Background
The Minnesota Immunization Information Connection (MIIC) is Minnesota’s immunization information system (IIS). Entry of COVID-19 vaccine administration data into MIIC was required under the COVID-19 provider agreement, meaning we have data on the majority of COVID-19 vaccine doses administered in Minnesota. Exceptions to this include the United States Veterans Affairs Department (VA) and other entities that received vaccine directly from the federal government. When this project began, MIIC had very complete records with respect to required elements, such as administration date, vaccine type, provider organization name, client’s date of birth, and contact information, but the system did not have a lot of data on metrics associated with health equity. Specifically, we had some race and ethnicity data, but it was incomplete. Further, like most IISs, MIIC is not able to capture other information such as interpreter use, incarceration status, homelessness status, or any information on health conditions. The Minnesota Department of Health (MDH) also did not have the resources to consistently analyze the data we did have on urbanicity, race and ethnicity, or ZIP code-based social-vulnerability index (SVI).
To better address these needs, MDH partnered with the Minnesota Electronic Health Record Consortium (EHRC). Data from MIIC was shared weekly with the EHRC and matched with demographic data from participating systems. The EHRC included ten of the largest health systems in Minnesota and eventually the Minneapolis VA. Once these data were matched, the EHRC had a very robust data set with complete immunization data and good-quality demographic data. The EHRC also had a dedicated team of analysts who were able to regularly produce data on vaccine uptake by sociodemographic factors, including race, ethnicity, incarceration status, homelessness status, comorbidities, SVI, and geography.
Lessons Learned and Key Factors for Success
This is a really successful partnership. We were able to create a data set in a unique way that allowed us to provide information on many more populations of interest than we have in the past. Obtaining a more complete understanding of our pockets of need has been invaluable in determining where we might have access issues for COVID-19 vaccine availability and also for determining characteristics of populations that might be vaccine hesitant so that public health outreach can be more tailored and effective.
We did have to push our comfort level a little with how we shared data, but the outcomes proved that the process was worthwhile. We worked closely with the MDH legal and security teams to ensure that our processes were allowable and used best practices. All data practices terms and requirements are also included in our contract with the EHRC.
Looking to the future, this process is also reproducible with routine vaccination or in other jurisdictions and with other data sets.
Supplemental Materials
- News articles/press releases
- https://mn.gov/governor/news/?id=1055-470649
- https://kstp.com/kstp-news/local-news/walz-announces-partnership-between-state-health-care-systems-on-race-and-ethnicity-data-collection/
- https://www.hcinnovationgroup.com/analytics-ai/big-data/article/21218974/minnesotas-ehr-consortium-helps-inform-statewide-vaccine-equity-efforts
- https://www.mnphy.com/0421_S3_DEEPTI_PANDITA
- https://www.startribune.com/study-homeless-and-incarcerated-minnesotans-struggled-to-get-covid-19-vaccines/600183499/
- https://www.hhrinstitute.org/dr-winkelman-talks-about-ehr-consortium-and-covid-19-on-healthy-matters-on-wcco-radio/