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A brief [recent] history of…immunization registries: A summary of the literature 2000-2007

A brief [recent] history of…immunization registries: A summary of the literature 2000-2007. IKK Steering Committee Topeka, Kansas May 8, 2007. A few definitions….

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A brief [recent] history of…immunization registries: A summary of the literature 2000-2007

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  1. A brief [recent] history of…immunization registries:A summary of the literature2000-2007 IKK Steering Committee Topeka, Kansas May 8, 2007

  2. A few definitions… • Immunization registries -- confidential, computerized information systems that collect and consolidate vaccination data from multiple health-care providers • Immunization information systems (IIS) – immunization registries with added capabilities

  3. Uses of IIS data… • Generating reminders • Calculating immunization coverage • Identifying pockets of at-risk children who need immunization services • Managing vaccine inventories • Improving vaccine safety • reduce over-immunization • enable adverse event reporting • provide data for post-licensure vaccine safety studies

  4. Where do we stand nationally… [MMWR 2006 Dec 15;55(49):1327-1329] • In 2005, ~56% of US children aged <6 years participated in an IIS (an increase from 48% in 2004). • During July-December 2005, ~75% percent of public vaccination providers and ~44% of private vaccination providers submitted vaccination data to an IIS. • To meet the Healthy People 2010 goal of 95% participation of children aged <6 years in an IIS, the number of participating children must increase from currently ~13 million to ~21 million.

  5. Some recent findings… • The weight of the evidence favors a national network of local and state immunization registries linked through common definitions and unique child identifiers, rather than a single national registry. [Annu Rev Public Health. 2003;24:227-246] • Parental support for immunization registries is high, and may increase with greater awareness of risks of vaccine-preventable diseases and the utility of vaccination. [BMC Public Health. 2006 Sep 22;6:236] • IIS can identify children in need of immunizations and generate reminders, but institutional vaccine delivery problems must be addressed if this is to be effective in inner-cities. [Ambul Pediatr. 2006 Mar-Apr;6(2):100-104] • Given the school nurses’ need to access children’s immunization information, combined with parents’ difficulty in producing complete records, increasing school nurses’ access to IIS must receive higher priority. [School Nurse News. 2004 Nov;21(5):18-21]

  6. The prevailing theme is participation by private providers • The success of IIS depends on participation by all vaccine providers. [J Public Health Manag Pract. 2001 Nov;7(6):67-74 & MMWR Recomm Rep. 2001 Oct 5;50(RR-17):1-17 ] • Private providers must be made aware of the value that IIS have for society, the potential fiscal and clinical influences on their practice, the costs and benefits, and areas for future improvement. [Pediatrics. 2006 Sep;118(3):1293-1295] • Interventions to increase availability and use of IIS should address provider and health organization needs. [Arch Pediatr Adolesc Med. 2002 Oct;156(10):978-985 ]

  7. Addressing critical knowledge gaps… • Promote widespread understanding of provider-based IIS to help private providers implement them. [Arch Pediatr Adolesc Med. 2002 Oct;156(10):978-985 ] • Research to identify private providers’ needs and how to address them should receive highest priority. [J Public Health Manag Pract. 2007 Jan-Feb;13(1):35-38]

  8. One potentially successful approach…[Pediatr Ann. 2006 Jul;35(7):500-506] • A project in New Jersey combined technology, public-private collaboration, and well-established quality improvement techniques. • The change process involved the whole office as a team in adopting new immunization delivery roles. • The greatest barrier to acceptance of the registry was (and continues to be) the need for manual data entry, rather than electronic data transfer from other record systems. • Sustainability of practice-based immunization changes will rely, in part, on the registry's ease of use and the continued visibility of public health at the practice level.

  9. Challenges for the future… • Must improve knowledge about IIS operations and minimize cost per record: [Cost Eff Resour Alloc. 2006 Aug 22;4:15] • fully characterize IIS-related costs • identify critical factors that affect IIS efficiency • Consider adopting more efficient and thoughtful use of combined information systems within public health departments [Am J Public Health. 2005 Nov;95(11):1923-1927 & J Public Health Manag Pract. 2004 Nov;Suppl:S66-S71 & J Public Health Manag Pract. 2004 Nov;Suppl:S30-S35 ] • Identify sustainable funding streams [J Public Health Manag Pract. 2001 Nov;7(6):67-74 ] • Assess impact of legislation on use of IIS [Am J Prev Med. 2001 Apr;20(3):208-213 ]

  10. For more information… • Bibliography and abstracts are available…ask me!! • Review the American Immunization Registry Association website: http://www.immregistries.org/pubs/index.phtml • Conduct a literature search on a specific topic at the National Library of Medicine website: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed

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