1. Inner City Community Physicians’ Use of a Private Immunization Registry
M. Irigoyen, S. Findley, K. Stambaugh, O. Peña, R. Jenders, M. Chitu
Northern Manhattan Immunization Partnership
Columbia University, New York, NY

2. Importance of Immunization Registries
Key tools for increasing and sustaining immunization coverage
In 2000: 24% of US children <6 in registry
Healthy People 2010 goal: increase to 95%
Universal provider participation key to achieve this goal

3. Role of Private Physicians
Private physicians administer most immunizations
Inner city children have multiple immunizations physicians
Immunization Record scatter

4. Northern Manhattan Immunization Partnership
CDC demonstration project in Northern Manhattan in New York City
Partner institutions:
New York Presbyterian Hospital,
Harlem Hospital Center,
Renaissance Health Care Network, St. Luke’s Roosevelt Hospital,
NYC DOH Child Health Stations

5. Northern Manhattan Immunization Partnership Registry EzVAC
New York Presbyterian Hospital
Ambulatory Care Network
School Based
Clinics
NYC DOH Citywide
Immunization Registry
Community
Providers

6. EzVAC Immunization Registry
Private registry in Northern Manhattan
Web-based and real time
Launched March 1999
Currently at 30+ practices
110,000+ children in the registry
98% vaccine capture rate
Types of clinics and settings

7. Implementing EzVAC to Private Physicians Offices
EzVAC was successfully launched at the hospital and school clinics
Next step launching EzVAC at private providers
get buy in (marketing)
deployment of EzVAC (technical piece)
integration into practice and use
EzVAC was successfully launched at the hospital clinic
the next stepwas to launch EzVAC at private ddoctors office in the community providers
First we had to get buy in (marketing)
deployment of EzVAC (technical piece)
integration into practice and use First step was to Now I will describe these steps and tell you how successful (or not) we were and the challenges we faced

8. Getting Buy In From Private Physicians
Selling points:
User friendly, web based interface
Automated VFC reporting
Reporting to NYC DOH Citywide Immunization Registry
Automated school printouts
Free hardware and services
Computer, monitor, and printer
DSL connection through Verizon DSL
Staff training and technical support
Monthly reports on the registry usage level

9. Characteristics of Physicians
N = 14 volunteer physicians
14 (100%) served Medicaid patients
12 (86%) y/o
11 pediatricians, 3 fam med
13 hospital appointments
12 solo practices
11 had 1 staff, 3 had 2 staff
80 children/week average
3 computer literate, 6 had office computers

10. Private Physician’s Use of EzVAC
23%
RARELY
NEVER
38%
39%
FREQUENT

11. Use of EzVAC First 6 Months by Practice

12. Factors NOT Associated With Patterns of Use
Physician’s age
Solo vs group practice
Physician computer literacy

13. Factors Associated With Patterns of Use
Pediatricians > Fam Med
Previously had computers in office
More staff in practice
Higher volume of patients

14. Factors Key to Success Physician champion
Successful integration of registry into practice flow by:
delegated data entry function to staff
made staff accountable
Physicians that took responsibility to enter data themselves rarely used the registry

15. Conclusion
We successfully deployed EzVAC at private offices in New York City.
Despite continued support and training use has been inconsistent.
Further studies are needed to identify barriers to adoption of immunization registries in inner-city, private office settings.