Integrating the MIIS into Your Clinical Practice
Thank you for your interest in using the Massachusetts Immunization Information System (MIIS) at your site. Before you ‘go-live’ with the MIIS, you will need to plan for and implement the following tasks: 1) create an organization-wide plan to meet the requirements of the July 2010 law requiring that providers inform patients about the MIIS, 2) register your users, and 3) train users on the MIIS.
Informing Patients
In July 2010, state legislation was passed (M.G. L. c. 1 11, s.2 4M) establishing the MIIS and mandating that:

All licensed healthcare providers who administer immunizations shall report to the immunization registry such data related to immunizations as the department determines is necessary for disease prevention and control.

Licensed health care providers administering vaccinations shall discuss the reporting procedures of the immunization registry with the persons receiving the vaccinations and their parents or guardians, when appropriate, and advise them of their right to object to the sharing of such information.

When organizations ‘go-live’ with the MIIS they must routinely inform patients about the MIIS and their right to limit the sharing of their immunization information with other providers using the system.
Tools for Informing:
Tools to assist with informing patients are available such as the MII S Fact She et. Additional materials are also available to assist with informing. These materials are available to all providers and can be downloaded from the MII S Resource 
 Center .

Give the MII S Fact Sh eet f or Pare nts an d Patients to each new patient in your practice and to all patients having their first immunization encounter after your ‘go-live’ date. It is not necessary to document provision of the Fact Sheet.
Display a MI IS poster in your registration areas and waiting rooms.
Incorporate MII S sa mp le la ngua ge in your new patient information and registration materials informing patients that your site transmits data to the MIIS.
Use the MII S provider e ma il or l etter tem pla te to inform your patients that your site transmits data to the MIIS. Include a link to the MIIS F act Sheet for Paren t s and Pat ients .
Distribute information about the MIIS broadly, via e-mail, regular mail, newsletter, website postings, etc. to your patient population.
If you are a birthing facility, include the MII S Fact She e t for Parents a nd Pat ie nts in the packets for new parents.

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Data Sharing
Data sharing status reflects whether the patient has been made aware of the MIIS and understands that they have the right to limit access to their information. All patients in the MIIS have a data sharing status of either Yes, No, or Unknown.

A ‘Yes’ or ‘No’ status means that the client has been made aware of the MIIS and understands their right to limit other providers’ access to their information. The default value for data sharing in the system is ‘Yes’ - this allows any user in the MIIS to access the Immunization Record. Should a patient decide that they want to limit who has access to their information, data sharing must be changed to ‘No’ (see Objecting to Data Sharing below).

An ‘Unknown’ status is reserved for historical immunization information where the MIIS has not yet been discussed with the client. If you are entering historical information through the web interface for a patient who has not yet had an immunization encounter, you must switch data sharing to ‘Unknown.’ Historical data sent electronically to the MIIS prior to the facilities ‘go-live’ date will be set to ‘Unknown.’ If you search for a client in the MIIS and find that they have data sharing set to ‘Unknown,’ you will be prompted to change data sharing status to either ‘Yes’ or ‘No’ in order to view the record.

Objecting to Data Sharing
If a patient or parent objects to data sharing (or wants to withdraw a previous objection) they must fill out the MIIS
 Objection (or W ithdra wal of Object ion) For m . Your organization will need to determine who will be responsible for changing the patient’s data sharing status at your practice. The designated staff will login to the MIIS and change the patient’s data sharing status, then fax the form to the MIIS Help Desk at 617-983-4301 and retain the form in the patient’s file. If you are exchanging data with the MIIS, you must log on to the system and manually change the data sharing status of your patient; you are not able to electronically transmit data sharing status to the MIIS via HL7 messaging.

Registration
The MIIS is hosted on the Executive Office of Health and Human Services Virtual Gateway (VG). Registration forms for the MIIS and the VG must be completed for your site(s) and for each user. In order to streamline the registration process, the MIIS team has designed a provider portal called the MI IS Resource C enter . Using this website, providers will input the required site and user registration information and four mandatory registration forms will be generated:

MIIS Provider Site Registration Agreement (one per site) VG Services Agreement (one per site)
VG Designation of Access Administrator form (one per AA – see below)
MIIS Individual User Agreement and Confidentiality Statement (one per user)

Access Administrators (AA) are responsible for coordinating registration and user account management at your organization. We recommend that you have more than one AA at your site and for large organizations, at least one AA for each department. A senior official, such as your Medical Director, CEO, site manager and/or, designee needs to review and sign all of the registration forms.

Training
We recommend training for all users of the MIIS. Even sites that will exchange data electronically from their EHR to the MIIS will need to have users log in to the web based application of the MIIS in order to:

Search for immunizations given by another provider for a client new to your practice
Manage a patient’s data sharing status
Run reminder/recall reports or other practice-level reports
Use the advanced immunization forecasting functionality to assist with vaccine decision making
Order vaccine

Online resources, which include webinars and instructor-led group trainings will be scheduled in regional locations throughout the state on an ongoing basis. Please contact the MIIS Help Desk for more information at
 MIIS he lpd esk @m ass.gov or (617) 983-4335.

Next Steps
While you are determining your site’s technical readiness, please discuss the clinical integration processes described above with the leadership and administrators at your organization.

When your site goes live, you will either automatically transmit (providers with EHRs) or manually enter (providers with paper records) current immunizations from your ‘go-live’ date forward. After your ‘go-live’ date, when current immunizations have been successfully transmitted or entered, data quality will be reviewed by staff at your organization and at the Immunization Division.

For more information, please contact the MIIS Help Desk:

(617) 983-4335 or m iishe lp desk @m ass.gov