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MAY
2000
Immunization
registry news from All Kids Count.
Issue
Number 14
MAY 31, 2000
Welcome
to SnapShots, All Kids Count's
newsletter about the progress, best
practices and accomplishments of
immunization registries across the
country. We invite you to share news
about your registry. Email us:
SnapShots@allkidscount.org or call us at
(404) 687-5615 with information about a
successful programmatic or technical
innovation, major accomplishment or
milestone that your registry has
reached. SnapShots is sent to
subscribers monthly by All Kids Count.
Current and past issues also are
available on the All Kids Count Web
site: www.allkidscount.org.
Washington
Legislative Briefing Underscores Need
for Sustained Funding of Registries
Former
First Lady Rosalynn Carter and Mrs.
Betty Bumpers, wife of former Senator
Dale Bumpers, joined with health experts
in early May to urge Congress to find
the political will and financial backing
for development of immunization
registries that can ensure every child
is immunized on time by age 2.
As
William H. Foege, MD, MPH, senior
advisor to the Bill and Melinda Gates
Foundation and world-renowned
immunization policy expert, said,
“Vaccines do no good if they are not
used. Creating a system to use them
properly is as important as developing
vaccines in the first place. One is the
product of good science; the other is
the product of good governance.”
Foege
and other experts spoke at a legislative
briefing in Washington, D.C., to inform
members of Congress about registries,
especially the need to find a sustained
funding. All Kids Count co-sponsored the
briefing with major health and education
organizations; Mrs. Carter and Mrs.
Bumpers, co-founders of Every Child By
Two, hosted. Congressional co-sponsors
were Senators Jack Reed (D-RI), Arlen
Specter (R-PA), Tom Harkin (D-IA),
Edward Kennedy (D-MA), Dianne Feinstein
(D-CA), Mike Enzi (UT), Richard Durbin
(D-IL), and James Jeffords (R-VT); and
Representatives Henry Waxman (D-CA);
Gene Green (D-TX); and James Greenwood
(R-PA).
Data
were presented showing that immunization
registries not only can increase or
sustain high immunization rates, but
they also can save twice what they cost.
A fully operational system of
immunization registries could annually
eliminate approximately $250 million in
costs incurred in this country by making
accurate, up-to-date immunization
information available to health care
professionals and schools. The cost to
complete and maintain immunization
registries is approximately $5 per child
per year, for all children up to age 6,
or $125 million annually.
Since
1992, over $200 million has been
invested in the development of
registries by federal, state and local
governments, and private foundations.
Approximately $50 million annually is
now being spent on registries. Of that,
42% is from federal funding for state
immunization programs (federal section
317 funding), while 58% is from
states/counties/cities, HCFA/Medicaid,
health plans, foundations and
fee-for-service.
Approximately $65 million
annually is needed to complete and
maintain community- and state-based
immunization registries. The 1999
National Vaccine Advisory Committee
report on immunization registries called
for a five-year grant program to fund
registries. For more on the legislative
briefing, go to http://www.allkidscount.org/key_issues/RegistryFunding/registryfunding.html
The
briefing made it clear that legislators
are concerned with immunizations, but
that most are not aware that
immunization registries are important
tools for sustaining high immunization
rates. We encourage all involved in
development of immunization registries
to contact their legislators, locally
and in Washington, to bring them up to
speed on the progress of their local
immunization registry.
Materials from the legislative
briefing are posted on the AKC web site,
www.allkidscount.org. If you are unable to download materials, please email info@allkidscount.org
with your request.
All Kids
Count Grantees Share Progress,
Challenges
The
16 All Kids Count II projects met in May
for two days at the final All Kids Count
grantee meeting in Atlanta to exchange
the lessons they have learned during
their two years as grantees of the
Robert Wood Johnson Foundation. In an
open exchange of information, the 16
projects (Arizona, Arkansas, Baltimore,
Connecticut, Michigan, Minnesota,
Nevada, New York City, Oklahoma, Oregon,
Philadelphia, Rhode Island, San
Bernardino Co., Santa Clara Co., South
Carolina, and Washington) presented
their progress toward and the challenges
encountered in meeting All Kids
Count’s definition of “fully
operational,” defined as a registry
that:
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Includes 95% of resident
children less than or equal to 24
months of age in the catchment area.
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Includes 95% of children less
than or equal to 24 months of age in
the registry with immunization
events other than Hep B if
administered in the hospital.
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Has 90% of all providers
(public and private) in the
catchment area submitting
immunization data to the registry.
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Generates reminder or recall
notices to parents, physicians
and/or outreach staff.
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Produces population-based
immunization coverage analysis.
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Adequately protects the
confidentiality of data: existence
of written confidentiality and
security polices.
The
All Kids Count National Program Office
recognized projects’ achievement and
progress with special awards:
Best
Overall Achievement: Baltimore and
Minnesota
Outstanding
Achievement: Arizona and Oregon
Most
Dramatic Increase in Private Provider
Participation: San Bernardino Co.,
CA
Most
Dramatic Increase in Children enrolled
in the Registry with Immunization
Histories:
Santa Clara Co., CA
Greatest
Increase in Registry Participation:
Michigan
Most
Timely Capture of Birth Data: Rhode
Island
Use
of Registry Data in Recalling Children:
Arkansas
Use
of Registry Data for Outreach to
Children: Philadelphia
Use
of Registry Data to Study the Impact of
New ACIP recommendations: Oklahoma
Accomplishment
and Leadership in Data Quality: New
York City
Creativity
in Recruiting Private Providers:
Connecticut
Resourcefulness
in Meeting Registry Challenges:
Nevada and South Carolina
Outstanding
Multi-County and State Partnerships:
Washington
Updated
descriptions of each of these projects
are available online at http://www.allkidscount.org/aboutakc/akcprojects/akcprojects.html
Use of
Registry Data Predominant Theme
Projects’
reports at the grantee meeting provided
participants with a wealth of new ideas
about registry issues. A major theme
that emerged was increased use of
registry data.
(Future issues of SnapShots will
report on other themes.)
Most
projects have until recently focused
their efforts on developing the
technology and populating the database
rather than using the data for public
health purposes or for the benefit of
the providers who participate. But as
registries have matured (i.e., more
providers submit data and more children
are in the database), they are able to
produce useful data. The reports that
registries can produce are now a major
incentive for providers, clinics and
health plans to participate in the
registry. Registries recognize the
importance of feedback to providers and
are aggressively developing ways to
provide more useful information faster
and easier.
Jeff
Weihl of Michigan noted humorously,
“We tell providers that the registry
does everything but the dishes.”
Michigan, like several other projects,
develops customized reports for
providers including a vaccine inventory
report, patient immunization status and history, doses administered report, and
several recall reports.
In
Arkansas, for example, an automated
feedback module has been developed in
response to requests from providers for
information about their practices. Once
the module is implemented, providers
will be able to request automated
feedback by fax, email or Web posting.
Reports will be sent to users on which
data were accepted and which were not
and why; doses administered; and clients
that are due or past due for shots.
Monthly reports will be sent to
non-reporting providers reminding them
to report. Coverage levels are expected
to increase. For the central registry
staff, the payoffs are many: The
feedback module will monitor which
providers are reporting, identify
pockets of need, and eventually lead to
improved data quality. It also will
minimize staffing resources by
generating reports automatically.
In
the Southwestern Minnesota registry (21
counties), data are used to measure
overall rates by county and clinic,
track vaccine usage changes, track
children with undeliverable addresses to
inform health plans, track the
effectiveness of reminder and recall,
and even help a health plan decide if
they needed an additional doctor by
doing a zip code analysis of age
cohorts.
Many
registries are enhancing their
technology to make provider reports
easier to access and more useful,
principally through moving to or
enhancing web technology. Other
enhancements being implemented by
various registries include the addition
of Geographical Information Systems
(GIS), interactive voice recognition
systems, and automated reminder/recall
telephone systems.
We
hope you will forward this e-mail to
others who may be interested in
receiving SnapShots.
To SUBSCRIBE, please go to http://www.allkidscount.org.
This information will remain
confidential and will not be sold or
passed on to other parties.
COMMENTS,
PROBLEMS OR QUESTIONS, PLEASE CONTACT US
AT:
All
Kids Count
750 Commerce Drive, Ste. 400
Decatur,
GA 30030
Voice: 404-687-5615
FAX:
404-371-0415
Web: http://www.allkidscount.org
E-mail: snapshots@allkidscount.org
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