Implementing Required School and Child Care Immunization Reporting through a Registry Julie Clark, MCIR Region 6, MDCH Kevin Czubachowski, Immunization Field Rep, MDCH

MCIR Activity 3.7 million children Over 47 million shot records 7,500 user log-ins to MCIR every day 2,203 provider sites submitted data in 2004

Need for School Integration Reasons for wanting to be able to integrate school data Improve the quality of immunization reporting Reduce school and LHD labor cost Reduce help desk and on-site database management cost Improve waiver and immunity data collection Create one system Communication Making data available to schools and child cares

Michigan Immunization Compliance Reporting History State law requires: All public and non-public schools report immunization compliance of their KD, 6 grade and new students into the school district All child care centers report their immunization compliance of all students > 12 attendees Started with paper reporting and manual assessment

Michigan SIRS History School Immunization Record-keeping System History: Development of a stand alone FoxPro database in 1988, school, LHD, state department Develop upgrades every time a new vaccine was added to day care or school requirements Support and distribution nightmares Program download available on the web (2003)

SIRS LHD and State Program Workgroup formation in 2001 Combined LHD and state school reporting Oracle database (SIRS 2) J-Initiator downloads for end users Encountered problems with operating systems, web browsers, printing

MCIR/SIRS Requirements document developed for a web application in Sept 2003 to incorporate SIRS with MCIR Work group meetings to hash out design and functionality, HIPAA, FERPA, roll out Regression and Beta Testing LHD web functionality for the 2004 day care and school immunization reporting

MCIR/SIRS School Roll Out 2004 MCIR Regions school recruitment MCIR view only training School access to view student immunization records Use of MCIR data to complete school immunization compliancy from a student’s original immunization record Schools and day cares continue to report to LHD using FoxPro application

MCIR/SIRS Roll out 2005 Issues with FERPA SIRS (upload DOE student data) User Agreements HeadStart Day Care 2465/5439=55% (Feb 06) Pre-School Public and Non-Public Schools - 4108/5595=73% (Feb 06)

Hurdles to School Data Integration Issues with trying to integrate data: LHD monitoring of school and child care data Training users based on roles Assessment variance between SIRS and MCIR/SIRS Explaining the differences between MCIR and MCIR/SIRS Selling the product to the users Electronic transfer abilities

MCIR/SIRS Combining data MCIR-immunization provider role SIRS- LHD, school and child care role LHD verification of school data How is it done?

Access to MCIR/SIRS

User Id and Password

Roles and Site Selection

SIRS/MCIR Home Page

Demographics

Roster

Modify Roster

SIRS User add immunization Waivers are by Series

Comparison

Reports

IP Status

Period Closing

How does this work at a LHD? IP-100/101 based off MCIR/SIRS user’s roster Breakdown of School and District immunization compliance Breakdown of reportable grades, K, O, 6

State Level View

LHD view of an IP-100

Immunization History LHD View Verification of School Data

LHD verifying Immunization Record

Immunization data viewable by Providers

How does this work at the State level? View IP-100/101 View individual school and district immunization compliancy data View Migrant school immunization compliancy

State View of School Immunization Compliance

State Level user sites edit abilities

Transfer Process for Schools

Ongoing Improvements and Data Quality Issues Reporting timelines coherence Ongoing Training issues User log in issues Conforming to new reporting standards Discoverer Reporting

Acknowledgments Bob Swanson, M.P.H., Project Leader, Acting Director, Division of Immunization Division of Immunization Support Staff Kevin Garnett, Gerry Bragg and tech support, Web and Database Design Workgroup and Macomb County Health Department, _ and Beta Testing John Baker, Site Administrator Assignee MCIR Regions and Help (MPHI) Desk 45 LHD’s, 4108 Schools and 2465 Child Care Centers

CzubachowskiK@michigan.gov jclark@phdm.org Contacts CzubachowskiK@michigan.gov jclark@phdm.org