Clinical decision support for immunization (CDSi)
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      Immunization clinical decision support (CDS), more commonly referred to as evaluation and forecasting, is an automated process that determines the recommended immunizations needed for a patient and delivers those recommendations to the healthcare provider. Health Information Systems (HIS), which include Immunization Information Systems (IIS), Electronic Health Records (EHRs), and Health Information Exchanges (HIEs), create CDS tools based on schedules and guidelines developed by the Advisory Committee on Immunization Practices (ACIP), a federal advisory committee responsible for providing expert external advice and guidance on the use of vaccines and related agents for control of vaccine-preventable disease in the United States. ACIP 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 CDS engines. New ACIP schedule changes are currently communicated only through scientific 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 scientific language into technical logic that can be processed within CDS engines is a time-consuming and complex process that happens mostly independently within the different HIS. Because interpretation of clinically-written ACIP recommendations can be challenging, CDS engine outputs often vary and do not always match the expectations of clinical SMEs.


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