Decision Support (MDS) Overview

Our MatchMerge Decision Support (MDS) is a standalone web service arising from more than a decade of development and use by immunization registries. In an immunization clinical workflow, clinicians are able to view an up-to-date history and see the next doses needed for their patients.

MDS complies with the Centers for Disease Contol’s (CDC’s) Clinical Decision Support for Immunizations (CDSi).  See:

MDS recommends next doses using a given immunization history and clinically-accepted rules.


It validates a patient’s immunization history against a set of clinically-accepted rules


MDS Features

  • Highly granular language for rules specification
  • Available as standalone, integrated with IZaware, integrated with MatchMerge Immunization Registry
  • Processes doses by antigen dose, not administered dose (see additional details)
  • Ability to associate identifier with each dose to match input with output (v1.6)
  • Tool for maintaining rules locally without programming
  • Easy reconfiguration of rules by preloading an XML configuration file or values stored in a database
  • Web-based testing tool for regression testing
  • Web Service interface with XML payload
  • Adult as well as childhood vaccines
  • Seasonal rules
  • Generic rules for each vaccine group
  • Differentiate by brand
  • Derives contraindications from full medical record
  • Installations in multiple jurisdictions

Our Difference

On the CDC web site is a diagram showing the recommended vaccine schedule for children.  Many implementations of vaccine forecast begin by processing a history of administered doses, and recommending the next vaccine in this summary schedule. There are several problems with this approach, and MatchMerge solves them:


MDS Standards

Our active contribution to Decision Support Service standards:

Healthcare Services Specification Project (HSSP)

Object Management Group (OMG):

Health Level Seven (HL7)

Public Health and Emergency Response Workgroup (PHER)

Service Oriented Architecture Workgroup (SOA)

Certification Commission for Health Information Technology (CCHIT)

IHE Patient Care Coordination (PCC)

American Immunization Registry Association (AIRA)

MDS Resources

State of Massachusetts CIO James Daniel speaking at a 2007 National Immunization Conference about the use of the Vaccine Forecast Decision Support Service:

Making Your Forecasting Algorithm Available as a Web Service

View The Presentation

Service-Oriented Architecture for Pediatric Immunization Decision Support

University of Washington School of Public Health, Public Health Informatics, chapter 2 in Biosurveillance and Biosecurity, published November 26, 2008, entitled, “Biosurveillance, Case Reporting, and Decision Support: Public Health Interactions with a Health Information Exchange


This paper describes support for three public health practice domains in demonstrations of a model health information exchange (HIE): bio-surveillance, case reporting, and communication from public health to providers through integrated decision support. The model HIE implements interoperability through the use of existing semantic and syntactic standards specified as part of Integration Profiles to support specific data transfer use cases. We implemented these profiles in several public health applications using a service-orientated architecture approach. Methods were validated for each public health domain in national showcase demonstrations. We believe that this work has implications for the integration of public health functions into any HIE, regardless of its architecture, because our informatics methods support a distributed environment. This approach may be extended to strengthen development of the Public Health Grid, a project currently being led by the Centers for Disease Control and Prevention.

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