What to do before you have a Registry?: Provider Preparation Presentation to 2002 National Immunization Registry Conference October 28-30, 2002 Philadelphia PA

NCIR History : North Carolina Immunization Registry (NCIR) introduced to Local HDs –a component of Health Services Info (Mainframe) System (HSIS) –main functionality to fulfill vaccine accountability

NCIR History : Efforts to bring full functionality to NCIR and to make it available to private providers –Key Functionality Still Missing: No Private Providers No Automated Recommendations No Reminder/Recall

NCIR History : Focus shifts to replacing NCIR with new system –Key Criteria in Selection of New System Meet all of CDC Minimum Functional Standards System Proven to Work System is Web-based

While moving towards a Web-Based system... Private Provider Accountability Assessment Program Registry Demonstration Project Readiness Steps

Private Provider Accountability Vaccines Administered Log –Accountability for state supplied vaccine –Page totals entered into VACMAN doses administered –Birth date, Service date, Eligibility entered into annual benchmark tool –Copy to Local HD to enter historical doses on own patients

Private Provider Accountability Vaccines Administered Log (VAL) –Patient Specific vaccine accountability form Name Birth date Eligibility/Insurance Service date Vaccine type and dose number in series –Notes section Record privately purchased vaccine Document lot #, manufacturer, expiration date of vaccine Vaccine Information Statement (VIS) Chart number Other important or identifying information

Private Provider Accountability - 2 Provider Specific Feedback Reports –Number of vaccine doses unaccounted for –Percent of total vaccine shipped that is not accounted for –Dollar amount of unaccounted for vaccine $$$

Success of Provider Preparation Steps -(in terms of registry preparation) Log forms and accountability feedback reports In use for over 3 years Approximately 1,100 providers report monthly Improvements in Vaccine Accountability Tedious task endears providers to the concept of new registry

Assessments in Public and Private Sector Public Sector Assessment –Health Departments actively using CASA –Track the widest possible cohort of children –Coordination with private providers Private Sector Assessment - AFIX –Feedback and Exchange of information –Introduction to CASA –Promotion of the PAiRS Project

Success of Provider Preparation Steps (in terms of registry preparation) Assessments Statewide “compliance” rate increased by 10% in 3 years Most counties track over 80% of birth cohort Local Health Departments have begun to place more emphasis on “Public Health Assurance Role”

PAiRS - Provider Access to Immunization Records Securely Periodic reload of immunization records from state registry and 2 managed care plans into a common database Built with in kind contributions from partnerships with the private sector Widely accessible, inexpensive and secure inquiry only access to immunization records via Internet Reliably identifies relevant records for an individual in the absence of a unique identifier

PAiRS - Provider Access to Immunization Records Securely Identify local early adopters and prepare them for registry implementation Begin to demonstrate value of registry to stakeholders - project visibility

Success of Provider Preparation Steps -(in terms of registry preparation) PAiRS Project Users in 152 sites as of 10/2002 Users in both public and private sector accustomed to patient matching features and internet use for looking up immunization records Private Providers have an understanding of the breadth of information that will initially populate the new registry

“Registry Readiness” Promote collaboration between public and private sector Introduce the concepts of Change of Process and Behaviors Realize importance of clinical correctness of existing data Promote the registry as an approaching reality - (finally) Minimize implementation time

Local Health Department Registry Readiness Tool Identify training needs of all staff who will work with the new registry Contact person works with state Immunization Branch to discuss potential problems, seek out technical support for increased readiness Identify how immunization delivery systems will change when the new registry is introduced

Success of Provider Preparation Steps -(in terms of registry preparation) Registry Readiness –Presentations made to regional meetings of local health department staff groups –Presentations made to local health departments and private providers –Central office team working on the process –~300 Records “cleaned up” in the existing system since 7/2002

Additional “Preparation” Measures Computer Capacities Survey administered at all VFC site visits –Question areas include: registry interest, current office computer systems, staff experience using computers –Over 1000 survey responses since 1998

The End! Contact: