ELECTRONIC CASA E-CASA MERGING AFIX AND IMMUNIZATION REGISTRY TO HELP INCREASE STATEWIDE IMMUNIZATION RATES

AFIX ASSESSMENT FEEDBACK INCENTIVITES EXCHANGE - eXchange

CLINIC ASSESSMENT SOFTWARE APPLICATION(CASA) Tracking Tool Assess Immunization History Produce Reports to analyze data

IMMUNIZATION NETWORK FOR CHILDREN (INC) Arkansas Immunization Registry (WEB-BASE, STATE WIDE) Program written for compatibility for CASA

CASA + INC = ELECTRONIC CASA or E/CASA

E-CASA HOW DOES IT WORK? Data is downloaded from the registry and imported into the CASA database CASA produces various reports for immunization assessment and tracking

ARKANSAS DEPARTMENT OF HEALTH CD/IMMUNIZATION WORK UNIT PROCESS ARKANSAS DEPARTMENT OF HEALTH CD/IMMUNIZATION WORK UNIT

75 COUNTIES FIVE (5) REGIONS

IMMUNIZATION SCHEDULE ACIP RECOMMENDED SCHEDULE BY 18 MONTHS OF AGE 4 DTaPs 3 IPVs 1 MMR 3 Hep Bs 3 Hibs

CASA ASSESMENT BY VFC REPS (2000) STANDARD PROCEDURES Line listing from INC Random record selection from CASA 50 Records or the birth cohort Manual assessment from IMM record

CASA ASSESSMENT REQUIREMENTS LHUs 1ST Quarter of each year Goal: 83% or higher If below 83%, 2ND Assessment (CASA) would be done in five (5) months

SELLING CASA COMPLAINTS FROM FIELD Not enough time Double keying PC Tickler system Duplicate record from registry Data entry not up-to-date Too many records for tracking

DOOR OF OPPORTUNITY PC placed in each LHU Real time data entry by RNs VFC site visit (requirement to offer CASA training) Registry data abstracted by last provider

SELL PITCH! Out source /In house IT produced program for data download E-CASA is Born Instead of all records - 19 months of age only Data generated on a monthly basis to LHUs Central office staff and VFC Reps train providers

WHY 19 MONTHS? A child should have all IMMs by 18 months of age Give the provider five (5) months to track any child that may be missing a shot(s) Our findings -Most children were missing the 4th DTaP One (1) visit could bring a child up-to-date before they turn 24 months of age

PROBLEMS - YES! Convincing the Agency to allow the program Computer problems from central office and field Staffing from central office Downloading data

OVERCOMING BARRIERS E-CASA requests exceeded staff resources Requests for numerous reports from Central Office LHU/Field Flu season activities became priority

RESULTS = INCREASE IN RATE / 11%

Arkansas Childhood Immunization Rates Improve FOR IMMEDIATE RELEASE February 10, 2005 Arkansas Childhood Immunization Rates Improve Arkansas Among Five States in Nation Showing Most Improvement (Little Rock--) The latest National Immunization Survey for July 2003 through June 2004 reveals Arkansas’ childhood immunization rates have increased 12.4 percentage points from 67.1 percent (in CY 2000) to 79.5 percent placing Arkansas among five states showing the most improvement. The rates are based on children 19-35 months of age who received four doses of Diphtheria, Tetanus, and Pertussis; three doses of Poliovirus; one dose of Measles, Mumps, and Rubella; three doses of Haemophilus Influenzae Type b; and three doses of Hepatitis B. This increase puts Arkansas closer to the U.S. National rate, which is 80.5 percent for the same time period. Other states showing improvement are New Mexico, Delaware, Ohio, and Florida. Connecticut leads the nation with a rate of 92.4 percent. According to Charles Beets, Communicable Disease/Immunization Work Unit Leader, “These increases are due to the hard work of local health units colleagues and private providers and their efforts to get these children immunized.” Dr. Fay Boozman, Health Department Director, states, “I am so proud of our local health units and private providers for what they have been able to accomplish. We have gone from 48th in the nation in 2000 to 32nd nationally for the period ending June 30, 2004.” ###

ARKANSAS RECOGNIZED! ARKANSAS LISTED AMONG FIVE STATES IN NATION SHOWING MOST IMPROVEMENT BY NIS WENT FROM THE 48TH TO 32ND NATIONALLY

WHERE DO WE GO FROM HERE? Produce data in a timely manner Allow the LHUs to abstract their own data using the new web-based registry Branch out to Non-ADH providers Working together!

THANKS TO: Charles Beets -CD Work Unit Leader Statewide Services-Renee Patrick & Jerry Jones/Lin Watson, Randy Lee & Karen Fowler -IT/D. Reeves & R. Canerdy LHU COLLEAGUES VFC Representatives: Dianne Pettit- Central Region Linda Hutchison-Northeast Region Mickey Sisco-Northwest Region Cassie Lewis-Southeast Region Devra Dougan-Southwest Region

ARKANSAS CONTACT Ruby A. Brown, VFC Coordinator CD/Immunization Work Unit 4815 West Markham, Slot 48 Little Rock, AR 72205 501-661-2170 rjbrown@healthyarkansas.com