1. Costs of Implementing an Immunization Registry in Private Clinics
National Immunization Conference
Chicago, IL
March 18, 2003
Tina Higginbotham
Director, Research Administration
Iowa Health System - Des Moines

2. Overview
Assess the costs of implementing the Immunization Registry and Information System (IRIS)
IRIS in 6 private clinics (pediatric & family practice)
Project Period: Nov Sept 2002
Project Director designed project, recruited clinics and coordinated implementation

3. Purpose
To determine whether the implementation and use of a population based immunization registry is both cost- and time-effective in the private providers’ clinics.

4. Pre-Study Considerations
Site Selection
Implementation

5. Site Selection Criteria
Location of the clinic
Size of the practice
Type of practice
Current hardware in use
Level of enthusiasm of clinic personnel

6. Implementation Site interviews Staff training Data collection/entry
off-site
Data collection/entry
types of data
personnel

7. Study Design
Variables
Models
Analysis

8. Variables Number of New Records Number of Updated Records
Number of Patients
Number of Immunization Reports Requested
Time to Create a New Record
Time to Update a Record
Time Saved (by IRIS) with Immunization Reports
Personnel Expense
Discount Factor

9. Models Longitudinal Model Start-up Model
Cost of IRIS for a patient, from birth through age 5 (routine use of IRIS over time)
Start-up Model
Initial costs associated with implementation of IRIS and resulting benefits to the clinic

10. Longitudinal Model Base case assumptions:
creation and updates of an IRIS record according to the CDC-recommended immunization schedule
1.5 requests for immunization reports

11. Longitudinal Model

12. Longitudinal Model Base Case Results
Creating & Updating Records
Cost
$5.33 per patient
Savings
$5.27 per patient
Savings Represent 98% of Cost

13. Start-Up Model Timeframe for model is six years Base case assumed:
all patients would require an average of 1.25 updates over the next five years
patients would request an average of one immunization status reports

14. Start-Up Model

15. Start-Up Model Base Case Results
Costs:
Creating & Updating Records in Current Year - $11,148
Creating & Updating Records in Future Years - $5,304
Total Cost - $16,452
Savings
Current & Future Years - $21,582

16. Comparative Data

17. Comparative Data

18. Supporting Studies Horne, et. al. Five clinics
Modeled the cost of a registry for a preschool child
Estimated 95% of costs were recovered through savings in retrieving and reporting immunization data

19. Supporting Studies Rask, et. al. Three clinics
Two different registries (no automated data entry)
Comparison of demographic and immunization transactions
Savings were not reported in this study

20. Conclusion
Qualitative assessments revealed generally positive impressions of IRIS
Costs incurred in short-term generate savings in long-term
increased efficiency in generating reports
greater efficiency with vaccine inventory
possible decrease in missed or duplicated immunizations

21. Acknowledgements Iowa Department of Public Health
Bureau of Immunizations
Wellmark Foundation
Lon Larson, PhD