Current Status of Immunization Information Systems in the U. S. Gary Urquhart, MPH Chief, Immunization Information Systems...
The Need for Immunization Information Systems in the U. S.
Births in the U. S. -  2006: 4.269 million live births (11,695 births every day). 1 The U.S. Census Bureau reports that be...
Patients with at least 1 immunization from Dane County Health Department Consolidation of Immunization Histories
Extra-Immunization <ul><li>A 2000 study published in JAMA found that 1 in 5 US children had received at least 1 extra vacc...
Public Health Emergencies <ul><li>Two recent papers describe the role of IIS during Hurricane Katrina: </li></ul><ul><ul><...
 
New Vaccines Continue to be Added to the U. S. Immunization Schedule and Increasing Costs 1985 and 1995 represent the aver...
Immunization Program Operational Support <ul><li>Immunization information systems provide operational support to immunizat...
Immunization Information Systems –  Relevance to Electronic Health Records or Health Information Exchanges Health Informat...
Immunization Information Systems –  Relevance to Electronic Health Records or Health Information Exchanges Distributed sys...
Current Status of U. S. Immunization Information Systems
Immunization Information Systems Age Groups Participating in an IIS Source:  2007 Immunization Information System Annual R...
National Participation: 71% Source:  2007 IISAR Immunization Information Systems – December 31, 2007 Participation Progres...
Immunization Information Systems Provider Site Participation in IIS Source:  2007 Immunization Information System Annual R...
<ul><li>IIS State Legislation (including Washington DC): </li></ul><ul><li>Authorizes an IIS:  27 states (53%) </li></ul><...
Immunization Information System Capacity to  Track Adolescent and Adult Vaccinations <ul><li>Data from the 2007 Immunizati...
<ul><li>77% of grantees have population-based IIS  </li></ul><ul><li>On average, 70% of newborn records are recorded in a ...
<ul><li>94% of grantees have a written confidentiality policy for their IIS </li></ul><ul><li>88% of grantees have a writt...
% 4:3:1:3:3 Coverage for Children 19-35 Months of Age Participating in an IIS and the Impact of Completing 1 Dose on Cover...
Percentage of Enrolled Females Aged 11-18 Years with  ≥1 Dose of HPV Vaccine,  by Site and Quarter
Source:  Data presented by Jim Lutz, KIDS IIS (Philadelphia, PA). 
Data and slide courtesy K. Enger Immunization Coverage with MMR by Zip Code Michigan Care Improvement Registry (MCIR), Mar...
Contact Information: Gary Urquhart, MPH Chief, Immunization Information Systems Support Branch Immunization Services Divis...
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Friday 3.30 Pm Gary Urquhart National Overview, Registries Phase Ii

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  • Friday 3.30 Pm Gary Urquhart National Overview, Registries Phase Ii

    1. 1. Current Status of Immunization Information Systems in the U. S. Gary Urquhart, MPH Chief, Immunization Information Systems Support Branch Immunization Services Division National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta, Georgia November 2008
    2. 2. The Need for Immunization Information Systems in the U. S.
    3. 3. Births in the U. S. - 2006: 4.269 million live births (11,695 births every day). 1 The U.S. Census Bureau reports that between 2006 and 2007, 38.7 million (13%) people moved in the United States - 11.7 million (30%) are < 19 years of age. 2 Increasing Populations – Population Mobility 1 U.S. National Center for Health Statistics, Vital Statistics of the United States, annual; and National Vital Statistics Reports (NVSR) 2 U.S. Census Bureau
    4. 4. Patients with at least 1 immunization from Dane County Health Department Consolidation of Immunization Histories
    5. 5. Extra-Immunization <ul><li>A 2000 study published in JAMA found that 1 in 5 US children had received at least 1 extra vaccine dose by age 19 to 35 months. 1 </li></ul><ul><li>Annual costs associated with extra-immunization were conservatively estimated to be $26.5 million. </li></ul>1 Feikema, SM, Klevens, RM, Washington, ML, Barker, L. Extraimmunization Among US Children. JAMA 2000;283:1311-1317.
    6. 6. Public Health Emergencies <ul><li>Two recent papers describe the role of IIS during Hurricane Katrina: </li></ul><ul><ul><li>The Houston-Harris County Immunization Registry estimated cost savings of more than $1.6 million for vaccine alone and $3.04 million for vaccine plus administration fees was found.* </li></ul></ul><ul><ul><li>A CDC assessment of more than 21,000 successful electronic immunization queries of children and adolescents estimated that more that $4.6 million was saved in revaccination expenses.** </li></ul></ul>* Boom, JA, Dragsbaek, AC, Nelson, CS. The Success of an Immunization Information Systems in the Wake of Hurricane Katrina. Pediatrics. 2007; 119:1213-1217. ** Urquhart GA, Williams W, Tobias J, Welch FJ. Immunization Information Systems Use During a Public Health Emergency in the United States. J Public Health Management Practice; SeptemberOctober 2007.
    7. 8. New Vaccines Continue to be Added to the U. S. Immunization Schedule and Increasing Costs 1985 and 1995 represent the average federal contract price to account for price changes within the respective year. April 2008 represents the minimum cost to vaccinate children and adolescents and is based on the federal contract price as of April 2, 2008. The 2008 cost to vaccinate includes the new ACIP expanded recommendation for influenza vaccine for all children 0-18 year of age. Last updated April 8, 2008. $45 $155 $1,105 $1,407
    8. 9. Immunization Program Operational Support <ul><li>Immunization information systems provide operational support to immunization programs, providers, patients, and parents by: </li></ul><ul><ul><ul><li>automating evidence-based strategies </li></ul></ul></ul><ul><ul><ul><li>producing real-time data to ensure that children, adolescents, and adults are protected against vaccine preventable diseases, and by </li></ul></ul></ul><ul><ul><ul><li>assisting programs to deploy their resources efficiently and effectively </li></ul></ul></ul>
    9. 10. Immunization Information Systems – Relevance to Electronic Health Records or Health Information Exchanges Health Information Exchanges are subsidy-based; pay to play. Data access limited to practices. Statutory support assures some financial sustainability; protection of privacy and security; governance; data is available to anyone entitled to access the IIS. Many EHR products offer an immunization module that shows a patient's immunization history but very little decision support functionality. Sophisticated functionality and decision support: deduplication; reminder/recall; coverage assessment; consolidation of records; vaccine validation and forecasting. EHR/HIE IIS
    10. 11. Immunization Information Systems – Relevance to Electronic Health Records or Health Information Exchanges Distributed systems. Software application maintained by the practice. Web-based systems maintained by state or local governments. Master patient index for a practice or group of practices. Tracks clinical encounters only. Master population index for a geopolitical area. Tracks children with and without vaccinations . EHR/HIE IIS
    11. 12. Current Status of U. S. Immunization Information Systems
    12. 13. Immunization Information Systems Age Groups Participating in an IIS Source: 2007 Immunization Information System Annual Report
    13. 14. National Participation: 71% Source: 2007 IISAR Immunization Information Systems – December 31, 2007 Participation Progress for U.S. Children aged < 6 years  95% Participation = 15 Grantees (27%)  80% Participation = 30 Grantees (54%)  60% Participation = 40 Grantees (71%) Challenges = 9 Grantees
    14. 15. Immunization Information Systems Provider Site Participation in IIS Source: 2007 Immunization Information System Annual Report
    15. 16. <ul><li>IIS State Legislation (including Washington DC): </li></ul><ul><li>Authorizes an IIS: 27 states (53%) </li></ul><ul><li>Mandates reporting: 14 states (27%) </li></ul><ul><li>Requires participation (Opt-Out): 44 states and Washington D.C. (86%) </li></ul>Immunization Information Systems State Legislation Source: Survey of State Registry Legislation (updated 11-9-2005)
    16. 17. Immunization Information System Capacity to Track Adolescent and Adult Vaccinations <ul><li>Data from the 2007 Immunization Information System Annual Report indicate that: </li></ul><ul><ul><li>About 17% (8 of 53 grantees) report that they include birth to < 23 years of age in their IIS. </li></ul></ul><ul><ul><li>About 77% (43 of 53 grantees) report that they include all ages in their IISs. </li></ul></ul>Source: 2007 Immunization Information System Annual Report
    17. 18. <ul><li>77% of grantees have population-based IIS </li></ul><ul><li>On average, 70% of newborn records are recorded in a grantee IIS within 6 weeks of birth </li></ul><ul><li>89% of grantees receive and process vaccine and other immunization data from their IIS within a month of vaccine administration </li></ul>Immunization Information System Status on Selected Performance Measures As of December 31, 2007 Source: 2007 Immunization Information System Annual Report Of those grantees with an IIS reporting:
    18. 19. <ul><li>94% of grantees have a written confidentiality policy for their IIS </li></ul><ul><li>88% of grantees have a written security policy for their IIS </li></ul><ul><li>43% of grantees can process and return an HL7 message as well as process and upload a record consistent with HL7 standards </li></ul>Immunization Information System Status on Selected Performance Measures As of December 31, 2007 Source: 2007 Immunization Information System Annual Report Of those grantees reporting:
    19. 20. % 4:3:1:3:3 Coverage for Children 19-35 Months of Age Participating in an IIS and the Impact of Completing 1 Dose on Coverage - December 2007 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% Idaho Illinois* Colorado Montana North Carolina Minnesota Rhode Island Texas Iowa Washington District of Columbia Wisconsin South Dakota Georgia Arkansas Michigan Philadelphia North Dakota Oregon Louisiana Grantees % IIS Participants with 4:3:1:3:3 Coverage % 4:3:1:3:3 Coverage for Children 19-35 Mths of Age Participating in an IIS Estimated NIS - 2007 4:3:1:3:3 Coverage (Counting Valid Doses) 1 Dose Completed Effect on 4:3:1:3:3 IIS Participant Coverage
    20. 21. Percentage of Enrolled Females Aged 11-18 Years with ≥1 Dose of HPV Vaccine, by Site and Quarter
    21. 22. Source: Data presented by Jim Lutz, KIDS IIS (Philadelphia, PA). 
    22. 23. Data and slide courtesy K. Enger Immunization Coverage with MMR by Zip Code Michigan Care Improvement Registry (MCIR), March 31, 2008
    23. 24. Contact Information: Gary Urquhart, MPH Chief, Immunization Information Systems Support Branch Immunization Services Division National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta, Georgia Phone: 404-639-8277 E-mail: [email_address]

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