MIIC News Flash - October 2022

Minnesota Department of Health sent this bulletin at 10/17/2022 09:51 AM CDT
Minnesota Department of Health

MIIC News Flash - October 2022

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October 17, 2022

Happy 20th Birthday, MIIC!

MIIC first went live as a statewide immunization information system (IIS) in September of 2002. Providers, local public health, and state workers all put in an enormous amount of work to make MIIC a useful system to meet public health needs. The MIIC team interviewed a few of the founders and early leaders of the system to capture the history of this cornerstone of immunization practice in Minnesota. We heard some incredible stories and wanted to share some of this history with all of you, our loyal users and readers!

Sneakernet

Did you know one of the earliest versions of MIIC ran on a “sneakernet”? In the mid-1990’s, local public health agencies throughout the state began surveying community stakeholders to identify barriers to keeping kids up-to-date with their routine childhood immunizations. Two primary barriers identified were the difficulty in maintaining a complete immunization record and frequent changes in the recommended immunization schedule, making it difficult to know when a child was due for another immunization. The Minnesota Department of Health (MDH) created a physical rolodex of index cards for local public health agencies to track children’s immunization records and to know when to notify parents their child was due for vaccination. To support this, data needed to get from the providers to local public health. But how? This was well before the heyday of the Internet and data exchange.  

Countryside Public Health found a creative solution. They would send floppy disks to immunizing providers in padded envelopes. For all the younger folks reading this, a floppy disk is the thing the ‘save’ icon in Microsoft Office is modeled after. Providers would export the immunization data from their clinic’s systems to this floppy disk and then mail it back to Countryside. Public health would upload the data into their regional registry and share back with the providers the full immunization history for any pediatric patients, plus what immunizations were needed and when. Public health also used the data to look at immunization coverage rates throughout their region. This exchange of data was referred to as a sneakernet because data had to be physically “walked” from one place to another, instead of relying on electronic sharing of data like we do now.  

Number of Immunizations in MIIC

Founding

In the late-1990’s, fueled by increased Internet use and concerns about potential problems with computers when the date changed from 1999 to 2000 (commonly referred to as Y2K) would impact local immunization registries, a push was made for to centralize the system. MDH explored several options before selecting a platform developed by the State of Wisconsin. This software came to be known as the Minnesota Immunization Information Connection, or MIIC. In September of 2022, the MIIC application went live and became available to providers in Minnesota through a web-based user interface.

Use of MIIC quickly caught on. By December 2003, more than 400 organizations were participating in MIIC and there were about 300,000 client records, representing almost 3 million immunizations. By 2004, those numbers jumped to almost 1 million individual records with 9 million immunizations. In those early days of MIIC, providers batched their immunization data into large files that they would login to MIIC and upload daily, weekly, monthly, or even quarterly. Some immunizations were hand-entered on a client’s record.
Did you know the immunization spreadsheet was born out of the H1N1 pandemic?

Growth

By 2005, MIIC became ready to receive electronic immunization messages. Four years later real-time data exchange was implemented. By 2013, MIIC was receiving as many as 6,000 real-time messages in a single day. In 2018, more than 4,000 sites were sending immunization data to MIIC electronically, with nearly half of those sites sending data in real-time. MIIC was receiving on average 600,000 update messages per month and 1 million query messages per month.

These numbers continued to grow during the COVID-19 pandemic response. Seeing the need for providers to query MIIC data for large portions of their patient population, the MDH team worked to implement a MIIC Data Lake and MIIC Bulk Query process. The MIIC Bulk Query process allows providers to upload a query file in a separate application and receive MIIC data back. This process lets providers query MIIC data for a large number of patients quickly and without slowing down the entire MIIC application.
Childhood Immunization Summary

Data use

MIIC was built on the premise that immunization data should be used to improve population immunization coverage. State and county childhood immunization coverage data and maps have been publicly available through the MN Public Health Data Access website since 2012. Since 2008 the Assessment Reports feature in MIIC can generate childhood immunization coverage rates for clinic or county populations. Adolescent immunization Assessment Reports were implemented in 2013. In July through September 2022, more than 900 childhood and adolescent immunization Assessment Reports were generated by MIIC users.  

In 2011, MDH initiated the first population-based reminder/recall project, which used MIIC data to send letters to individual in high-risk zip codes who were due or overdue for routine immunizations. In 2012, the MIIC team implemented the Client Follow-up function. MIIC users can employ this function to create cohorts of patients who are not up to date on immunization and send them communications to come in for those shots.
Did you know MIIC receives immunization data for Minnesotans from other states?

MIIC today

Currently, MIIC contains about 9 million client records, representing more than 129 million immunizations. More than 6,000 organizations with over 15,000 active users participate in MIIC, representing a variety of provider types including clinics, hospitals, long-term care facilities, schools, and childcare centers. Today, most immunizations are reported electronically. In the first half of 2022 86% of immunizations were reported to MIIC through electronic data exchange, compared to 8.7% reported through upload of the immunization spreadsheet and 5.4% hand-entered.

Thank you to everyone who has made MIIC a success these past 20 years. Thousands of providers can use MIIC data to inform clinical decisions and public health practice; reach out to individuals due or recommended for immunizations; and assess community-level immunization coverage rates because of this decades long project! As we look forward to the future of MIIC, we can’t wait to continue building partnerships to ensure all Minnesotans receive the right vaccine at the right time. Here’s to the next 20 years!

Exception screen directions

Occasionally when using MIIC you will reach a red ‘Error Report’ screen. The MIIC team tracks how often these error screens display and relies on comments provided to further investigate common issues.

If the red ‘Error Report’ screen displays for you while using MIIC, please enter the following information into the comments box:

  • What function you were using?
  • What browser you were in when the screen appeared (e.g., Edge, Chrome, Firefox)?
  • What action you took before the screen appeared?
  • Other import information (e.g., if you were entering an immunization which vaccine was it).

After typing the information in the comments box, click the ‘save’ button before leaving the page.

Error report screen

Find My Immunization Record

Individuals who are looking to access their MIIC immunization record or for more information about their MIIC immunization record can find that information on Find My Immunization Record. This page includes information on how individuals can access their MIIC immunization record and answers to frequently asked questions.

If individuals contact you to access their MIIC immunization record, you should print and share a copy with them. For more information, refer to our Client Search and Printing Immunization Records MIIC User Guidance and Training Resources.

Client follow-up: COVID-19 doses report has expanded

The COVID-19 doses report will now show up to five COVID-19 doses for each client. The COVID-19 doses report is only available when using COVID-19 as the Vaccine Type when creating a client follow-up cohort. Users can use client follow-up to identify clients who are recommended and/or overdue for selected vaccines and conduct follow-up to those individuals. Learn more about Using Client Follow-Up.

Save the date: MIIC Biannual Webinar Series

MIIC is hosting a four-part webinar series on Tuesdays from 11:30 a.m. – 12:30 p.m. from Oct. 25 to Nov. 22 (excluding election day, Nov. 8). Registration is not required and Continuing Education Units (CEUs) will be available. The topics and links to webinar are listed below.

For questions or help accessing the meeting information and links to join, please contact the MIIC Help Desk at health.miichelp@state.mn.us. Hope to see you there!

Reminder: All organizations should have an active administrator

Per the Data Use Agreement (DUA) all organizations must sign to participate in MIIC, organizations must “designate an Administrator for MIIC who is responsible for establishing and overseeing individual user accounts within the Organization.” A MIIC administrator is responsible for creating and maintaining user accounts within your organization. The creation, activation, deactivation, and updates to user accounts should be done by the administrator.

A recent enhancement in MIIC now allows schools and other organizations with ‘Read Only’ access to MIIC to designate a person(s) to manage the user accounts themselves directly within MIIC. Discuss as an organization to ensure everyone knows who the designated MIIC Administrator is. If you’re not sure, or if your organization has not yet designated a MIIC Administrator, reach out to the MIIC Help Desk with your organization code at health.miichelp@state.mn.us.  

Reminder: Schools can query MIIC using the bulk query function

There is a function available for schools to bulk query MIIC for student immunization data. For public and charter school users, this functionality is available within the AISR application you are familiar with. For private school users, this functionality is available in a similar application, the Student Immunization Query Tool. The bulk query tool allows you to upload a list of enrolled students to generate several output reports, including full vaccination histories, COVID-19 vaccination history, and aggregate COVID-19 vaccination rate data.

Schools are encouraged to utilize this new bulk query function in place of the Submit Client Query function within MIIC.

The bulk query function is available for K-12 schools, both public and private, as well as institutions of higher education (IHE). However, private schools and IHE must use a separate version of the application. The links to both versions of the application and their user guides are available under “Bulk query function” on School Health Personnel Immunization and Disease Reporting.

The bulk query function is for student immunization data only.