Expansion of community pharmacies' role in public vaccine delivery to children: Opportunities and need.

Despite the positive impact pharmacists have had on access to vaccines, only a limited number of community pharmacists and pharmacies are able to participate in most federal- and state-supported vaccine programs. In this commentary we (1) review vaccination services currently provided by community pharmacists in the United States, (2) highlight regulatory, reimbursement, and role-based barriers to community pharmacists' participation in the vaccines for children (VFC) program, a cornerstone program to support vaccinations of children in the United States, and (3) suggest changes to support and improve VFC participation for all health care providers. For the purposes of this commentary, community pharmacies are defined as retail pharmacies not associated with a health care system, hospital, or clinic.

A Demand for Data to Improve Outcomes Creates the Why to Move to Third Generation Immunization Information Systems.

Investments over the past two decades to collect and store immunization events established a national population health data asset. The ability to track vaccine usage and storage has increased accountability, lowered wastage, protected valuable resources, and provided the correct vaccines at the right time. Sixty-four immunization registries support the current immunization ecosystem, yet all investments to date have been through state and federal funding. Much of the technology supporting these registries is becoming harder to support, limiting the utilization of the data. For the most part all current systems have legacy 2nd-generation technology and architectures as their foundation Current technology investments in these national assets tend to be for systems that within the next five years will not be cost effectively sustainable with only federal, state and local funding. Yet quality data is being reported by immunization providers across the health care network that is increasing exponentially through electronic data exchanges integrated within Electronic Health Records (EHR) and Pharmacy Management Systems (PMS) This increase in high-quality patient immunization records creates opportunity to build immunization intelligence from the data. However, 2nd-generation Immunization Information Systems (IIS) limit the effective and timely use of this information. Considering the increasing value of the data to public and private sectors working to close immunization care gaps in populations, supporting technology must ensure easy access This is the first of two papers that highlights the power of these national registries and the data they contain to provide opportunity intelligence to the immunization ecosystem user community. Paper one illustrates the "why" for change and the need for a truly community collaborative path forward to move from 2nd- to 3rd-generation systems through partners that leverages cost sharing and common goals The end goal is to establish new supporting technology assets that accelerate the use of data to impact vaccine preventable disease (VPD) outcomes which create a new model for public-private investments to sustain the IIS national infrastructure. The second a working paper with assumptions to be tested ("Model for Sustaining and Investing in Immunization Information Systems"), shares cost and investment strategies to complete the migration and create sustainable immunization systems for the future.