M&I Content Areas

		Pre-Measurement	Testing & Discovery	Assessment	Validation
	Transport	x	x	x	x
	Submission/Acknowledgment	x	x	x	x
	Query/Response	x	x	x	x
	Clinical Decision Support	x	x	x	x
	Data Quality Incoming/Ongoing	x	x	x	x
	Data at Rest	x	x	x
	Patient Matching – HL7	x	x	x
	Provider Participation	x	x
	Patient Matching – Extract	x

Transport

This content area evaluates IIS alignment with the CDC SOAP/Web Services transport standard. Since its adoption in 2012, support for this standard has significantly increased, with nearly all IIS demonstrating compliance. While IIS may continue to support other transport methods for legacy systems, the CDC SOAP WSDL has become the dominant standard within the IIS community, ensuring consistent and reliable data exchange.

Resources and Reports:

• Measures and Tests for IIS Assessment – Transport 
• Community-wide Town Hall meeting recording and presentation slides 
• Transport training videos: Transport 101, SOAP WSDL 101, and SOAP Transition Strategies
• Baseline and quarterly IIS Assessment Aggregate Status Reports: Transport
  
• Transport Validation Report - Basic Level
• Transport Validation Report - Complete Level
• Finalized IIS Validation Measures and Tests for Transport 
• Community-wide Town Hall meeting for Transport Validation recording and presentation slides 

Submission/Acknowledgement

This content area measures the ability of an IIS to accept HL7 v2.5.1 immunization update (VXU) messages and return acknowledgment (ACK) messages in alignment with the National IIS HL7 Implementation Guide. 

AART sends HL7 messages specifically to test if the IIS processes the messages, makes appropriate decisions, and responds back to the sender. The ACK messages from the IIS are checked for HL7 conformance using the NIST HL7v2 Immunization Test Suite.

Resources and Reports:

• Validation Report - Basic Level
• Validation Report - Complete Level
• Measures & Tests - VXU/ACK Validation
• Town Hall meeting recording- VXU/ACK Validation
• Aggregate Assessment Reports
• Measures & Tests - VXU/ACK Assessment 

Query/Response

This content area measures the ability of an IIS to return timely and appropriate HL7 v2.5.1 response (RSP) messages when external systems send query (QBP) messages for immunization-related data.

AART sends HL7 queries specifically to test if the IIS can appropriately make decisions and respond to the incoming message. The RSP messages from the IIS are checked for HL7 conformance using the NIST HL7v2 Immunization Test Suite. 

Resources and Reports:

• Validation Report - Basic Level
• Validation Report - Complete Level
• Measures & Tests - QBP/RSP Validation
• Town Hall meeting recording - QBP/RSP Validation
• Aggregate Assessment Reports
• Measures & Tests - QBP/RSP Assessment

Clinical Decision Support

This content area measures the capability and accuracy of the Clinical Decision Support (CDS) engine within the IIS to provide vaccination evaluation and forecasts for patients based on Advisory Committee on Immunization Practices (ACIP) recommendations.

AART leverages HL7 VXU and QBP messages to measure the capability and accuracy of three CDS concepts: Evaluation Status, Earliest Date, and Recommended Date.

Resources and Reports:

• Validation Report – Basic Level
• Validation Report – Complete Level
• Measures & Tests - CDS Validation
• Town Hall meeting recording- CDS Validation
• Aggregate Assessment Reports
• Measures & Tests - CDS Assessment

Data Quality Incoming/Ongoing

This content area measures the ability of an IIS to detect data quality issues for essential fields from data exchange partners.

AART sends HL7 messages that contain intentional data quality errors (e.g., vaccination date before birth) to test if the IIS can detect poor data quality. The IIS is also assessed on the ability to retain (and return) vaccination events from submission to query without changing the meaning (e.g., NDC mapped to CVX, return key information about a vaccination event). 

Resources and Reports:

• Validation Report – Basic Level
• Validation Report – Complete Level
• Validation Measures & Tests
• Town Hall meeting recording - DQI Validation
• Aggregate Assessment Reports
• Measures & Tests - DQI Assessment

Data at Rest

This content area measures the completeness, validity, and timeliness data quality elements of de-identified patient-level and vaccine-level data extracted from IIS production systems. The IIS generates a data extract for immunization records residing in their database for all patients ages 0-2 years. The IIS uses AIRA/NIST tooling to de-identify and transform the extract into an aggregate detections file (ADF) that contains counts of the data quality issues that can be further analyzed in AART.

Resources and Reports:

• Measures & Tests - DAR Assessment  
• Town Hall meeting recording – DAR Assessment 
• Technical Resources - DAR Assessment 
• IIS Participation Guide: DAR 

Patient Matching – HL7

This content area tests the ability of an IIS to match and consolidate records with name, address, and other key field variations across different HL7 messages. AART sends HL7 vaccination messages (VXUs) that contain demographic changes (e.g., typos, patient name field variations) to the IIS and then queries it to validate matches.

Resources and Reports:

• NEW Measures & Tests for Assessment - Patient Matching HL7
• 211 measures from Testing & Discovery were advanced into Assessment to measure IIS alignment
• Individual Assessment reports for IIS will be available in AART by March 31, 2025. 

Provider Participation

This content area gauges enrollment in and reporting to IIS by immunization providers using proxy data. It leverages VFC provider data reported to CDC from the Immunization Information Systems Annual Report (IISAR) and Vaccine Tracking System (VTrckS).

Individual Testing and Discovery reports for IIS are available in AART. IISAR data can be reviewed by visiting the IISAR Survey Data web page (see VFCEnr and VFCRep variables).