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Integrating Systems: The Impact on an Immunization Registry

Integrating Systems: The Impact on an Immunization Registry. 2002 Immunization Registry Conference Paul Schaeffer, MPA NYC DOHMH (212) 676-2329 pschaeff@health.nyc.gov Co-Authors: Deborah Walker, Alexandra Ternier (DOHMH) Alison Chi (MHRA). Objectives.

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Integrating Systems: The Impact on an Immunization Registry

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  1. Integrating Systems: The Impact on an Immunization Registry 2002 Immunization Registry Conference Paul Schaeffer, MPA NYC DOHMH (212) 676-2329 pschaeff@health.nyc.gov Co-Authors: Deborah Walker, Alexandra Ternier (DOHMH) Alison Chi (MHRA)

  2. Objectives • Describe modifications to the Citywide Immunization Registry (CIR) applications due to the implementation of the Master Child Index (MCI) • Describe programmatic challenges and solutions

  3. Background -MCI • The Master Child Index (MCI) is a NYC Child Health Registry that integrates data from: • Citywide Immunization Registry (CIR) • Lead Quest Registry (LQ) from the Lead Poisoning and Prevention Program • Vital birth records • Additional child health databases (in the future)

  4. Rationale for Integrating the Registries • CIR and Lead Quest (LQ) target the same population • CIR and LQ currently separate systems • Inability to relate data for the same child across the systems • Missed opportunities for children who are under-immunized and at risk for lead poisoning • Lack of access by providers to lead screening information

  5. Background-CIR and LQ • CIR contains over 2 million records with over 14 million immunization events • LQ contains about 1.7 million children with over 3.9 million blood tests • CIR contains demographics and immunizations of children up to 21 years of age • LQ contains demographics, lead test results and case management events of children up to 18 years of age

  6. Goals of Integration • Centralize access to immunizations and lead tests • Improve data quality for both registries • Leverage resources • Create a NYC Child Health Registry and a Data Warehouse • Provider access to both immunization and lead screening test information

  7. Steps to Create MCI • Developing Requirements & Specs • Building MCI Core Services • Configuring servers and platforms • Building MCI Administration Tools • Modifying CIR and LQ • Data loads into MCI • Deploying MCI

  8. Master Child Index MCI Database (Oracle) MCI Database Server (Unix) MCI Administration Tools (VB Application) MCI CoreServices Win 2000Servers (Geo-Support, MEDD) LQ Database Server (NT) CIR Database Server (UNIX) CIR Client LQ Client LQ Database (Microsoft SQL) CIR Database (Oracle) CIR Front End Power Builder Application LQ Front End Power Builder Application

  9. CIRApplications • Power Builder Front-End Application – CIR search and merge screens • Smart Search – Query Tool and recall report generator • On-Line Registry – Provider Online access

  10. Currently searches CIR and displays immunization data Human review - merging Will search CIR(fields not stacked) and display immunization and lead data using MCI Services Human review done in MCI only CIR Front-end ApplicationUser screens to search individual children and produce immunization reports – phone calls

  11. Currently searches CIR for immunization data and Produces files for Data Exchange (with MCOs) and Reminder Recall reports on matched kids Will search the CIR for immunization data and Use MCI Services to retrieve lead data on children found in the CIR to generate output files Smart SearchQuery tool that searches, matches, and retrieves CIR records in batch – MCOs, Board of Ed

  12. Will search CIR and Display child immunization and lead data using MCI Services On-Line RegistryOnline query tool for providers to access individual CIR records • Currently searches CIR and • Displays child immunization data

  13. Programmatic Challenges • Phase out CIR Front-End application • Who will be responsible for merging records – individual programs, or a MCI team? • Setting “agreeable” thresholds for merging

  14. Programmatic Challenges(continued) • Ownership of data – CIR will now disseminate LQ data • Fiscal issues between CIR and LQ • Joint Project Activities – data dissemination • MCI System Operations & Maintenance – need to divide responsibilities between MIS, MCI, CIR and LQ staff

  15. Future Plans – Applications • Complete modifications to CIR applications to include LQ data • Eventually all CIR applications will go against the MCI – full integration • Finalize inter-program protocols for De-duplication, address standardization and data dissemination

  16. Future Plans – CIR and LQ • Expand communication between Programs – Weekly Meetings!!!!! • Cross-training between programs • Standardize human review • Phone calls – providers and parents • Data Sharing – MCOs, reminder letters, Board of Ed

  17. Future Plans – MCI • Expand MCI to include Medicaid Population • Begin Data Warehouse • Leverage Resources • Expand partnership between CIR and LQ to include provider education and outreach

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