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Utilizing Immunization Registries in Local Public Health Accreditation

Utilizing Immunization Registries in Local Public Health Accreditation. Kevin Czubachowski Immunization Field Representative Michigan Dept. of Community Health Wendy Nye Supervisor, Region 4 Michigan Childhood Immunization Registry. Michigan Local Public Health Accreditation Program.

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Utilizing Immunization Registries in Local Public Health Accreditation

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  1. Utilizing Immunization Registries in Local Public Health Accreditation Kevin Czubachowski Immunization Field Representative Michigan Dept. of Community Health Wendy Nye Supervisor, Region 4 Michigan Childhood Immunization Registry

  2. Michigan Local Public Health Accreditation Program • Development of the accreditation process • Assessment Protocol for Excellence in Public Health (AFEXPH) • Accreditation Steering Committee • Primary steps in accreditation process • Inclusion of registry related indicators

  3. Michigan Childhood Immunization Registry (MCIR) • Established through Public Health Code requirement • Tracks children birth to 20 years • Providers required to record shots administered as well as histories • Software development • Access granted to registered users • State divided into 6 regions

  4. Accreditation & the MCIR • Focus on immunization/registry related indicators • Assess where local health departments stand • Work with local health departments and providers to “clean up”

  5. Registry-Related Indicators • Assessments using registry data: • Semi-annual assessment & reporting • Age cohort: 19 to under 36 months • Over 50% for doses: 4 DTaP, 3 Hib, 3 Polio, 1 MMR, 3 Hep B, & 1 Varicella • Local health’s role in registry: • Submits data within timelines • Attends regional advisory board mtgs.

  6. Behind the Scenes Indicators • IAP reports include immunization coverage levels (submitted semi-annually) • LHD shows evidence of recall system & collaboration with private providers • Doses administered & compliance reports for VFC participating providers • Provider updates using registry news screen and newsletter

  7. Assess Local Health Department Status (County X) • January 2002: County profiles & ad hoc reports to identify areas of concern • County profile: 33% (48% w/o Varicella) • Large pediatric provider not giving Varicella: 9% (83% w/o Varicella) • Developed an action plan and presented to LHD to reach accreditation goals by July 2002

  8. Action Plan Activities • Focus on children 12 to 31 months • County-wide report listing children needing Varicella • Drafted & sent letter from the LHD asking for Varicella records • Provider education for pediatrician • Legacy data collection & entry

  9. “Cleaning Up” • Entered shot histories for 4 large volume immunization practices • Utilized ad hoc reports to identify children with incorrect or no county field • 813 letters sent (March 2002): 139 replies to region regarding Varicella history (return rate: 17%) • Identification of duplicates

  10. Clean Up Results • April 2002: • County rate: 38% • June 2002: • County rate increased to 43% • July accreditation visit: • County rate increased to 52%

  11. Lessons Learned: Benefits • Increased county rates (spill-over) • Better data quality • Identified “border” providers • Higher awareness of registry impact among data entry/management staff • Stronger relationship with LHD

  12. Lessons Learned: Barriers • Buy-in from local health department and staff • Provider relationships with local health department & registry • Organizational relationships • Lack of staff training • Technical issues • Funding

  13. Registry Support for Accreditation • Final question: • Has the accreditation process increased the state immunization rates and increased registry compliance? • Final answer: • YES!!!

  14. Contact Information • Kevin Czubachowski, MDCH Immunization Field Representative • 810-985-9246 • E-mail: CzubachowskiK@michigan.gov • Wendy Nye, Supervisor, Region 4 MCIR • 810-257-3562 • E-mail: Wnye@co.genesee.mi.us

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