As 2024 comes to an end, it is an opportune time to reflect back on all we have accomplished over the past year and where we go in the New Year. The year started off with Immunization Information Systems (IIS) asking, “where does IIS fit into the Data Modernization Initiative (DMI)”? Though DMI officially launched at the end of 2019, immunization programs had their hands full with the COVID pandemic response, which only made the need for DMI even more relevant and crucial to public health.
The Public Health Infrastructure Grant (PHIG) initially focused funding on disease surveillance and data analytics platforms aligned to CDC’s five DMI key priorities: Building the Right Foundation, Accelerating Data into Action, Developing a State-of-the-Art Workforce, Supporting and Extending Partnerships, Managing Change and Governance. Each of these priorities pertains to IIS, but it was not stated explicitly until CDC identified immunization data as one of the core data sources within the Public Health Data Strategy. With this public declaration, immunization programs considered how they might gain a seat at the DMI table and what role they might play in the overall data modernization program. Through our interaction with various jurisdictions, HLN identified several strategies to highlight IIS’ connection to DMI with its robust patient demographic and vaccination data, its breadth of electronic data exchange among many diverse partners, especially since the pandemic, including healthcare providers, hospitals, pharmacies and federal partners through the Immunization Gateway (IZG), its acute attention to data quality, and its foray into emerging technologies such as FHIR.
The strategies became more relevant in August 2024 with IIS as a recipient of additional PHIG funding geared specifically to modernizing immunization information systems. Though some IIS projects did not receive the grant directly, the funding was earmarked for IIS and therefore the program finally had a seat at the table and a voice in how the funding might be spent.
While the COVID pandemic response highlighted the strengths and limitations of the IIS and its data, the DMI funding underscores the need to modernize antiquated technology that has spurred IIS since the mid-late 1990s. Programs began assessing their IIS to identify and prioritize gaps, implement strategies to update the IIS technology and workforce, and determine ways to facilitate electronic data storage, access and use. With this momentum of activity and funding behind them, the next question is, where does IIS go from here?
This is a question many of us within the immunization community have been discussing for several years. We recognize the competing forces driving IIS further from the limelight experienced during the pandemic and acknowledge the potential impact from the administration change that will likely yield legal, fiscal, and regulatory changes for vaccines and IIS. While we do not have a crystal ball, we do have deep community-wide understanding and engagement in figuring out what is next for IIS. Discussions regarding the next generation of IIS generated ideas of various ‘pillars’ or criteria that could be considered fundamental to an IIS. Pillars of reliability, scalability, flexibility, and sustainability were raised initially along with substitutable, pluggable, swappable, cost-effective, and easy to acquire. These criteria, as well as the details of the specific tools or techniques to erect these pillars, will need to be discussed further within the IIS community and once agreed, will need to be prioritized by each jurisdiction. However, there seems to be consensus on the need to define a path forward, assess a program’s existing platform, and prioritize the required pillars to implement a modernized IIS.