Immunization Registries

Update, 2003

Immunization Registries

Update, 2003

Gail Williams, MPH, CHESNational Immunization Program

Centers for Disease Control and Prevention

Gail Williams, MPH, CHESNational Immunization Program

Centers for Disease Control and Prevention

Increase to 95% the proportion of children (0<6 years of age) in a fully operational population-based immunization registry

(Healthy People 2010, objective 14.26)

Increase to 95% the proportion of children (0<6 years of age) in a fully operational population-based immunization registry

(Healthy People 2010, objective 14.26)

Healthy People 2010 ObjectiveHealthy People 2010 Objective

Progress towards HP goal, 2001Progress towards HP goal, 2001

Overall = 31%0% to 33% (21)34% to 66% (15)67% to 100% (15)

Note: States in white have only non-population-based registriesSource: Immunization Registries Annual Report, 2002

Functional Standards

0 5 10 15 20 25 30 35 40

Disaster Recovery#

Deduplication#

HL7

Security**

Confidentiality

NVAC Core data set

Record created in 6 weeks (from birth)

Reports

Reminder/recall

Determine immunization needed

Official Record

Data quality measures#

Process within 4 weeks of administration*

Available at time of encounter

Fu

nc

tio

na

l S

tan

da

rd

Number of Population-Based Projects

1999-2000

CY 2000

CY 2001

Strengthening Our StandardsStrengthening Our Standards 12 Functional

Standards Reinforced in the upcoming

guidance document Supported in the Certification

Process

PROW Standards of Excellence NVAC endorsement Design of demonstration sites Notice to Readers: MMWR

12 Functional Standards Reinforced in the upcoming

guidance document Supported in the Certification

Process

PROW Standards of Excellence NVAC endorsement Design of demonstration sites Notice to Readers: MMWR

Strengthening Our PartnershipsStrengthening Our Partnerships

American Immunization Registry Association Association of Immunization Managers Committee on Immunization Registry Standards and

Electronic Transactions Connections Every Child by Two Health care professional organizations Public health organizations Government public health and financing organizations

American Immunization Registry Association Association of Immunization Managers Committee on Immunization Registry Standards and

Electronic Transactions Connections Every Child by Two Health care professional organizations Public health organizations Government public health and financing organizations

Strengthening Providers ParticipationStrengthening Providers Participation

Health Care Professional Participation Work Group (HCPWG)

Members: AAFP, AAHP, AAP, AIRA, ANA, APA, ECBT, Kaiser, NACHC, NMA, CDC Registry Value Provider Marketing Marketing/Education Integration/Research

Health Care Professional Participation Work Group (HCPWG)

Members: AAFP, AAHP, AAP, AIRA, ANA, APA, ECBT, Kaiser, NACHC, NMA, CDC Registry Value Provider Marketing Marketing/Education Integration/Research

Strengthening Our Data QualityStrengthening Our Data Quality

1. Certification

2. De-duplication test cases

3. National Immunization Survey

1. Certification

2. De-duplication test cases

3. National Immunization Survey

Certification Helping registries become “certification-ready”

Certification Helping registries become “certification-ready”

Technical Work Group Pilot tested voluntary certification criteria in:

Michigan New Jersey Utah

Where are we now?

Technical Work Group Pilot tested voluntary certification criteria in:

Michigan New Jersey Utah

Where are we now?

De-duplication Test Caseshttp://www.cdc.gov/nip/registry/dedup/dedup.htmDe-duplication Test Cases

http://www.cdc.gov/nip/registry/dedup/dedup.htm

National Immunization SurveyNational Immunization Survey• Pilot tested

Arizona MichiganOklahoma Washington, DC

• Provides Coverage Estimates• Provider Verified Patient Histories

Assess completeness Compare NIS to Registry data

• Pilot testedArizona MichiganOklahoma Washington, DC

• Provides Coverage Estimates• Provider Verified Patient Histories

Assess completeness Compare NIS to Registry data

Registry Sentinel Sites

Oregon: Cities of Salem and Portland

New York City

Arizona: Coconino County

Michigan: Jackson, Kent, Muskegon Co. Utah: Salt Lake County

Oklahoma

San Antonio

Washington, D.C

Sentinel Sites: ProfilesSentinel Sites: ProfilesSite # of Children Providers % with

≥2 doses Est. % Duplicates

AZ 10,546 ALL 91 0-1

UT 18,259 PUBLIC 96 8

NYC 18,607 PRIVATE 100 12.6

SAT 64,435 WIC 97 <1

OK 112,574 PUBLIC 100 <5

OR 28,497 ALL 98 <1

MI 90,141 ALL 100 5

DC 18,407 Medicaid MCO’s 92 <1

Source: Sentinel Site Reports, May 2003Source: Sentinel Site Reports, May 2003

Sentinel Sites: DataSentinel Sites: Data Describe vaccination coverage by age group and

antigen Compare vaccination series data with data from past

quarters and the lower confidence interval of the 2001 National Immunization Survey (NIS) estimate

Describe immunization coverage by age group and antigen

Provide data on ad hoc requests

NOTE: NIS 2001 data are not directly comparable to 2003 sentinel site quarterly reports.

Describe vaccination coverage by age group and antigen

Compare vaccination series data with data from past quarters and the lower confidence interval of the 2001 National Immunization Survey (NIS) estimate

Describe immunization coverage by age group and antigen

Provide data on ad hoc requests

NOTE: NIS 2001 data are not directly comparable to 2003 sentinel site quarterly reports.

Shot entry date not recorded> 8 weeks4+ - 8 Weeks1 week - 1 month (30 days)< 1 week

% R

eporte

d

0

20

40

60

80

100

A B C D E F G H

Sample:Timeliness of Registry Data

% Registry Consent and Participation, Preliminary Findings, May 2003

% Registry Consent and Participation, Preliminary Findings, May 2003

0102030

405060

708090

100

Arizona DC Michigan Oklahoma

% consented % 1+ shot in registry

0102030

405060

708090

100

Arizona DC Michigan Oklahoma

% consented % 1+ shot in registry

Challenges for Immunization Registries

Challenges for Immunization Registries

Ensuring the participation of all or almost all immunization providers and parents,

Ensuring appropriate technical functioning of registries to enable high quality data collection, use, and exchange,

Ensuring the confidentiality of registry information and the privacy of registry participants, and

Ensuring a sustainable funding stream for continued immunization registry support.

Ensuring the participation of all or almost all immunization providers and parents,

Ensuring appropriate technical functioning of registries to enable high quality data collection, use, and exchange,

Ensuring the confidentiality of registry information and the privacy of registry participants, and

Ensuring a sustainable funding stream for continued immunization registry support.

Recommendations to Improve Immunization Registries…..

Recommendations to Improve Immunization Registries…..

Ensure Provider demand for registries • Complete and accurate history• Reminders and recalls

Ensure registries support immunization program objectives• 12 Functional Standards• PROW Standards of Excellence

Ensure Privacy and Confidentiality Monitor state and federal legislation • Research impact of state legislation on IR.• Clear legal authority

Ensure Provider demand for registries • Complete and accurate history• Reminders and recalls

Ensure registries support immunization program objectives• 12 Functional Standards• PROW Standards of Excellence

Ensure Privacy and Confidentiality Monitor state and federal legislation • Research impact of state legislation on IR.• Clear legal authority

http://www.cdc.gov/nip/http://www.cdc.gov/nip/