HL7 Protocols
American Samoa Department of Health Immunization Division (ASDoHID)

Secure Patient Information between two entities

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At a glance: ​  The demand for electronic health information exchange among care professionals is growing along with nationwide efforts to improve the quality, safety, and efficiency of health care delivery. Meaningful use requirements, new payment approaches that stress care coordination, and federal financial incentives are all driving the interest and demand for health information exchange. 

Data  Exchange  Updates

Version	Date	Notes
1.1	March 2022	Modification to template in consultation with jurisdiction
1.0	February 2022	Modification in advance of stakeholder template review
0.2	November 2021	Simplified and removed word form elements
0.1	June 2021	Draft shared with jurisdictions receiving onboarding technical assistance

Background

Organizational onboarding contact
Provide contact information for the person responsible for oversight and coordination of the organization’s onboarding efforts.

Name

Title/role

Email address

Phone number

Electronic health record information
Provide information about your organization’s electronic health record (EHR) system that will be used in data exchange with the IIS. 
EHR vendor/developer

How long has your EHR product been in use by your organization? 

Immunization information
Provide information about your organization’s immunization practice.
Does your organization administer immunizations? 
Select one
☐ Yes
☐ No
If yes, does your organization administer publicly purchased vaccine? (E.g., Vaccines for Children vaccine)
Select one
☐Yes
☐ No
☐ Unknown

General Protocols

Data exchange registration information
Provide information about the reason for the data exchange registration. 

Reason for data exchange registration
Select one
☐ Establish a new interface
☐ Change to an existing interface
Indicate desired transport. SOAP Web Services is preferred; if alternate is selected, indicate reason.
Select one
☐ SOAP Web Service, CDC WSDL
☐Other 

Indicate desired message format. HL7 2.5.1 is preferred; if alternate is selected, indicate reason.
Select one
☐HL7 2.5.1
☐Other 

​Indicate desired interface type (Submission only is the currently enabled functionality, but please let us know if other interface types may be desired for possible future deployments)
Select one
☐Submission with query
(Allows for the reporting of data from EHR to IIS; also allows for clinicians to access patient immunization information from the IIS while working within their EHR.)
☐ Submission only 
(Allows for reporting of data from EHR to IIS.)
☐ Query only 
(Allows for clinicians to access patient immunization information from the IIS while working within their EHR.)
If change to an existing interface, indicate change(s)
Select all that apply
☐ Change in transport
☐ Change in message format
☐ Addition/removal of facility/facilities
☐ Add query and response messaging
☐ Transition in EHR system
If change to an existing interface, describe change(s) indicated

Examples

Registration for Data Exchange with the American Samoa Department of Health Immunization Division (ASDoHID) WTIR

Complete this Registration Form to register your desire to exchange data with the 

Organization address (street, city, state, ZIP)

Type of organization
Select all that apply