Advancing Population and Public Health Reporting and Outcomes with Vaccination Data Exchange (APPROVE)

The response to the COVID-19 pandemic in the United States has underscored the need for—and importance of—a sturdy public health infrastructure, occurring in the larger context of an increasing number of reportable infectious diseases over the past decade. Surveillance of reportable infectious diseases, including COVID-19, is complex due to disparate information systems and organizations. Despite advances in technology, most public health information technology (IT) systems are not interoperable and thus do not have the capability of robust seamless electronic data exchange.

The Minnesota Department of Health hosts the Minnesota Electronic Disease Surveillance System (MEDSS) and Minnesota Immunization Information Connection (MIIC) systems. MIIC serves as a central repository for vaccination data for Minnesota, used by nearly 6,000 diverse health care organizations, with data for approximately 110 million immunizations for 6.5 million individuals. MEDSS receives case reports of reportable infectious conditions and electronic laboratory reports for supporting case management, contact tracing, and outbreak investigations from State programs, local public health agencies, and clinical partners. While robust, these systems are not interoperable and have varying capabilities for data exchange with the widely adopted electronic health records (EHRs) in the State. The result is an inability to robustly assess public and clinical heath data in context. For example, although approximately 5.5 million COVID tests were reported to MEDSS by December 2020, these data could not be evaluated easily in the context of an individual’s vaccine status.

The specific aims of the research are as follows:

• Characterize the enablers and barriers to using a novel interoperability tool for electronic vaccination data exchange within public health systems.
• Evaluate the use of an evolving interoperability tool for electronic vaccination data exchange across public health and EHRs in clinical care.

This study will address a gap in knowledge by evaluating interoperability approaches for electronic vaccination data exchange between IT systems for infectious disease surveillance, vaccinations, and EHRs. It will use mixed methods to assess the MEDSS and MIIC systems within Minnesota’s Department of Public Health, guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) implementation framework.

Research findings will enhance data-driven decision making—and ultimately healthcare quality—by facilitating data exchange between IT systems within public health and across public health and clinical care. While the study will be done in the State of Minnesota, findings will be generalizable and applicable to public health settings in other States, meeting the critical need for better surveillance of all vaccine-preventable diseases.