Clinical decision support for immunization (CDSI) : logic specification for ACIP recommendations. Version 1.8
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Clinical decision support for immunization (CDSI) : logic specification for ACIP recommendations. Version 1.8

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  • Alternative Title:
    Logic specification for ACIP recommendations
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  • Description:
    Currently, Health Information Systems (HIS) – which can include Health Information Exchanges (HIEs), IIS and Electronic Health Records (EHRs) – provide healthcare providers with immunization evaluation and forecasting tools designed to automatically determine the recommended childhood 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 age for vaccine administration, number of doses, dosing interval, and 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.

    In an effort to harmonize the outcomes of existing HIS CDS tools, the Immunization Information System Support Branch (IISSB) at the CDC funded the Clinical Decision Support for Immunization (CDSi) Project to develop new clinical decision aids4 for each vaccine on the children’s immunization schedule to:

     Make it easier to develop and maintain immunization evaluation and forecasting products

     Ensure a patient’s immunization status is current, accurate, consistent, and readily available

     Increase the accuracy and consistency of immunization evaluation and forecasting

     Improve the timeliness of accommodating new and changed ACIP recommendations

    The outcome of enabling the above results is to ensure that patients receive proper immunizations, i.e., “the right immunization at the right time.”

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