1

Developing RegionalRegistry Software: Lessons from California

San Joaquin Valley Health ConsortiumCalifornia DHS Immunization Branch

HLN Consulting, LLC

2

NIP Presentation Outline

I. Project GoalsII. Project OutcomesIII.Strategies for Success

October 28, 2001

3

Strategic GoalsEstablished October 2001

• Support Immunization Outreach

• Regionalize County and Local IZR Systems

• Bridge Public & Private Health Systems

• Infrastructure for California Statewide Hub

4

Project ChallengesOctober 2001 – October 2002

• Five Recently Created Regional Entities

• 24 Counties, 2 Million Children Under 6

• Complex State Disclosure Regulations

• History of False Starts

• > 500,000 Legacy Patient Records

5

Project StructurePublic-Private-NFP Partnership

• Funded by State and Federal Sources

• Administered by Mary Wallace, Director, San Joaquin Valley Health Consortium

• Managed by Ayesha Gill, Ph.D., Director, CA DHS Immunization Branch SIIS

• Developed by HLN Consulting, LLC

6

Strategic OutcomesOctober 2002

• Regional Systems with Identical Software

• Increasing Private Provider Participation

• Planning for Statewide IIS Hub

• Infrastructure for Bioterrorism Preparedness

• Sharing of Expertise and Work Outputs

7

Product Goals October 2001

• Intuitive Hi-Speed Web Interface

• Compatible with old Client Server Data

• Compatible with HIPAA Privacy Laws

• & State and County Disclosure Regulations

• Minimize “total cost of ownership”

8

Product Outcomes October 2002

• Web-based Multi-county Registry Database

• Now In Production in 5 Regions, As Planned

• Easily Customizable in Each Region

• New CA Regions Forming to Use CAIR

• Software Copyright by CA DHS

9

Product Outcomes (2)CA Automated Immunization Registry (CAIR)

• 3-Tier Architecture for Security and Performance

• Integrated Inventory Control and Reporting

• Tiered Access Levels for User Accounts

• Customizable CASA Data Export

• Context-Sensitive HTML Manual

10

Product Outcomes (3)CAIR Software and HIPAA

• Logging of Patient Disclosure

• Logging of Patient Data Viewing and Editing

• Masking of Confidential Data Fields

• Enforcement of 128-bit SSL encryption

• Strong Passwords and Session Timeouts

11

CAIR Patient History Page

12

CAIR Online User Manual

13

Strategies for SuccessRegistry Software Development

• Continuous Stakeholder Involvement

• Weekly Conference Calls

• Continuous Rapid Development

• Full Visibility of Process and Product

• Rapid-Response Prototyping

14

Tactics for Success User’s Group Participation in Development

15

Tactics for Success (2)Registry Software Development

• Regular Attendance by Stakeholders

• Dedication to Outcomes

• Availability of Expert Counsel

• Web-Based Communication Tools

16

Tactics for Success (3)Web Communication Tools

• Project Web Page with Minutes and Specs

• Discussion Board with Q & A

• Issue Tracking Database and Reports

• Web Conferencing for Prototyping

17

Project Web PageWeb Communication Tools

18

Web Discussion Board with Q & A

19

HLN Issue Tracking Web Database

20

CAIR Data Model in Hummingbird BI/Query

21

Today’s LessonsRegistry Software Development

• Continuously Involve Stakeholders

• Design, Prototype, Code, Test (and again!)

• Keep Tabs on Legislation and Standards