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Registries as tools for provider quality assurance and clinic assessment Diana Bartlett National Immunization Program Immunization Registry Support Branch
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Background “Core Elements For AFIX Training and Implementation” (April 2002) identify registry data as an option for data collection during the vaccination coverage assessment process
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Methods 56 of 64 CDC immunization grantees responded to provider quality questions in Immunization Registry Annual Report Self-report Descriptive statistics calculated using MS Excel
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Results 39% of responding grantees use the registry to monitor the VFC vaccine administration 66% could identify VFC-eligible children in the registry 30 (55%) use the registry to do provider assessments as part of AFIX
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Results: Using registries Of the 31 grantees that use a registry in AFIX… 13(42%) start with a registry-based review and supplement with chart review 7 (23%) only use registry records for their AFIX assessments 8 (26%) start with a chart review and supplement w/registry data 3 (9%) use some other method
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Results: Characteristics Of the grantees that only use the registry in AFIX visits: All have 100% participation in public sites Only use registry for public site AFIX assessments
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Results: Medical Home During AFIX, which registry records do you select to calculate the coverage for "Provider X"? 40% from all children seen most recently from Provider X 25% from all children seen one or more times by Provider X 35% from another method
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Results: Generating reports 30/31 grantees responded 77% generate reports by exporting data to CASA 23% generate reports directly by registry software
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Results: HEDIS measures 28/56 (50%) grantees reported that they provide HMOs with information for HEDIS reporting Of these 28, 20 also use registry in AFIX process
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Results: Vaccine management 24 (43%) grantees reported that they use the registry to track vaccine inventory 6 of these grantees reported that they use the registry to order vaccines Only one state (Maine) reported that they use the registry to order vaccines through VACMAN
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Conclusions Registries used to assess vaccination coverage in public clinics Many registries store VFC-eligibility information CASA main software for reports Registries assist in HEDIS reports
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Percent Difference between Coverage Levels based on Clinic-based vs. Registry-based Data, San Antonio, 1998-99, n=92 clinics Conclusion: Registry-based coverage > clinic- based coverage Percent coverage difference
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Discussion Data quality assurance Complete data for population Inactivating records- medical home Training of providers and VFC-AFIX staff on using the registry
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Next steps VFC-registry assessment in Utah to measure Time savings for AFIX staff to use registry data for assessment (CASA) Time savings to providers to produce electronic doses-administered reports Continue collecting data on registries and AFIX/CASA activities
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