|
Purple indicates an area covered by an AKC I or II immunization registry. Click on the map to view a brief for that area's project, or select from the
list below. Information is only available for current (Phase II) projects.
Phase I and II All Kids Count projects collectively represent the country's most advanced base of experience with immunization
registry development and operation.
Under the guidance of the National Program Office
(NPO) of All Kids Count, All Kids Count projects work toward four common goals:
- The development of model programs.
- Ensuring that the All Kids Count program is complementary, not duplicative or competitive with other efforts.
- Sharing successful development techniques from the All Kids Count projects with the public health community.
- Assuring that the successes of the program can be replicated and sustained on a national basis.
Although each All Kids Count project is developing an immunization information system tailored to its community's unique needs, the
projects grapple with common issues and obstacles. These include:
- Customizing registry systems to meet the needs of their community.
- Maintaining security of records.
- Gaining participation of providers and managed care organizations.
- Building coalitions of public and private sector organizations.
- Investigating innovative technologies.
- Exploring reminder/recall and outreach strategies.
- Setting standards for data collection and exchange.
- Establishing linkages with other programs, such as WIC.
- Overcoming cultural differences and boundaries.
- Participating in immunization-related legislation efforts.
Back to about All Kids Count
AKC II Project Brief
Project Name:
Arizona State Immunization Information System
Contact:
Kathy Fredrickson
3815 North Black Canyon Highway
Phoenix, Arizona 85015-5351
Tel: (602) 230-5855
Fax: (602) 230-5817
KFredri@hs.state.az.us
Area Covered:
State of Arizona
Annual Birth Cohort:
71,042
Sources of Funding:
The Robert Wood Johnson Foundation
(AKC II), Flinn
Foundation, federal funds, state funds
Percentage of 0-2 year-old target population in the registry with immunization histories:
19.3%
Percentage of immunizations given in the private sector:
Approximately 50%
Percentage of private providers submitting and retrieving data from the registry:
Approximately 52%
Registry software, hardware platform and network architecture:
Software: PC-based data collection application (PC-Immunize) written Paradox for Windows and migrating to Delphi.
Back-end database: Oracle 7.3 on a Sun Sparc 2000 Network architecture: State frame relay network for county health departments; dial-in modem connections via local and toll-free lines; Internet e-mail. In development: FTP and possible web-enabled application.
Linkages with other programs:
WIC.
Do you have legislation, or are you planning to introduce legislation, authorizing the establishment of a registry?
Effective January 1, 1998, providers are required to report immunization data to the state into
ASIIS.
How has legislation, or the lack of legislation, been beneficial or detrimental to the project?
Although it is too early to answer the question completely, the immediate benefit has been the addition of immunization data to the database.
List the three most significant problems/lessons learned:
- Registry
development, implementation, and support are a
team effort in which all succeed or all fail.
Technology is not the only answer.
- Building
relationships with private providers is
paramount; thus, the time and effort to
integrate their systems by working with their
billing vendors is an on-going essential.
- Data
quality, timely provider feedback, registry
evolution, value added features, and an
on-going education, training and registry
marketing effort are all essential for
sustainability and success.
List three most significant accomplishments:
- Surpassing our installation goal of 145 sites by 25% (182 sites by the end of 1997).
- Successfully implementing the last major component of the registry software to allow for statewide record retrieval from the central registry.
- Obtaining collaboration from 94% of all patient management vendors (16/17) to write the export capability to send data to PC-Immunize.
List three current priority objectives for 1998:
- Expand the user base to 350 sites.
- Initiate new users group specifically for private provider sites to provide education and information as well as solicit
input on this group's registry needs and requirements.
- Populate registry with Electronic Birth Certificate
(EBC) data.
Back To Top
AKC II Project Brief
Project Name:
Arkansas Immunization Registry System (AIRS)
Contact:
Karen Fowler, Health Program Analyst
Arkansas Department of Health
Division of Communicable Disease/Immunization
4815 West Markham, Mail Slot #48
Little Rock, AR 72205
Tel: (501) 661-2720
Fax: (501) 661-230
kfowler@mail.doh.state.ar.us
Area Covered:
State of Arkansas
Annual Birth Cohort:
Approximately 35,000
Sources of Funding:
The Robert Wood Johnson Foundation (All Kids Count II), the Centers for Disease Control and Prevention, WIC, State Medicaid reimbursement
Percentage of 0-2 year-old target population in the registry with immunization histories (other than first Hep B shot):
There are approximately 73,000 immunization records on children ages 0 –2 years within AIRS. However, no programming is currently in place to distinguish those with only one Hep B.
Percentage of immunizations given in the private sector:
It is generally felt that 20% to 30% are given in the private sector although there is no supporting data. A survey (completed in 12/97) was conducted to determine who provides immunization services in the State. From the 4,763 physicians most likely to provide immunizations surveyed, 1,940 responded. Of the responders, 430
(22.2% or less than 10% of physicians surveyed) indicated they had given immunizations within the last 12 months. Data is still being processed to distinguish public from private.
Percentage of private providers submitting and retrieving data from the registry:
There are 225 private provider sites currently submitting and requesting immunization data manually. There are 5 private provider facilities that have electronic access. Each of these facilities has
multiple sites.
Registry software, hardware platform and network architecture:
Software: PACE and COBOL languages are used by in-house programmers
Hardware: WANG mainframe
Network architecture: Four WANG 12000 processors connect the Arkansas Department of Health field offices via a 56Kbps digital
leased line. The four processors are connected via an Ethernet (802.3) and/or fiber optical FDDI network scheme. Non-health department facilities dial up using a special communication software package.
Linkages with other programs:
AIRS is a part of an integrated Common Customer database within
the Arkansas Department of Health where like information is shared among the various programs. The Division of Vital Records provides selected birth certificate information to populate the database as well
as updates from the death certificates. WIC has access to an immunization evaluation screen that alerts staff of immunization needs. In addition, the Department of Human Services has access
for foster children and the Children's Medical Services Division. And, one hospital project provides immunizations to day cares and head start programs within a section of the Little Rock area.
Do you have legislation, or are you planning to introduce legislation, authorizing the establishment of a registry?
Act 432 was passed in 1995 establishing the registry and requiring the reporting by immunization providers. In 1997, there was an amendment authorizing the Board of Health to expand access to
those other than "health care professionals" as specified in Act 432. Rules and regulations are in the final stage of processing.
How has legislation, or the lack of legislation, been beneficial or detrimental to the project?
Immunization legislation packages have been initiated, supported, and virtually unopposed by both the medical and political communities. Although not officially implemented, there has been
increased awareness of the registry and its importance to improving immunization levels.
List the three most significant problems/lessons learned:
- Record duplication.
- Data accuracy.
- Maintaining forecasting tables.
List three most significant accomplishments:
- Linkage with WIC and Vital Records.
- Registry legislation.
- Statewide access in the public sector.
List three current priority objectives for 1998:
- Expanding electronic access to private providers
- Improving and maintaining data quality
- Marketing the registry and its tools (reports, CASA, GIS, automatic reminder/recall, etc.)
Back To Top
AKC II Project Brief
Project
Name:
The Connecticut Immunization Registry and Tracking System (CIRTS)
Contacts:
Joan Christison-Lagay
Health Dept-131 Coventry Street
Hartford, CT 06112
Tel: (860) 547-1426
Fax: (860) 722-8000
Jillian Wood
135 Broad Street
Hartford, CT 06105
(860) 525-9738
(860) 524-1092
jwood01@snet.net
Area Covered:
State of Connecticut
Annual Birth Cohort:
46,000-48,000
Sources of Funding:
Centers for Disease Control and Prevention via Connecticut Department of Public Health, Aetna Foundation (1993-1995), The Robert Wood Johnson Foundation (All Kids Count II)
Percentage of 0-2 year-old target population in the registry with immunization histories:
84%
Percentage of immunizations given in the private sector:
80%
Percentage of private providers submitting and retrieving data from the registry:
Approximately 70% submit but currently only 10% retrieve.
Registry software, hardware platform and network architecture:
Current system uses the early edition of Acclaim by Public Health Software, called ICES, a DOS
Foxpro-based application.
We have chosen new software,
CDSI, through the CDC process. Modifications to make it specific to CT begin in August, to be
operational by 12/98. Because of this delay, we are currently exploring possibilities of putting old software on the new hardware.
Linkages with other programs:
There are no electronic linkages yet. WIC makes telephone or paper queries.
Do you have legislation, or are you planning to introduce legislation, authorizing the establishment of a registry?
Passed and signed in May 1994. Utilized by CIRTS effective January 1, 1995.
How has legislation, or the lack of legislation, been beneficial or detrimental to the project?
Benefits:
All children can be enrolled unless parent refuses enrollment in writing.
- Providers understand that they must provide information to CIRTS and can see the advantage of reporting to a centralized system.
- Private sector insurance companies which provide Medicaid managed care are willing to contract with CIRTS to collect and report on immunizations.
- Private companies are paying a public sector program for the information it gathers, eliminating duplicative data collection.
Disadvantages:
Legislation not specifiy enough on what registration information is
required. Current birth certificates (through which children can be entered) does not specify the intended medical home of the infant, telephone number for family, or alternate person through which the
family can be contacted. Thus, many infants enrolled from birth certificate information cannot be found. Legislation does permit regulations through which CIRTS is trying to address this limitation.
In addition, once all providers are online and report immunizations on all children in their practices, not just Medicaid children, the problem will lessen.
List the three most significant problems/lessons learned:
- It is harder and more tedious than it seems.
- It is worthwhile to offer remuneration to pediatric practices for pulling/entering back histories when a system first starts
enrolling children. To avoid this, it might be wise not to back track large numbers of children. CIRTS learned the hard way.
- Staff entering from remote sites need constant training and oversight.
List three most significant accomplishments:
- Passing legislation.
- Cooperating with CT Department of Social Services and Medicaid Managed Care plans to receive contracts from
the Plans to collect and report on data. It is much easier for practices to report to one central registry that can track children from one plan and/or practice to another.
- Demonstration that Medicaid managed care children on the registry have more readily available immunization histories
and higher recorded up-to-date immunization rates than children not in the registry.
List three current priority objectives for 1998:
- Install new software and hardware system to enable providers statewide to link electronically to
CIRTS.
- Link electronically all public providers and large private practices to
CIRTS.
- Link birth hospitals and collection of relevant birth and registration information to
CIRTS.
Back To Top
|
