Creating an immunization content database for knowledge management across clinical systems

Abstract

Purpose: A initiative at an academic medical center to create a single database of immunization-related content to inform the build and configuration of immunization-related knowledge assets across multiple clinical systems is described.

Methods: Semistructured expert interviews were conducted to ascertain the immunization information needs of the institution's clinical systems. Based on those needs, an immunization domain model constructed with data available from the Centers for Disease Control and Prevention (CDC) website was developed and used to analyze and compare current immunization-related content from CDC data sources with the content of the institution's clinical systems.

Results: Five identified clinical systems that used immunization-related content collectively required 22 unique information concepts, 11 of which were obtainable from CDC vaccine code sets. The proportion of vaccines designated by CDC as active products (i.e., currently available administrable vaccines) that were included in the 5 clinical systems ranged from 59% to 95%; in addition, some non-active-status vaccines were listed as active-status products in the various clinical systems. Upon further review, updates to immunization-related content in the 5 clinical systems were implemented.

Conclusion: Creating a single database for immunization-related content based on CDC data facilitated an explicit and tractable knowledge management process and helped ensure that clinical systems had correct and current content. The immunization domain model created has the potential to assist in the automated detection of updates and relaying those updates to the applicable clinical systems.

Keywords: clinical decision support; clinical knowledge management; data management; immunization; information retrieval; information systems.