EHR-IIS Interoperability Expert Panel Project
The EHR-IIS Interoperability Expert Panel Project focuses on three separate and independent technological components: technical interoperability, semantic interoperability, and patient de-duplication.Technical Interoperability
Technical interoperability concerns the physical transmission and receipt of health data from one system to another through a transport layer technology. This project seeks to provide a recommendation for a standardized transport layer protocol for immunization-related messaging. One of the major components of this project is the formation of a panel of experts to investigate and determine which transport layer technology would most effectively enhance interoperability between IIS and health information systems.The Transport Layer Expert Panel that formed in January 2011 consisted of 41 industry experts representing the Office of the National Coordinator (ONC), the CDC Public Health Informatics and Technology Program Office (PHITPO), the American Immunization Registry Association (AIRA), the Electronic Health Record Association (EHRA), the Indian Health Service (IHS), IIS vendors, EHR vendors, and IIS programs. The panel conducted a thorough investigation and comparison of four transport protocol options. This involved the evaluation of each protocol against 20 agreed-upon business requirements, as well as the HL7 2.5.1 Use Cases. The panel's intent was to identify and recommend a unified technical interoperability framework for immunization-related transport that would allow for both broad adoption and long-term viability as an industry standard.
Through numerous remote working sessions and a three-day, in-person session in Atlanta in early March 2011, the panelists came to the consensus that SOAP Web Services is the recommended standard. The other evaluated protocols were ebXML, HTTPS, and STMP + S/MIME. While the panel recommends SOAP, it significantly acknowledges the role and value of the other transport layer options. It is not the expectation of the panel or of the EHR-IIS Interoperability Project that IIS programs discontinue the use of existing transport protocols or those currently under development. The panel's findings do not represent a mandate for IIS programs but rather a recommendation in an effort to move towards standardization across the immunization messaging community.
Findings
The panel's findings were formally presented at the National Immunization Conference (NIC) in March 2011. The collaborative work of the panel was documented in a 75-page Recommendations document which details the panel's methodology, justifications for its recommendation, detailed acknowledgement of the other transport protocols, and a summary of the impacts of a SOAP implementation.Transport Layer Protocol Recommendation[PDF-894KB/75 pages]
This document details the panel's methodology, justifications for its recommendation, detailed acknowledgement of the other transport protocols, and a summary of the impacts of a SOAP implementation.
Resources
To support the SOAP recommendation, the expert panel developed resources to support software interface engineers and technical project managers.SOAP Implementation Resources
Case studies of SOAP implementation efforts, lessons learned, and documentation of SOAP tools, including coding samples for the WSDL in Java and .Net.
Formal Specification
Describes transport, security, and SOAP operations, parameters, and faults for SOAP-based HL7 transmissions to an IIS.
Semantic Interoperability
Semantic interoperability refers to the ability to automatically interpret the information exchanged meaningfully and accurately in order to produce useful results as defined by the end users of multiples systems. To achieve semantic interoperability, both sides must refer to a common information exchange reference model, which for the IIS community has been defined as Health Level 7 (HL7) messaging. This project focused on developing tools to aid in HL7 immunization-related messaging towards the promotion of health system interoperability. One of the major components of this project was the formation of a panel of experts to address the challenges faced by vendors in interpreting local HL7 2.5.1 Implementation Guides and contracting RFP documentation due to the variance among IIS programs.The HL7 Messaging Expert Panel that formed in February 2011 is consisted of 31 industry experts representing the AIRA, EHRA, IIS vendors, EHR vendors, and IIS programs. The panel supported the development of the following useful tools for IIS programs:
- A Local HL7 2.5.1 Implementation Guide Template (available in both full and condensed versions)
- A template for documenting local data exchange business rules
- Comprehensive HL7 test cases addressing structure, vocabulary and data quality, which are congruent with the HL7 2.5.1 Implementation Guide (not yet available)
For information on the CDS Project and the Immunization Information Systems Support Branch, see Clinical Decision Support (CDS) Project.
Vaccines: IIS EHR-IIS Interoperability Expert Panel Project
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