Clinical decision support for immunization (CDSI) : logic specification for ACIP recommendations. Version 4.3
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Clinical decision support for immunization (CDSI) : logic specification for ACIP recommendations. Version 4.3

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  • English

  • Details:

    • Alternative Title:
      Logic specification for ACIP recommendations
    • Description:
      In 2019, approximately 96% of U.S. children under the age of six participated1 in an Immunization Information System (IIS), an increase from 82% in 2010. 2 Adolescent participation in 2019 was 82%, up from 60% in 2010. Adult participation in 2019 increased to 60% up from 22% in 2010. Given this widespread IIS participation, it is important that each patient’s immunization record is consistent and up to date within an IIS.

      Health Information Systems (HIS) – which can include Health Information Exchanges (HIEs), IIS, Electronic Health Records (EHRs), and others – provide healthcare providers with immunization evaluation and forecasting tools designed to automatically determine the recommended immunizations needed when a patient presents for vaccination. These recommendations are developed by the Advisory Committee on Immunization Practices (ACIP). ACIP is a federal advisory committee responsible for providing expert external advice and guidance to the Director of the Centers for Disease Control and Prevention (CDC) and the Secretary of the U.S. Department of Health and Human Services (DHHS) on use of vaccines and related agents for control of vaccine-preventable disease in the United States. Recommendations include but are not limited to age for vaccine dose administered, number of doses, dosing interval, risk factors, precautions, and contraindications.

      After ACIP recommendations are published, technical and clinical subject matter experts (SMEs) work to interpret and integrate them into their evaluation and forecasting engines. An example of an evaluation and forecasting engine is a tool an IIS might use to alert a physician that a presenting child is overdue for a Measles, Mumps, and Rubella (MMR) vaccination. New ACIP schedule changes are currently communicated only through clinical language, in publications like the Morbidity and Mortality Weekly Report (MMWR) and the Epidemiology and Prevention of Vaccine-Preventable Diseases ("The Pink Book"). The translation of that clinical language into technical logic that is processed within evaluation and forecasting engines is a time-consuming and complex process that happens mostly independently within the different HIS. Due to the challenge of interpreting clinically written ACIP recommendations, clinical decision support (CDS) engine outputs often vary and do not always match the expectations of clinical SMEs.


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