Staff Spotlight: Kevin J. Dombkowski

Kevin Dombkowski, DrPH, MS, has been partnering with public health agencies and health care providers for over a decade to evaluate the effects of electronic data exchange between electronic health record (EHR) systems and immunization information systems (IIS). During this period, a dramatic increase in the adoption of EHR systems has taken place, with nearly 90% of office-based physician in the U.S. having adopted their use in clinical practice. 

Dr. Dombkowski partnered with the Centers for Disease Control and Prevention (CDC) to better understand how immunization providers in Michigan use EHR interoperability with our statewide IIS, the Michigan Care Improvement Registry (MCIR). The widespread use of EHRs physician practices had led to the integration of these systems throughout patient workflows as well as to foster electronic data exchange between healthcare providers. Through detailed telephone interviews and on-site observations with 45 provider practices in Michigan, Dr. Dombkowski’s team (Anne Cowan, Pooja Patel, Hannah Peng) assessed how vaccination workflows may be impacted by EHR / IIS interoperability. 

A few key findings are summarized here across the steps that typically comprise the workflow of a vaccination visit.

Implications of these findings: 

• These processes have impacts on practices’ EHR data quality, as well as that in MCIR.  Accurate assessment of patients’ eligibility for vaccines using either EHRs or IIS requires accurate reconciliation of doses, which can be a time-consuming process.
• Although interoperability may include some time savings to practices, there are other data reconciliation processes that may offset some of those time savings
• Strategies to facilitate the efficient reconciliation of information between MCIR and EHRs may lessen the burden on staff time