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State-Scale Immunisation Tracking: 2M Records

How a state health department ran immunisation tracking across 2 million patient records.

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About the Project

Immunisation registries underpin childhood immunisation, flu campaigns, and school-entry compliance at state scale.

Industry

Government / Public Health

Statewide immunisation tracking for childhood programs, flu campaigns, and school entry.

  • Public Health
  • Immunisation Registry
  • School Compliance
Business Type

State Health Department

A state agency replacing a registry built more than 15 years earlier.

  • State Agency
  • Multi-Provider Network
  • Legacy Replacement
Core Offering

State-Scale Immunisation Registry

2 million patient records with real-time submission and query at the point of care.

  • 2M Records Migrated
  • HL7 FHIR R4
  • Real-Time Query
  • Coverage Reporting
Submission Pathways

Every provider has a way in

Four pathways, including a web portal that completes a record in under two minutes.

  • FHIR Direct
  • CSV Upload
  • HL7 v2 ORU
  • Web Portal
Infrastructure

FedRAMP Moderate Cloud

Horizontally scalable cloud that absorbed 4x peak volume during a vaccination campaign.

  • FedRAMP Moderate
  • Horizontal Scaling
  • Role-Based Access
Build your idea

Talk to our experts

Scope your own population-scale health registry with our informatics team.

  • Free Consultation

Tracking Before the System

The legacy registry left data stale and incomplete.

15+ Years Old
The legacy registry was built more than 15 years before the replacement decision. Repeatedly extended and patched, it retained fundamental architectural limits: manual file uploads with no standardized pathway and no real-time EHR connectivity.
2-4 Weeks
The result was persistently incomplete, delayed data. An immunisation given at a private practice might not appear for two to four weeks — a serious vulnerability for pandemic response requiring rapid assessment of population vaccination status.
Burdensome
Providers consistently reported submission as burdensome and error-prone, maintaining their own extract-and-upload process without health-department support. Many smaller and rural providers had simply stopped submitting.

Real-time data at population scale.
Every provider, every system.
Public health you can act on.

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The Technical Architecture

  • FHIR-Based Immunisation Data Standard

    FHIR-Based Immunisation Data Standard

    FHIR-Based Immunisation Data Standard

    • Built on HL7 FHIR R4 Immunization and Patient resources
    • FHIR-capable EHRs submit directly to the registry
    • Real-time FHIR query for authorized staff
  • Multiple Submission Pathways

    Multiple Submission Pathways

    Multiple Submission Pathways

    • Web-based direct entry portal for low-volume providers
    • Standard CSV upload for structured exports
    • HL7 v2 ORU interface for legacy systems
  • Real-Time Identity Resolution

    Real-Time Identity Resolution

    Real-Time Identity Resolution

    • Probabilistic matching on identifiers and demographics
    • Tuned on known match pairs from the legacy registry
    • Monitored in production for systematic match errors
  • Scalable, Secure Cloud Infrastructure

    Scalable, Secure Cloud Infrastructure

    Scalable, Secure Cloud Infrastructure

    • FedRAMP Moderate authorization for PHI handling
    • Horizontal scaling for spiky immunisation load
    • Absorbed flu-season and campaign surges
  • Public Health Reporting & Access

    Public Health Reporting & Access

    Public Health Reporting & Access

    • Coverage dashboards by county, age band, and vaccine
    • Schools and clinics query under consent-based access
    • De-identified extracts for epidemiology, no PHI

The Challenges We Solved

Hover a row to see what changed.

Public Health Impact

Real-time FHIR turned the registry into decision support that is current at the point of care.

The Results

Every number below was measured in production after launch — not projected in a pitch deck.

2M

Patient Records Migrated — Up to 15 years of history preserved

94%

Real-Time Submission Rate — Within minutes — was days/weeks

4x

Peak Volume Handled — During a vaccination campaign

<2 min

Per-Record Direct Entry — Lowest-barrier submission path

Global presence

Three offices. One team.

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