Presented on behalf of APHL at the 2019 NAPHSIS: SYSTEMS & INTEROPERABILITY WORKSHOP

1. AIMS PlatformAPHL Informatics Messaging Services
October 8, 2019

2. Topics
● Down Memory Lane
● AIMS Today
● High-Level Capabilities of AIMS
● Compliance & Security
● Current Use Cases
● Investing in the Future
Founded In
2008

3. Down Memory Lane
● 2008
○ First transmitted file via RnR - PHLIP Flu Surveillance to CDC
○ Physical Servers at data centers
● 2010
○ Technical Assistance (TA) offered
● 2013
○ Completed 1st FISMA Audit
● 2014
○ Moved to Amazon Web Services (AWS)

4. Down Memory Lane
● 2016/2017
○ Securely transmitted 1 millionth message
○ STEVE 2.0 goes live
○ Completed 2nd FISMA Audit
● 2017
○ First Quest ELR message arrives in Kansas via AIMS
● 2018
○ First ELIMS messages transmitted from CDC to Texas
○ Went live with Houston Methodist for eCR
● 2019
○ Completed 3rd FISMA Audit
○ R&D Innovation Projects
○ Project w/ Chile, South America for Flu
○ AIMS Business Strategy

5. AIMS in Numbers
Messages
Processed/
Month
30M
STEVE 2.0
since 2016
215M
AIMS
Trading
Partners
200+

6. Healthcare Community Platform

7. A National Resource for Interoperability
Influenza
NREVSS
AMD
NMI
NCHS
VPD
LRN
Animal Rabies

8. Cloud Computing
● Migrated to AWS on March 1, 2014
● Located in the AWS East and West US Regions
● Robust Continuity of Operations and Disaster Recovery
● AWS Certified Developers, Project Managers, Integration and
Security Engineers

9. Security & Compliance
● HIPAA Eligible and Compliant Services
● System Security Plan (SSP)
● FISMA Audits - 2013, 2016, 2019

10. Technical Services

11. Transport Toolbelt
● S3
● Direct Secure Messaging
● NwHIN XDR
● SFTP
● Web Services
● Thin Client (STEVE)
● PHINMS
XDR

12. Interoperability

13. The AIMS Team
Hospital Health Public Health

14. Use Cases
● PHLIP - Flu Surveillance
● Lab Response Network (LRN)
● Case Notifications
● Newborn Screening (NBS)
● Antimicrobial Resistance Lab Network (ARLN)
● Advanced Molecular Detection (AMD)
● Rabies Animal ELR
● Vaccine Preventable Diseases (VPD)
● PHIZ Immunization Hub
● ELIMS

15. Use Cases
● Emerging Infections Program (EIP)
● STEVE 2.0
● Quest ELR
● Interstate Messaging for ELR
● Electronic Case Reporting (eCR)

16. Quest ELR

17. Quest ELR

18. Interstate Exchange: Empowering the States

19. What is Electronic Case Reporting(eCR)?
The automated generation
and transmission of case
reports from electronic
health records (EHRs) to
public health agencies for
review and action.
Care
Documented in
EHR
Public Health Case
Investigation
Reportability
Response
Decision Support
Electronic Initial
Case Report
Trigger CodesSupplemental
Info Exchange
eCR

20. Using the AIMS Platform for eCR
● AIMS receives eICR
● Reportable Conditions
Knowledge Management
System (RCKMS) runs
decision support
● AIMS creates Reportability
Response document for
provider
● Public health receives eICR,
and RR if desired
● End Goal: PHA consumes
eICR message into
surveillance system
Public
Health
AIMS Platform
RCKMS applies
jurisdiction rules
Reportability Response
created for provider
RR sent back to provider;
eICR and RR passed to
public health
Provider
Electronic Initial Case
Report received

21. Electronic Case Reporting(eCR)

22. Electronic Case Reporting(eCR)

23. Electronic Case Reporting(eCR)
There are 5,564 U.S. Registered Hospitals and 208,807 Practicing Primary Care Physicians.
● Technical Challenges
○ Many to many connections multiply
complexity and effort - not just add
them
○ Consistent exchange of specific data
○ Security of connections
○ Error handling
● Legal Challenges
○ Point-to-point contracts
○ HIPAA minimum necessary
requirements
○ DUA and BA development costs for
clinical “side”
○ DUA costs for public health “side”

24. Electronic Case Reporting(eCR)

25. Electronic Case Reporting(eCR)
● Using the NIST Validator
● Schematron based on Release 2 STU
1.1
● Online validator for Developers
○ Webpage access to NIST
validator
○ Structural validation
○ Vocabulary validation
● In-line Validation of Messages
○ Covers all incoming messages
○ Structural validation
○ Vocabulary validation

26. Electronic Case Reporting(eCR)
Self Service Reusable Documentation Training/Education

27. Electronic Case Reporting(eCR)

28. Applications on AIMS
● Via AIMSPlatform.com
● ID & Access Management
(MFA/2FA)
● NARF Process
● Lab Web Portal - ARLN
● PHIZ - Immunizations
● EIP+ - Emerging
Infections Program

29. Investing in the Future
● Increase Self-service for AIMS Trading Partners
● Health Information Service Provider (HISP)
● Intelligent Message Processing (IMP)
● Advanced & Scalable Integration Engine Processing
● Enhanced Notifications & Alerts
● Updated and newly accessible Dashboards/Portals
● Business Strategy

30. Where Can I Find More Information?
WWW - www.AIMSPlatform.com Email - informatics.support@aphl.org
Patina Zarcone
patina.zarcone@aphl.org
1-240-485-2788
Dari Shirazi
dari.shirazi@aphl.org
1-319-325-0760
Eddie Gonzalez Loumiet
eddie@ruvos.com
1-850-570-8248