections would need to be implemented among these systems for such data exchange to occur, which is time and resource intensive. Instead, a single connection to the IZ Gateway enables immunization registries to share data with multiple providers. You can learn more about the three main components of the IZ Gateway, Share, Connect, and Access, on our website.

A Farewell, but not for the IZ Gateway

After nine years with HHS, I am preparing to leave the public sector. I was lucky enough to work with a team of brilliant colleagues on the IZ Gateway — my passion project and one that is changing the world of immunization records. The team, led by experts from the Office of the CTO and CDC, is continuing to expand immunization record access in these trying times. The COVID-19 pandemic now presents an unprecedented need for the IZ Gateway, as this infrastructure can play a critical role during mass vaccination campaigns. The arrival of COVID-19 mass vaccinations will be the ultimate test of the power of the IZ Gateway, and further underscores the need for continuous innovations in health care, as the foundations we build today are often critical to addressing the problems of tomorrow.

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Health Data
Health IT