Electronic Health Record (EHR) Interoperability with the Michigan Care Improvement Registry (MCIR)

Faculty Contact: Kevin J. Dombkowski, DrPH, MS

For over a decade, immunization providers have had the capability to send information electronically to the Michigan Care Improvement Registry (MCIR) regarding vaccination doses administered by their practices. Recent initiatives by the Michigan Department of Health and Human Services (MDHHS) have focused on enabling such transfers to take place in real-time through automated connections between practices' electronic health record (EHR) systems and the MCIR using transactions conforming to industry-standard HL7 messages. The same standards-based messaging approach can be used to send a patient's complete vaccine history from MCIR to practices' EHRs to achieve bidirectional interoperability. Enabling such standards-based exchanges between EHRs and MCIR will enable wide participation by practices, permitting information for all vaccine doses to be available for immediate use in both systems in real time.

Our objective is to evaluate MCIR data quality following the initiation of electronic immunization data exchange using real-time HL7 messaging from EHRs.  We will assess the timeliness, completeness and accuracy of data transfers to and from MCIR.

We will develop an evaluation plan that assesses the degree to which changes in electronic reporting to MCIR may be evident among primary care practices and retail pharmacies located throughout Michigan. Evaluation will include a diversity of sites using MCIR, varying across several characteristics, including:

  • geographic region of Michigan;
  • EHR vendor products;
  • health system affiliation; and
  • health information exchanges (HIEs).

In addition, we will assess changes relative to the method used to report immunizations to MCIR prior to the HL7 interoperability intervention (i.e., either manual keyboard entry or electronic file transfers). We will use data obtained from MCIR databases to assess the degree to which key immunization data quality metrics may have changed among doses reported for children and adults as well as to identify opportunities for improvement to facilitate statewide implementation of real-time bi-directional interoperability between EHRs and MCIR.

For more information, please contact:
Kevin J. Dombkowski, DrPH, MS
University of Michigan
Child Health Evaluation and Research (CHEAR) Unit
300 North Ingalls Building, Room 6D05
Ann Arbor, MI 48109-5456
Telephone: (734) 615-6758 FAX: (734) 764-2599
Email: kjd[at]med.umich[dot]edu