Registry Evolution: Lessons Learned Alisa Johnson October 28, 2003

Topics ImmuLink Overview Evolution Identifying change Lessons Learned Conclusions

Overview

Serves Twin Cities metropolitan region of Minnesota 770,000 records, 5.6 million immunizations. Approximately 1,000 users at 145 sites.

145 Participating Sites Community Health Departments Health Care Providers School Districts Charter and Private Schools Child Development Centers Community Action Agencies

Populated with Minnesota Birth Certificate Data (1990 - Present). Populated with Immunization Data from Public/Private Healthcare Providers and Schools. Updated automatically by linking names, birth dates, or mother’s birth name to existing records. New records are created for those individuals not currently in the registry.

Recruit and enroll new sites Accept data from users Ensure data quality Ongoing programming Train and support users Provide ongoing customer service and communication

Data Submission Options: Electronically sent datafiles extracted from database, practice management, and billing systems. Data directly entered into the registry.

Why a “Lessons Learned” presentation now? Decade milestone Big changes in our future

Evolution

Evolution In the beginning… Modem-based More tech involved Small staff taking on all duties Marketed to county and community clinics Had to sell idea of registry

Evolution Ongoing Switch to web-based application Added enhancements Added direct data entry option Refined de-duplication program Updated algorithm Added reminder cards Added schools Increased staff, redefined responsibilities

Evolution Currently…. Expanding to new counties Adding new sites Programming for community changes Staff duties shifting Merging with statewide registry Updating program plan

Identify Change

Change Technology Staffing Finances Laws and Regulations Community Structure

Change Program Analysis Surveys Focus groups Technology updates Internal communications Participant communications

Change Seek out information & use it…. Review and update policies Change procedures Adapt technologies Refocus energies

Lessons Learned

“If you build it, they will come…” Not necessarily….. Beginning stages = sell the idea Once established = sell the product Reminders Contraindications, etc Manufacturer, Lot #’s

“The best laid plans…” Make plans, in pencil Write definitions, in pen Policies and procedure manuals are never final Revisit and update plans often Get input Document progress

“It’s hard to be humble…” Your registry is not perfect Your data is not perfect Human error is inherent in all tasks Big egos impede production and progress Open your minds to learn and adapt

Nobody’s perfect…. Goal: Identify shortcomings Acknowledge them Address them Improve them to the furthest extent possible

Realize your limitations... More importantly, remember your purpose Are you within your government statutes, program guidelines, grantee duties, etc? Are you enforcing your policies? A registry is a registry - not a medical professional. Provide the info, let the professionals make the decisions. Allocate your resources accordingly

A registry is only as useful as it is useable... What we thought was useful wasn’t used….. Reminder cards Registry itself Customizing features Is your system intuitive?

We don’t work in a vacuum…. Change, Staffing issues, EMR’s, budget cuts, financial issues, attitudes, new statutes/policies (HIPAA!), computer issues, technology technicalities…..

“ Starring….Me!” Share credit Ask for help Share experiences Listen Recognize and Acknowledge contributions Celebrate accomplishments

Summary

Lessons Learned…. Be receptive to change, new ideas, possibilities Be honest Know your community Listen to your participants, colleagues Provide options USERS deem necessary Have a plan, but…be fluid….. Maintain and enforce policies Share ideas, failures and successes

Contact Information Alisa Johnson 612-348-4125 alisa.johnson@co.hennepin.mn.us