# Presentation: 7ULQG2CLNZM3B432QOOF2Q3MTYRM2XUB

##  Registry Update       Diane Simpson

- Robb Linkins
- Terry Boyd

**Notes:**
First Thanks:
Robb – background information
Terry – data and maps

Hard to imagine modern life with out computers.
Think about your trip.
	BANKS – knew if you had $ to withdraw cash
	AIRLINE – knew I you had a reservation, what type of ticket, 		frequent flyer miles, where you sit.
	HOTEL – special meals
So why when a child receives immunizations do parents and providers so often rely on hand held cards or paper medical records.

##  History of Registries

- 1974:    Delaware establishes registry based 	       on encounter data
- 1980:    AIMS –Automated Immunization                                                            	       Management System
- 1991:    Expert panel recommends national 	       	       registry system
- 1992:    All Kids Count funds 24 state and   	                         	       community registries

**Notes:**
IT’S NOT THAT REGISTRIES ARE A NEW IDEA!

San Antonio in mid 80’s

Work picked up in the last 10  years.

##  History – Part II

- 1993:  NIP awards registry planning grants
- 1994:  NVAC recommends expanded 	 	      	     funding and new federal policies
- 1997:  Presidential directive launches      	     	     Initiative on Immunization Registries
- 1998:  NVAC hearings on registries
- 1999:  NVAC report on registry
- 2000:  HP 2010 goal: 95% <6 y.o. enrolled

## Immunizations Registries Phase I

**Building the Systems**

**Notes:**
SO LET’S ASSESS WHERE WE ARE!

As noted in the last 10 years we have been hard at work building systems.

## Developing the hardware and software
Establishing necessary laws and rules
Developing specifications for privacy and confidentiality
Establishing technical standards
Outreach to providers
Enrolling children

**Establishing necessary laws and rules**
**Developing specifications for privacy and confidentiality**
**Establishing technical standards**
**Outreach to providers**
**Enrolling children**

** ****Phase I Accomplishments:**** Building the Systems**

**Notes:**
This is a list of tasks that have been confronted over the last 10 years at the state and/or national level.

## Projects Meeting Functional Standards

- 38 Responses from population based registries
- *Quesstion changed from 99/00

- Deduplication

- Official immunization records

- Coverage reports

- Reminder/recall

- Automatically determine the
- immunization(s) needed

- Exchange immunization records using HL7

- Recover lost data

- Ensure security

- Protect confidentiality

- Process immunization information within
- 1 month of administration

- Access the time of encounter

- Establish record within 6 weeks of birth

- NVAC core data elements**

- 0

- 5

- 10

- 15

- 20

- 25

- 30

- 35

- 40

**Projects**

- 1999 - 2000

- CY 2000

**Notes:**
And in year 2000 – this is where you’ve told us we stand.

FUNCTIONAL STANDARDS
Develop a state input and the hard work of technical ADV group
Doing well with, and
Made significant improvements over last few years.

## Public Provider Participation in a Population-Based Immunization Registry

**Public Provider Participation in a Population-Based Immunization Registry**

**Notes:**
Despite well functioning systems progress in participation has been much slower.

## Private Provider Participation in a Population-Based Immunization Registry

**Private Provider Participation in a Population-Based Immunization Registry**

## Children 0-5 Years of Age Participating in a Population-Based Immunization Registry

**Children 0-5 Years of Age Participating in a Population-Based Immunization Registry**

**Notes:**
Overall only 22% of children in the US have at least 2 immunization visits recorded in a registry.  And unknown but small percent of children have ALL their visits recorded.

##    Where are we?

**2000**

**2010**

**22%**

**95%**

- You are here

- Goal

**   ****Where are we?**

**Notes:**
So here is where we are and this is where we need to be.

##  Goal Requirements:

- Enroll an additional 10% of children each year for next 8 years
- Bring remaining 24 states to status of fully functioning, state-wide registry
- Assist another 25% of public provide sites and 55% of private provider sites to participate

**Notes:**
Our work is laid out for us.

## Immunization Registries:Phase II

**Implementing the Systems**

**Notes:**
So now in 2001
We move into Phase II
Implementing the systems we’ve built.

##  Reaching the Goal:

- 1.  Think strategically
- 2.   Work cohesively
- 3.   Implement creatively

**Notes:**
The goal of 95% children enrolled in a registry will no “just happen”
WE MUST

##  Think Strategically

- Develop a national strategic plan on how best to reach HP 2010 Goal
- Set timed, realistic goals
- Determine best methods
- Implement and monitor activities
- Measure achievement

##  Work Cohesively

- State and Local Health Department involvement in goals and objectives of strategic plan
- Coordinated activities through national organizations (AIRA, ECBT) and events
- National standards accepted and adopted

##  Implement Creatively

**Every Child By Two Awards:**
**Arkansas:  Recalled children who had received invalid doses of vaccine**
**Oklahoma:  Assessed IPV implementation**
**Sentinel Sites**
**Cities, states or counties where a subset ****of children <6 routinely added to registry**
**Sites used to monitor coverage and do special studies**
**	**

## Registry Sentinel Sites

- New York City:  9 private providers (16,588)

- Arizona:  Coconino County (12,294)

- Michigan:  Jackson, Kent, Muskegon Counties
- (92,879)

- Utah: Utah County Health Department (22,500)

- Oregon:  Managed care (10,533)

- Oklahoma:  Public health clinics (160,000)

- San Antonio:  WIC (32,410)

- Washington, D.C.:  Medicaid Managed Care (18,605)