Immunization Repository for a Large Healthcare Delivery System

Client

Our client is one of the largest not-for-profit hospital and physician networks in the United States with over 15,000 providers and over 2 million patients under care.

Background

To comply with government guidelines and improve continuity of care, our client is developing an
enterprise-wide registry of immunization records for all patients across 11 hospitals and affiliated
outpatient clinics. This initiative coincides with their multi-year implementation of the Epic EMR
system, which will ultimately import both real-time and legacy immunization data.

Challenge

Hospitals and outpatient clinics within the client’s network utilize various EMR and ambulatory
systems, from different vendors and even in-house development. These systems hold over 40 million legacy immunization records accumulated over several years. Unfortunately, the data quality is inconsistent (“dirty”) with significant structural and content variations, even within the same system. Preserving the historical sequence of data across all systems is crucial. However, historical inconsistencies and ongoing edits by clinicians (both current and past records) make importing legacy and current immunization records concurrently a significant challenge. To address this, the organization has implemented a temporary ban on editing current records until the legacy data import is complete. This decision creates strict time constraints for importing the vast amount of legacy data.

Solution

For over two years, a joint team of Clinovera and client engineers, medical informaticians, analysts, and hospital IT staff collaborated to design a sophisticated process and infrastructure. This system populates the immunization repository with historical and real-time data, enabling export to Epic and government agencies. We developed 13 interfaces: inbound from client systems and outbound to Epic and the state vaccination registry.