1. Utilizing Immunization Registries in Local Public Health Accreditation
Wendy Nye
Supervisor, Region 4
Michigan Childhood Immunization Registry
Kevin Czubachowski
Immunization Field Representative
Michigan Dept. of Community Health
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9/20/2019

2. Michigan Local Public Health Accreditation Program
Development of the accreditation process
Assessment Protocol for Excellence in Public Health (AFEXPH)
Accreditation Steering Committee
Primary steps in accreditation process
Inclusion of registry related indicators
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9/20/2019

3. Michigan Childhood Immunization Registry (MCIR)
Established through Public Health Code requirement
Tracks children birth to 20 years
Providers required to record shots administered as well as histories
Software development
Access granted to registered users
State divided into 6 regions
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9/20/2019

4. Accreditation & the MCIR
Focus on immunization/registry related indicators
Assess where local health departments stand
Work with local health departments and providers to “clean up”
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9/20/2019

5. Registry-Related Indicators
Assessments using registry data:
Semi-annual assessment & reporting
Age cohort: 19 to under 36 months
Over 50% for doses: 4 DTaP, 3 Hib, 3 Polio, 1 MMR, 3 Hep B, & 1 Varicella
Local health’s role in registry:
Submits data within timelines
Attends regional advisory board mtgs.
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9/20/2019

6. Behind the Scenes Indicators
IAP reports include immunization coverage levels (submitted semi-annually)
LHD shows evidence of recall system & collaboration with private providers
Doses administered & compliance reports for VFC participating providers
Provider updates using registry news screen and newsletter
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9/20/2019

7. Assess Local Health Department Status (County X)
January 2002: County profiles & ad hoc reports to identify areas of concern
County profile: 33% (48% w/o Varicella)
Large pediatric provider not giving Varicella: 9% (83% w/o Varicella)
Developed an action plan and presented to LHD to reach accreditation goals by July 2002
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9/20/2019

8. MCIR Assessment Report
9/20/2019

9. Action Plan Activities
Focus on children 12 to 31 months
County-wide report listing children needing Varicella
Drafted & sent letter from the LHD asking for Varicella records
Provider education for pediatrician
Legacy data collection & entry
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9/20/2019

10. “Cleaning Up”
Entered shot histories for 4 large volume immunization practices
Utilized ad hoc reports to identify children with incorrect or no county field
813 letters sent (March 2002): 139 replies to region regarding Varicella history (return rate: 17%)
Identification of duplicates
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9/20/2019

11. Clean Up Results January 2002 County rate: 33% April 2002:
June 2002:
County rate increased to 43%
July accreditation visit:
County rate increased to 52%
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9/20/2019

12. Lessons Learned: Benefits
Increased county rates (spill-over)
Better data quality
Identified “border” providers
Higher awareness of registry impact among data entry/management staff
Stronger relationship with LHD
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9/20/2019

13. Lessons Learned: Barriers
Buy-in from local health department and staff
Provider relationships with local health department & registry
Organizational relationships
Lack of staff training
Technical issues
Funding
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9/20/2019

14. Registry Support for Accreditation
Final question:
Has the accreditation process increased the state immunization rates and increased registry compliance?
Final answer:
YES!!!
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9/20/2019

15. Contact Information
Wendy Nye, Supervisor, Region 4 MCIR
Kevin Czubachowski, MDCH Immunization Field Representative
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9/20/2019