Registries as tools for provider quality assurance and clinic assessment Diana Bartlett National Immunization Program Immunization Registry Support Branch

Background  “Core Elements For AFIX Training and Implementation” (April 2002) identify registry data as an option for data collection during the vaccination coverage assessment process

Methods  56 of 64 CDC immunization grantees responded to provider quality questions in Immunization Registry Annual Report  Self-report  Descriptive statistics calculated using MS Excel

Results  39% of responding grantees use the registry to monitor the VFC vaccine administration  66% could identify VFC-eligible children in the registry  30 (55%) use the registry to do provider assessments as part of AFIX

Results: Using registries  Of the 31 grantees that use a registry in AFIX…  13(42%) start with a registry-based review and supplement with chart review  7 (23%) only use registry records for their AFIX assessments  8 (26%) start with a chart review and supplement w/registry data  3 (9%) use some other method

Results: Characteristics  Of the grantees that only use the registry in AFIX visits:  All have 100% participation in public sites  Only use registry for public site AFIX assessments

Results: Medical Home  During AFIX, which registry records do you select to calculate the coverage for "Provider X"?  40% from all children seen most recently from Provider X  25% from all children seen one or more times by Provider X  35% from another method

Results: Generating reports  30/31 grantees responded  77% generate reports by exporting data to CASA  23% generate reports directly by registry software

Results: HEDIS measures  28/56 (50%) grantees reported that they provide HMOs with information for HEDIS reporting  Of these 28, 20 also use registry in AFIX process

Results: Vaccine management  24 (43%) grantees reported that they use the registry to track vaccine inventory  6 of these grantees reported that they use the registry to order vaccines  Only one state (Maine) reported that they use the registry to order vaccines through VACMAN

Conclusions  Registries used to assess vaccination coverage in public clinics  Many registries store VFC-eligibility information  CASA main software for reports  Registries assist in HEDIS reports

Percent Difference between Coverage Levels based on Clinic-based vs. Registry-based Data, San Antonio, , n=92 clinics Conclusion: Registry-based coverage > clinic- based coverage Percent coverage difference

Discussion  Data quality assurance  Complete data for population  Inactivating records- medical home  Training of providers and VFC-AFIX staff on using the registry

Next steps  VFC-registry assessment in Utah to measure  Time savings for AFIX staff to use registry data for assessment (CASA)  Time savings to providers to produce electronic doses-administered reports  Continue collecting data on registries and AFIX/CASA activities