Improved interoperability makes it easier to track immunizations in St. John’s Health

These days, patients get vaccines at pharmacies, urgent care centers and primary care clinics, among other places.


It is difficult for suppliers to keep track of them. Different portals and platforms make this challenging. When asked about a specific vaccine, patients often respond, “I don’t know, I think I got that one.”

Susan Freese, RN, provider application manager at St. John’s Health in Jackson, Wyoming, shares an example from his own health care.

“I was helping a friend move and it was January,” she recalls. “I slipped on the ice and split my head open. They asked me, “When was your last tetanus shot?” I said, “I couldn’t tell you.”

“But with the Oracle Cerner Immunization Registry Reporting and Query technology linked to the EHR, clinicians were able to see that I had the vaccine three years ago,” she continued. “Although another shot wouldn’t necessarily have hurt me, it saved me the expense of having it again and saved the supplies. And, of course, nobody wants to have extra vaccines.”

Before Oracle Cerner technology was created, clinicians at St. John’s Health had to log into the Wyoming Immunization Registry separately to review and record vaccines.

If immunizations are given anywhere in the health system of St. John, someone will need to document this information in both the EHR and the Wyoming Immunization Registry. This meant maintaining spreadsheets and entering that data into the systems at the end of each week.


Oracle Cerner’s registry tool electronically sends vaccine data to the Wyoming Immunization Registry and pulls information from the EHR to reduce manual processes like spreadsheets.

It’s a tool used all day, every day, in the outpatient clinic and inpatient space for near-instant vaccine data exchange.

“When you can automate manual processes, it helps prevent staff burnout and provides a more complete picture of patient healthcare.”

Susan Freese, RN, St. John’s Health

“This interoperable solution works to give patients and clinicians a more complete view of health histories, including immunizations,” Freeze noted.


“It’s much more efficient to have that two-way interface on the Oracle Cerner tool,” Freese said. “When we administer vaccines, they are automatically transferred to the state without any additional effort after completing our documentation in the Cerner CommunityWorks EHR.

“Our nursing team doesn’t have to manage so many separate logins or push buttons,” she continued. “Instead of having to do these hundreds and thousands of manual and duplicate data entries, clinicians could do all their work in the EHR.”

John’s Health implemented the technology in 2019. The tool became critical when the COVID-19 pandemic hit, reporting vaccinations to the state.


“In order for shipments of COVID vaccine to be released to various entities, Wyoming required that all vaccines be reported to the state within 48 hours of administration,” Freese recalled. “We worked with the Cerner team to quickly get everything ready to electronically submit these new vaccines to the state registry.

“TheThe emergency use permit went out Friday and St. John’s Health gave their first doses the very next Tuesday,” she added. “Almost instantly, the immunizations were recorded in the Wyoming Immunization Registry.”

St. John’s Health is a small but powerful organization, she says.

“With the first round of COVID vaccines, we were able to administer about 10,000 doses to our most exposed population, including the elderly, the immunocompromised, healthcare workers and others,” she said.

“Without the functionality to register these doses in the Wyoming registry within this required 48-hour period, we would not have been able to continue receiving shipments, giving these second doses and vaccinating people as quickly as we did,” she continued.

As this year’s flu season approaches, the health organization is planning ahead.

“We intend to apply the lessons learned from our previous experience with COVID-19 to future flu seasons,” she noted. “I would estimate that we save several minutes per patient and then hours per week because of this capability.”


“I wholeheartedly encourage other facilities to implement this interoperability strategy,” Freese advised. “Yes, you have to work in advance. You should allocate staff to attend implementation meetings as well as complete testing and monitoring.

“There’s a little bit of ongoing maintenance, like reviewing a monthly report from the state, fixing transmission errors,” she said. “Although there are follow-ups there, the benefits go far beyond that support.”

The time saved for medical staff in terms of manually entering all administered vaccines into state registries is definitely worth it, she added.

“When you can automate manual processes, it helps prevent staff burnout and provides a more complete picture of patient care,” she concluded. “The biggest benefit for clinicians: less time at the computer, more time face-to-face with patients.”

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a publication of HIMSS Media.

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