1. “THIS WILL TAKE JUST A MINUTE OF YOUR TIME”
USE OF REGISTRY TO VERIFY RANDOM DIGIT DIAL SURVEY INFANT COVERAGE DATA
San Diego Immunization Program

2. SDIP The San Diego Immunization Program
Established in 1992
County of San Diego HHSA the lead agency
Collaborative of community agencies and programs
Access and availability of immunization services
Community education and outreach
Assessment and evaluation

3. SDIR The San Diego Regional Immunization Registry
Established in 1997
Enhancements to web application
Data exchange with Imperial County
PROW assessment site
Health Plan interactions
Latest stats: over half million clients with IZ records

4. What is the RDD Telephone Survey?
Survey of immunizations of San Diego County residents
Ages 19 months and above
Provides additional information, wider age range, and larger sample size than National Immunization Survey data on San Diego

5. Methods of the RDD Telephone Survey
Random selected telephone numbers
Multi-language interviewers
Immunization dates from recall and records
Verification of information from providers
Weighted statistical coverage

6. BACKGROUND RDD surveys assess vaccination coverage
1995 – 1998 children’s vaccination dates reported by parents were verified only by directly contacting healthcare providers

7. VERIFICATION METHODS BEFORE REGISTRY
·  Surveyors called households, requested vaccination dates of children 19–36 months, and permission to verify dates with providers the parents listed.
·  For children not UTD according to parent-reported vaccinations, staff members requested providers to report vaccination dates.
·  Staff entered shot dates from parents & providers into database

8. VERIFICATION METHODS WITH REGISTRY AND PROVIDERS
Since 1999, the first year the Registry was available, children not UTD were looked up in the Registry to verify vaccination
If UTD in Registry, then the provider was not contacted
Children not UTD in the Registry were further verified by contacting their providers

9. VERIFICATION RESULTS WITH REGISTRY OR PROVIDER
Denominator = number of children whose records we should verify (parents gave permission to verify & not UTD in parents’ records).
If child is UTD in Registry, we do not try to verify further.
Not verified (red) because: we could not find provider, provider not find child in records, a few providers declined to verify.
1995: we did not calculate verification results, because in that first year, they collected little data on verification process.
1999: we did not calculate, because in the first year of the Registry, they used the Registry little for verification.
2001: no RDD survey.
2003: UTD in Registry (yellow) lower than in 2002, because 2003 UTD included Hep A & pneumococcal.
Before
Registry
With
Registry

10. VERIFICATION RESULTS WITH REGISTRY
Denominator = number of children whose records we should verify (parents gave permission to verify & not UTD in parents’ records)
Any IZ in Registry = had any shot dates in Registry, whether UTD or NUTD
UTD in Registry lower in 2003 than 2002, because 2003 UTD included Hep A & pneumococcal

11. CHALLENGES OF USING REGISTRY
Misspelled names
Different names on different records
Wrong birth dates
Overcome by searching alternatives until find matching information
These problems are easier to solve with Registry than with providers

12. BENEFITS TO IMMUNIZATION STAFF
Verifying in the Registry is faster than by contacting provider
Easier to try alternate spellings and birth dates in the Registry
Finding discrepancies in data enables correcting Registry data
Registry always works, but some faxes to & from providers are lost in transmission
Able to verify more children with Registry + providers than with only providers

13. BENEFITS TO CLINICIANS
Need to verify fewer children’s vaccinations for the Immunization Program’s surveys
The average provider’s list of children decreased from 7 to 6 children; greater reductions for providers using Registry
Clinics who use only the Registry for vaccination record keeping need not verify any shot dates
Reduced requests for data from public health maintains relationships

14. CONCLUSIONS
As more providers increase the numbers of children in the Registry, it becomes more useful for verifying vaccination coverage
In future, Registry alone might be used to calculate vaccination coverage instead of conducting surveys