1. Collaboration between
Utility of a Regional Immunization Registry in a Pediatric Emergency Department
Collaboration between
SUNY Upstate Medical University, Onondaga County Health Department and CNY Immunization Registry

2. Authors CNY Immunization Registry Katie Reed, MPA
SUNY Upstate Medical University
Jim Callahan, MD, FAAP, FACEP
David Reed, MD, FACEP
Victoria Meguid, MD, FAAP
Susan Wojcik, MS
Onondaga County Health Department
Cynthia O’Connor, MPA

3. Medical Students Participating
SUNY Upstate Medical University
Michael Danca
Shari Goldfarb
Toni Torrillo
Amit Kumar

4. For Patients treated in a Pediatric Emergency Department
1. Can a registry be accessed during real-time ED care to determine immunization status?
A. Prevalence of registry patients in the ED?
B. Immunization status per registry?
C. Rate of parental agreement with registry?

5. Healthy People 2010
“Population-based immunization registries will be a cornerstone of the nation’s immunization system by the year 2010”
Link health care providers with immunization partners such as HMO, WIC, etc…
95% of all children under the age of six will be in an immunization registry.

6. Prior Investigations
Randomized Study of Tracking with Outreach and Provider Prompting to Improved Immunization Coverage and Primary Care. Rodewald LE, et. al., University of Rochester, New York, in Pediatrics, Jan 1999
Providing Immunizations in a Pediatric Emergency Department: Under-immunization Rates and Parental Acceptance. Cunningham SJ, Jacobi Medical Center, Bronx, in Pediatric Emergency Care, August 1999

7. CNY Immunization Registry
Regional registry, part of NYSIIS
Population-based 14 county region
Data collection began in 1998
Voluntary physician participation
Signed consent required

8. Number of Children Consented Regionally

9. 14 County Saturation
Misspell
NYSDOH July, 2001

10. Primary Target Area Saturation
NYSDOH July 2001

11. Study Setting CNY population 1.5 million Syracuse MSA 735,000
Regional University Pediatric Emergency Department (17,530 visits)
Designated tertiary pediatric ED (54% of all peds ED visits to Syracuse Hospitals)

12. Methods Approved by IRB
Study Design: Prospective, observational, cohort study of ED patients 10 and younger
Study Period: 7 weeks of summer 2001
Convenience sample 10A-MN (95% of volume)
Interviews performed by medical students

13. Registry Access
Study site affiliated with University Pediatric and Adolescent Center
Facilitated access from pediatric internal database with regional database, due to lack of modem access
Trained medical student to query and print immunization history report using HealthyShot, registry software

15. Results

16. Results

17. Individual Immunization Deficiencies

18. Conclusions Real-time access was possible in an ED
34% of the children were in CNYIR
39% were documented to have immunization deficiencies
Only 26% were aware of IR enrollment
ED-PCP or outreach communication after an ED visit may improve identification of under-immunized patients

19. Next Steps
Continue to work on efforts to encourage data quality reviews at the providers sites.
Continue public awareness campaign to parents/guardians about IR
Establish mechanism for follow up to kids indicating immunization deficiencies.

20. Contact Information
Katie Reed
Director, Public Health
Partners In Health Systems
PO Box 249
5703 Enterprise Parkway
Dewitt, NY
ext 7217