SVIS - Immunization Info Systems Interview

Form Approved

OMB No. 0920-0879

Exp. Date 04/30/2017

ATTACHMENT – H: Interview Instrument

Immunization Information Systems Examination of Services and Value Project

IIS Interview Data Collection Instrument

Interview Introduction

The purpose of this interview is to better understand the unique challenges and characteristics of each IIS as well as to give the opportunity for the IIS to further elaborate on assessment responses. The responses will ultimately help CDC to provide better support for IIS.

Prior to the interview, the project team has reviewed a number of existing data sources to inform us about your IIS. The data sources include: your responses from the online assessment, 2012 IISAR, your IIS Business Plan, conference presentations and any other relevant research.

The interview consists of 4 sections and has a total of 15 questions. The interview should take no more than 2 hours to complete. You may want to include other members of your organization who can assist you in answering the interview questions. Please note: The expectation is that the online assessment will have been completed prior to the interview.

If you have any questions regarding this interview or would like to provide any additional information, you can contact Anne Cordon via email at [email protected] or via phone at 470-246-4218.

Section 1 – Process and Organization

In reviewing your responses to Q 1 in the online assessment, we would like you to please elaborate on any challenges related unmet needs,

1. For the functions indicated as having a rating of less than optimal, please describe any specific issues or challenges related to performing these functions.

• Prompt: For the functions listed in Q1 in the online Assessment, please summarize how you are performing each function.

Notes:

2. Has your IIS implemented any new processes or quality improvement initiatives in recent years? If so, please describe the initiative and the results.

1. Was there any realized cost savings or efficiency?

2. What was the result (e.g. was the gain operational or technical?)

• As respondent is mentioning different initiatives, be sure to capture the following data points: Initiative name, primary focus, major activities, cost/level of effort, and results – operational and/or technical. If the interviewer is unable to capture the data point from the respondents answer, prompt with any of the following questions to ascertain the missing data point(s):

• Prompt: What is the name of initiative?

• Prompt: Can you describe the initiative? Was it primarily focused on quality or on process?

• Prompt: What were the major activities involved?

• Prompt: What was the cost/level of effort? (e.g. financial cost, staff hours, etc.)

• Prompt: What were the results? Were the gains mostly operational or technical?

Notes:

3. Please describe where your IIS resides organizationally in relation to the broader immunization program.

• If the respondent needs clarification on what is meant by “relation to the broader immunization program”:

• Prompt Some aspects of the relationship we are interested in include: value of the IIS to immunization program goals, program management, sharing of any costs, services, infrastructure, staff, etc... And whether it is a collaborative, combative, or indifferent relationship.

Notes:

4. Describe the relationship of the IIS to the rest of your public health agency in terms of inter-related programmatic goals and objectives, shared resources, etc.

• If the respondent needs clarification on what is meant by the “relationship with the rest of the PHA agency”:

• Prompt: For example, what is the priority of the IIS? Where does it fit in, especially with other IT projects or infrastructure or staff? What is the perceived importance of IIS and support for IIS initiatives? Value of IIS services?

• Prompt: For example, how is the data used outside of the immunization program? What integration exists with other programs for improving health?

• Prompt: For example, use of IIS functionality for other public health services such as HIE data exchange? Emergency preparedness/ outbreak response / patient safety response, etc.

Notes:

• 4a. Prompt: If clarification is needed from assessment: What is your IIS staff breakdown?

• Where do your resources reside by resource type?

• What is the FTE count by resource type?

• How many FTEs are dedicated to the IIS?

• Prior to the interview, interviewer will review assessment responses and check for any “N/A” or “Don’t Know” or unclear responses. For each that exist, please follow one or more of the following prompts (depending on the situation) to elicit more clarity:

• Prompt: If you would like to elaborate upon any of your responses from this section of the Online Assessment, please discuss here.

• Prompt: In the assessment, we noticed that you wrote [N/A, Don’t Know] for Questions(s) [reference questions number]. Can you please clarify your responses?

• Prompt: In the assessment, your response to Question(s) [reference question number] was unclear to us. Can you please clarify your responses?

5. What are the major [operational] challenges experienced by your IIS? (e.g. staffing, skill gaps, technology, process, etc.)

• If the respondent is unsure about what the skill gaps may be:

• Prompt: Major skill gaps may include HL7, activities related to Meaningful Use such as onboarding, exchange with EMRs, analytics, etc.

• Prompt: Other operational challenges could include funding, leadership support, inefficient equipment, etc.

Notes:

6. What are the five most significant attributes or critical success factors that characterize your IIS? This could be related to processes, technology, leadership and relationships, resources, etc.

   1. Could any of these attributes be shared or represent a significant value to other IIS?

   2. For those IIS s functions and support services indicated in questions 3 and 5 of the online assessment that were rated as very feasible to share , please elaborate. Please describe any technical, organizational/legal and architectural implications for sharing.

   3. If shared services were available, which ones would you be most interested in and willing to use?

Notes:

Interviewer Prompt: “Is there anything else you would like to add that we have not covered in this section on Process and Organization?”

Section 2 – Stakeholder Relationships

Stakeholders

• Centers for Disease Control and Prevention (CDC )

• American Immunization Registry Association (AIRA)

• Association of Immunization Managers (AIM)

• Health Information Exchanges (HIE)

• Immunization Programs

• Hospitals

• Primary Care Providers

• Specialty Care Providers

• Department of Defense (Armed Forces)

• Department of Veterans Affairs (VA)

• Health Plans

• Indian Health Centers/Clinics

• State/County/City Health Departments

• K-12 Schools

• Colleges

• Patients/Clients

• Women, Infants and Children (WIC)

• Child Welfare Programs (TANF, Foster Care, Juvenile Justice)

• State Medicaid Program

• Retail Pharmacies

• Accountable Care Organizations

• Electronic Health Record Vendors

• Vaccine Manufacturers

• Public Health/Immunization Coalitions

• Medical Associations

• Others

7. Please describe your key relationships with the above stakeholders as applicable.

   1. Unique aspects

   2. What are the most valuable services your IIS provides to these stakeholders and why do you say that?

   3. For the reports that you indicated as highly valuable on the online assessment, why do you say that and how does your IIS produce these reports (ad-hoc, automated, user generated, etc.).

• Do you have ways of measuring the value to stakeholders? For example, can you estimate a percentage of stakeholders that use a specific report or functionality such as immunization coverage or vaccine inventory?

Notes:

8. Has your IIS had any particular successes and/or challenges in dealing with any of these stakeholders? If so, please elaborate.

• If the respondent does not elaborate fully on the successes or challenges, prompt them to describe:

• Prompt: What was the situation?

• Prompt: What is the type of relationship/interaction?

• Prompt: What was the outcome?

• Prompt: What are factors that were important in the outcome?

• Prompt: Were there any lessons learned from this relationship?

• Prompt: Would you be able to share your experience with other IIS?

Notes:

9. Please describe on-going or future initiatives, challenges and commitment to IIS interoperability with other systems.

• If not addressed in #8, describe the support and coordination for IIS interoperability from the technical community outside of your agency IT (e.g., IIS vendors, EHR vendors, etc.).

Notes:

Interviewer Prompt: “Is there anything else you would like to add in this section?”

Notes:

Section 3 – Financials

Prompt - Review and validate financial input responses from assessment.

“Please elaborate on the maintenance, development, management costs of running your IIS.” (Ask as needed.)

10. Please elaborate on any unique sources of funding or successes in obtaining funding for your IIS (identified in the assessment) in the past 3-5 years.

    1. Can any of your unique funding strategies be shared with other IIS as a potential best practice? If yes, please elaborate.

    2. Any financial support and management for IIS interoperability received by your IIS.

    3. Are there any new funding sources your IIS plans to pursue in the future? Which and why?

    4. Do you have any ideas about potential, non-traditional funding sources?

• Prompt: Are there potential funding opportunities if resources were available to pursue them?

• Prior to the interview, interviewer will review assessment responses and check for any “N/A” or “Don’t Know” or unclear responses. For each that exist, please follow one or more of the following prompts (depending on the situation) to elicit more clarity:

• Prompt: If you would like to elaborate upon any of your responses from this section of the Online Assessment, please discuss here.

• Prompt: In the assessment, we noticed that you wrote [N/A, Don’t Know] for Questions(s) [reference questions number]. Can you please clarify your responses?

• Prompt: In the assessment, your response to Question(s) [reference question number] was unclear to us. Can you please clarify your responses?

Notes:

11. What are the 3-5 most impactful factors or trends that drive cost in your organization?

• What is your IIS doing to address those issues?

• Do you foresee any challenges for your IIS?

• Do you anticipate having to make any changes as a result of increased costs or reduced budget?

• If the respondent needs clarification on what is meant by “factors”:

  • Prompt: For example: internal factors (within your IIS or immunization program) or external factors (stakeholder demands, legislative mandates, etc.)

Notes:

12. Is your IIS currently providing or planning to provide any services or products that could bring in funding/revenue in some way and support your program? If so, please elaborate.

• Prompt: Describe the obstacles or barriers from preventing your IIS from capturing any funding now?

• Prompt: Has your IIS considered offering any additional services or making changes or enhancements that would make them more valuable to your stakeholders?

• Prompt: Has it been discussed within your IIS / public health system?

• Prompt: Has your IIS discussed it with any external stakeholders?

• If the respondent needs clarification on what is meant by “revenue-generating services”:

  • Prompt: For example, what services do you provide which are financially valuable to stakeholders? Do you think these stakeholders would pay for that service? For example, could certain reports, services, or access to data be charged for?

• If the respondent answers affirmatively that they have considered making changes to reports to justify charging: “Please describe:

  • Prompt: Which reports and what changes/enhancements have been made or considered?

  • Prompt: Which stakeholder(s) would receive the reports?

  • Prompt: Did the stakeholder(s) request the changes?

  • Prompt: Have you considered what the charge for the report(s) would be?

  • Prompt: Have you explored if the revenue from the report(s) would benefit your IIS

Notes:

Interviewer Prompt: “Is there anything else you would like to add in this section on Financials?”

Notes:

Section 4 –IIS Environment

12. Please describe any potential changes in your jurisdiction’s legal framework affecting IIS. This might include mandates in legislation or regulation, or departmental policies.

• Prompt: Support for your IIS interoperability efforts from your jurisdiction’s legislative and departmental leadership.

• Prompt: The governance model for IIS interoperability including any specific policies.

• Prompt: Expanding access/mandated reporting

• Prompt: Creating constraints on your IIS.

Notes:

12. Describe your IIS’s place in the Enterprise Architecture (EA) of your organization/parent organization. Existing architecture diagrams with a brief explanation will be sufficient. Please include current and future plans if applicable. <Please let us know if you can provide us with any existing architecture diagrams>

• If respondent needs clarification on what is meant by “Enterprise Architecture”:

  • Prompt: EA describes how your IIS information, processes and technology fit within your parent organization or the larger “enterprise” e.g. your Executive Office of Human Services. Your IIS may be a standalone system, hosted in a separate environment, or it may share components of with other systems, etc. Does your IIS stand on its own? If not, how does it fit in the larger IT structure?

1. Describe any advantages your EA gives your IIS (e.g. organization or technical strategies, shared services, etc. as an interface engine.)

• If respondent needs clarification on what is meant by “advantages”:

  • Prompt: For example, you may get great technical resources because you are part of the larger IT enterprise.

b) Describe any constraints your IIS faces given your architecture.

• If respondent needs clarification on what is meant by “constraint”:

• Prompt: For example, there are difficulties you face in response time for changes, IT help, funding for system enhancements etc. based on where your architecture is housed.

3. Please describe any future changes (under way or planned) in relation to your enterprise architecture.

Notes:

14. In the context of the changing healthcare landscape, what do you believe should be the top 3-5 priorities for IIS in the next few years?

Notes:

Notes:

Interviewer Prompt: “Is there anything else you would like to add in this section?”

Conclusion

Thank you for your participation in this interview. Your responses will ultimately help CDC to provide better support for IIS.

If you have any questions regarding this interview or would like to provide any additional information, you can contact Anne Cordon via email at [email protected] or via phone at 470-246-4218.

Public reporting burden of this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74,  Atlanta, Georgia 30333; ATTN:  PRA (0920-0879).