Hawaii Immunization Registry:
FAQ’s from Tuesday March 25, 2008
1. This is a voluntary program, how will patients/physicians opt in or out?
Patients at their point of health care will have the option to:
1. Opt in w/only their physician and DOH able to access the record
2. Opt in w/ all authorized users (see #14) able to access the record
3. Opt out
DOH is considering legislation for 2009 and requests the AAP’s support to make it an
“opt-out” system. Everyone’s data would be included in the Registry unless a patient
specifically “opts-out” in writing. Currently the system requires patients give consent
(“opt-in”) to have their information included in the registry. Provider participation,
regardless of patient “opt-in/opt-out,” is voluntary.
2. How will the DOH incentivize, encourage the practitioner to participate? i. e.
what value does HIR add to the physician's practice to offset the cost of staff time
to input data.
DOH: Value that an Immunization Registry adds to a physician’s practice:
 Consolidates immunizations from all providers into one record
 Helps to ensure timely immunization for individuals who change providers
 Easily provides an accurate, official copy of an individual’s immunization
history
 Provides forecasting/immunization decision support
 Assists in preventing unnecessary, duplicated, or missed immunizations
 Facilitates reminder/recall.
HAAP encouraged DOH to explore this issue as the more physicians who see value
in the system and participate early in the process will make the system more
successful.
3. How prepared is DOH to work with doctors with electronic medical records to
receive data electronically?
DOH has a list of EHR vendors collected during the technical subcommittee’s
survey and will be working w/them on translational software.
HAAP recommended that DOH make that list available so that providers could
check to see if their EHR vendor is on the list.
4. Has DOH talked to the health plans about their role in HIR? e.g. to incentivize
physicians to participate?
NO: DOH does not have an initiative to look at this area althoughho DOH would
support HAAP in their efforts in working with the health plans. DOH has also
considered assisting in inputting physician’s patients and inventory into the registry
upon participation.
5. Is there a plan to get the previous shot record into HIR, e.g. submit previous
F14's or DOH yellow cards to the registry for input?
NO: Since parents must currently consent to have their child’s immunization
information included in the Registry, previously submitted F14’s or yellow cards may not
be entered without a parent’s written consent.
6. How will the birth HepB vaccine be inputted?
This would take buy-in by the birthing facilities to enroll patients in HIR and then
either enter the data into the Registry or create a data transfer. There are potential
problems due to changes in the baby’s name.
7. To avoid the need to double entry the vaccination (into HIR & into practitioners’
medical record) what are the options for hard copy printing of the vaccines given
on that day?
EDS software can print up a “cover sheet” that lists all vaccines given
HAAP asked DOH to share what the cover sheet looks like so that input on its
format could be given.
8. Will Tb screening information be added in?
NO: Because TB screening is not an immunization, it will not be included in the
HIR software. However, this information may be entered on a “fillable” Form 14/school
form, which may then be saved on the physician’s computer.
9. The registry will be able to print a F14. Will the practitioner be able to
electronically add in all the other F14 information (e.g. PE, BP, Vision, hearing) ?
If so then the practitioner could save staff time by filling out the form
electronically, and saving it for future use, when parents /schools/ licensed day
care / sitters ask for additional copies of the form. This might be seen as a
valuable + for HIREG participation.
Based on input from providers after the EDS software demo, EDS is working on
making this possible.
10. During the DOH 2008 - 2009 K-8 flu vaccination program will that info be put
into HIR?
Once HIR is up and running the DOH would want to input the influenza
information, but realistically this may not be until 2009 or later.
11. Are there any active users in solo or 2-3 person group private practice of the
existing EDS registries on the mainland that we could dialogue w/ to get their
impression of the system and how they have been able or unable to get the
registry into their normal work flow?
EDS has been asked to supply a list. DOH has been in contact with Elizabeth
Sobczyk, Manager of Immunization Incentives with the AAP to assist with this request
as well.
12. How is HIR being funded? Is there a long term funding plan?
HIR is funded via the annual CDC Immunization federal grant, HMSA Foundation
grant and funding is dependant on receiving yearly outside funding. It is not funded
under the DOH budget.
13. Who will be in charge of HIR? Will it be a part of the DOH Immunization
Branch?
Security and use of HIR will fall under DOH.
14. Who will have access to information in HIR? Who will be able to input
information? Who will be able to edit information?
Initially HIR will be open primarily to healthcare providers w/ plans for having
preschools, elementary, middle and high schools able to access the information in read
only format. DOH has not yet explored possibility of daycare providers accessing the
information. There are currently no plans for patient access.
Acronyms:
HIR – Hawaii Immunization Registry
EDS – software vendor developing HIR