Utilizing Immunization Registries in Local Public Health Accreditation Wendy Nye Supervisor, Region 4 Michigan Childhood Immunization Registry Kevin Czubachowski Immunization Field Representative Michigan Dept. of Community Health _________________________________________________ 9/20/2019

Michigan Local Public Health Accreditation Program Development of the accreditation process Assessment Protocol for Excellence in Public Health (AFEXPH) Accreditation Steering Committee Primary steps in accreditation process Inclusion of registry related indicators _________________________________________________ 9/20/2019

Michigan Childhood Immunization Registry (MCIR) Established through Public Health Code requirement Tracks children birth to 20 years Providers required to record shots administered as well as histories Software development Access granted to registered users State divided into 6 regions _________________________________________________ 9/20/2019

Accreditation & the MCIR Focus on immunization/registry related indicators Assess where local health departments stand Work with local health departments and providers to “clean up” _________________________________________________ 9/20/2019

Registry-Related Indicators Assessments using registry data: Semi-annual assessment & reporting Age cohort: 19 to under 36 months Over 50% for doses: 4 DTaP, 3 Hib, 3 Polio, 1 MMR, 3 Hep B, & 1 Varicella Local health’s role in registry: Submits data within timelines Attends regional advisory board mtgs. _________________________________________________ 9/20/2019

Behind the Scenes Indicators IAP reports include immunization coverage levels (submitted semi-annually) LHD shows evidence of recall system & collaboration with private providers Doses administered & compliance reports for VFC participating providers Provider updates using registry news screen and newsletter _________________________________________________ 9/20/2019

Assess Local Health Department Status (County X) January 2002: County profiles & ad hoc reports to identify areas of concern County profile: 33% (48% w/o Varicella) Large pediatric provider not giving Varicella: 9% (83% w/o Varicella) Developed an action plan and presented to LHD to reach accreditation goals by July 2002 _________________________________________________ 9/20/2019

MCIR Assessment Report 9/20/2019

Action Plan Activities Focus on children 12 to 31 months County-wide report listing children needing Varicella Drafted & sent letter from the LHD asking for Varicella records Provider education for pediatrician Legacy data collection & entry _________________________________________________ 9/20/2019

“Cleaning Up” Entered shot histories for 4 large volume immunization practices Utilized ad hoc reports to identify children with incorrect or no county field 813 letters sent (March 2002): 139 replies to region regarding Varicella history (return rate: 17%) Identification of duplicates _________________________________________________ 9/20/2019

Clean Up Results January 2002 County rate: 33% April 2002: June 2002: County rate increased to 43% July accreditation visit: County rate increased to 52% _________________________________________________ 9/20/2019

Lessons Learned: Benefits Increased county rates (spill-over) Better data quality Identified “border” providers Higher awareness of registry impact among data entry/management staff Stronger relationship with LHD _________________________________________________ 9/20/2019

Lessons Learned: Barriers Buy-in from local health department and staff Provider relationships with local health department & registry Organizational relationships Lack of staff training Technical issues Funding _________________________________________________ 9/20/2019

Registry Support for Accreditation Final question: Has the accreditation process increased the state immunization rates and increased registry compliance? Final answer: YES!!! _________________________________________________ 9/20/2019

Contact Information Wendy Nye, Supervisor, Region 4 MCIR 810-257-3562 E-mail: Wnye@co.genesee.mi.us Kevin Czubachowski, MDCH Immunization Field Representative 810-985-9246 E-mail: Czubachowskik@michigan.gov _________________________________________________ 9/20/2019