1. Registry Evolution: Lessons Learned
Alisa Johnson
October 28, 2003

2. Topics ImmuLink Overview Evolution Identifying change Lessons Learned
Conclusions

3. Overview

4. Serves Twin Cities metropolitan region of Minnesota
770,000 records, 5.6 million immunizations.
Approximately 1,000 users at 145 sites.

5. 145 Participating Sites Community Health Departments
Health Care Providers
School Districts
Charter and Private Schools
Child Development Centers
Community Action Agencies

6. Populated with Minnesota Birth Certificate Data (1990 - Present).
Populated with Immunization Data from Public/Private Healthcare Providers and Schools.
Updated automatically by linking names, birth dates, or mother’s birth name to existing records.
New records are created for those individuals not currently in the registry.

7. Recruit and enroll new sites
Accept data from users
Ensure data quality
Ongoing programming
Train and support users
Provide ongoing customer service and communication

8. Data Submission Options:
Electronically sent datafiles extracted from database, practice management, and billing systems.
Data directly entered into the registry.

9. Why a “Lessons Learned” presentation now?
Decade milestone
Big changes in our future

10. Evolution

11. Evolution In the beginning… Modem-based More tech involved
Small staff taking on all duties
Marketed to county and community clinics
Had to sell idea of registry

12. Evolution Ongoing Switch to web-based application Added enhancements
Added direct data entry option
Refined de-duplication program
Updated algorithm
Added reminder cards
Added schools
Increased staff, redefined responsibilities

13. Evolution Currently…. Expanding to new counties Adding new sites
Programming for community changes
Staff duties shifting
Merging with statewide registry
Updating program plan

14. Identify Change

15. Change Technology Staffing Finances Laws and Regulations Community
Structure

16. Change Program Analysis Surveys Focus groups Technology updates
Internal communications
Participant communications

17. Change Seek out information & use it…. Review and update policies
Change procedures
Adapt technologies
Refocus energies

18. Lessons Learned

19. “If you build it, they will come…”
Not necessarily…..
Beginning stages = sell the idea
Once established = sell the product
Reminders
Contraindications, etc
Manufacturer, Lot #’s

20. “The best laid plans…” Make plans, in pencil Write definitions, in pen
Policies and procedure manuals are never final
Revisit and update plans often
Get input
Document progress

21. “It’s hard to be humble…”
Your registry is not perfect
Your data is not perfect
Human error is inherent in all tasks
Big egos impede production and progress
Open your minds to learn and adapt

22. Nobody’s perfect…. Goal: Identify shortcomings Acknowledge them
Address them
Improve them to the furthest extent possible

23. Realize your limitations...
More importantly, remember your purpose
Are you within your government statutes, program guidelines, grantee duties, etc?
Are you enforcing your policies?
A registry is a registry - not a medical professional. Provide the info, let the professionals make the decisions.
Allocate your resources accordingly

24. A registry is only as useful as it is useable...
What we thought was useful wasn’t used…..
Reminder cards
Registry itself
Customizing features
Is your system intuitive?

25. We don’t work in a vacuum….
Change, Staffing issues, EMR’s, budget cuts, financial issues, attitudes, new statutes/policies (HIPAA!), computer issues, technology technicalities…..

26. “ Starring….Me!” Share credit Ask for help Share experiences Listen
Recognize and Acknowledge contributions
Celebrate accomplishments

27. Summary

28. Lessons Learned…. Be receptive to change, new ideas, possibilities
Be honest
Know your community
Listen to your participants, colleagues
Provide options USERS deem necessary
Have a plan, but…be fluid…..
Maintain and enforce policies
Share ideas, failures and successes

29. Contact Information
Alisa Johnson