Data Quality Improvement: Using Best Practice Guidelines to Improve IIS Operations

1. Data Quality Improvement: Using Best Practice Guidelines to Improve IIS Operations National Immunization Conference 2009 Presented by: Jodi Warren, RN, BSN CHILD Profile Immunization Registry

2. Objectives • Outline the current statistics of the IIS population, both patient and provider • Describe the data quality improvement process adopted • Share key actions taken based on process results

3. Background on CHILD Profile (IIS) • Washington’s population is: 6,587,600 • Number of records in IIS: 5,754,436 • Kids with 2 or more immunizations • 19-35 months = 98% (117,317/119,109) • Kids with complete records • 4:3:1:3:3 = 48% (56,581/119,107)

4. Provider Participation

5. Provider Submission Types

6. How Data Comes In to IIS

7. Data Quality Improvement Process

8. AIRA/MIROW Business Rule Breakdown: 32 Total Business Rules 22 Rules were adopted/modified 10 Rules were not adopted Key Areas of Improvement Data Loading Policy and Procedure documentation Follow up on provider data quality Internal Data Quality monitoring procedures developed. Process Review Results

9. Action: Adopted Business Rule • A patient should not have more than: • 50 vaccinations before 5 years of age. • 35 vaccinations before 2 years of age. • 70 vaccinations regardless of age.

10. Records with 50+ imms

11. Records with 40+ imms(Excluding Influenza Vaccine)

12. Records with 30+ imms for <3 yr (Excluding Influenza)

13. Action: Modified Business Rule • These queries will be run semi-annually. • A patient should not have more than: • 40 vaccinations or more between the ages of 3-18 years old, excluding influenza. • 30 vaccinations or more for < 3 year olds, excluding influenza and RSV-IGIM.

14. IRMS Patient ID/Medical Record Number Facility ID (Account Number) Full Address Additionally: (highly desirable) Patient Middle Name Gender Guardian First Name or Mother’s Maiden Name Phone Number Email Address (Future – VFC Status) Patient Name, First Patient Name, Last Patient Date of Birth Vaccination Encounter Date Vaccine Type Action: Modified Business Rule • The set of data items from the Electronic Medicaid/Billing Records must include: (NOTE: These are the recommended data elements that the IIS would like.)

15. Action: Modified Business Rule • For administered vaccinations, Report Submission Date (date file received) should be within 30 days of Vaccination Encounter date. • Best – Weekly: Large Providers • OK – Bi-Monthly: Everyone else • Minimum – Monthly: Smaller Practices • Encourage Manual data entry for smaller practices.

16. Action: Non-Adopted Rules • Trade name, Manufacturer, CVX code, CPT code, and Vaccine type should not contradict one another • Vaccination Encounter date should be within the Vaccine Product License Date range. • The percentage of vaccination events in which the responsible party name is the same as the patient name should be within an expected threshold level (to be determined by each IIS). • A patient should not have more than 7 DTaP Vaccinations by age 7. • A patient should not have more than 10 vaccinations per visit.

17. Action: Not adopted (cont.) • Vaccination Encounter date should not be after the lot number expiration date. • A patient’s VFC eligibility should be consistent with the funding source of the vaccine administered (state specific). • An administered vaccine should not have a medical contraindication for a patient. • Hepatitis B birth doses from the Vital Records feed should be reported within an agreed upon timeframe.

18. Keys to Success? Have a dedicated person to identify and prioritize data quality issues. Use a team approach in working to improve the data quality of the IIS. AIRA/MIROW Document helpful in pointing you in the right direction.

19. Presenter: Jodi Warren, RN, BSN Data Quality Coordinator for CHILD Profile PHONE: 1-800-325-5599 or (206)-263-8322 Email: jodi.warren@kingcounty.gov WEBSITE: www.childprofile.org Presenter: Jodi Warren, RN, BSN Data Quality Coordinator for CHILD Profile PHONE: 1-800-325-5599 or (206)-263-8322 Email: jodi.warren@kingcounty.gov WEBSITE: www.childprofile.org