HLN and Oregon Health Authority Present Optional Approaches to Oregon's School Immunization Reporting Process at Atlanta Conference

Noam H. Arzt, Ph.D.At the 2018 National Immunization Conference (NIC) held in Atlanta May 15-17, HLN co-presented Diverse Stakeholder Perspectives to Improve Oregon’s School Immunization Reporting Process in collaboration with the Oregon Immunization Program (OIP). Aaron Dunn, Oregon’s Immunization Program Manager, and Marcey Propp, HLN Project Manager, presented the project context, approach, and outcomes as part of the segment for Improving measurement and reporting to foster clear vaccine communication. The project context included antiquated technology, the growing complexity of vaccine requirements, and excessive, redundant and unnecessary workload that culminated in making the current school immunization reporting process unsustainable. 

While OIP knew their own requirements, they identified the need for an external contractor to assess the needs and obstacles of key stakeholder groups, identify feasible options to the current process, and evaluate the alternatives based on state-defined criteria. The Oregon Health Authority then contracted with HLN to conduct stakeholder engagements across the state, as well as interview other states as to how they manage the school immunization reporting process.

Notes from the sessions and interviews were documented with all requirements reflected in a Requirements Traceability Matrix for the state’s use in subsequent project phases. Three options for Oregon’s consideration were developed in alignment with stakeholder requirements and project principles as outlined during the project kickoff.

• Model 1: Enhances and leverages Oregon’s most complete electronic source of immunization data, ALERT IIS.
• Model 2: Similar to Option 1 in that a centralized system is used to assess student immunization data and generate all required reports and exclusion letters. However, instead of using ALERT IIS as this system, Option 2 introduces a new “system of record” and includes query capability to ALERT IIS to leverage its abundant data.
• Model 3: Largely similar to the current process, with a couple of notable exceptions such as the replacement of antiquated technology with more modern technologies that would be more maintainable long-term, and the introduction of an electronic data collection option for schools via an online parent portal to electronically submit immunization data.

The models were evaluated across two sets of criteria, one state defined and another from the stakeholder perspective, with the benefits and limitations of each documented and presented in a variety of ways for Oregon’s consideration. The project identified several process elements for Oregon to consider such as, some non-technology fixes (e.g., rules changes to address paper requirements), and the need for more guidance, training, and tools at the local level.

As deliberation continues at the State level to determine the optimal approach for Oregon, stakeholder response to the project was favorable in terms of being asked for their participation and input. Regardless of the model selected, it is broadly understood and documented that a link to the Immunization Information System (IIS) and support for data exchange are critical to improving the process.