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Regional Early Childhood Immunization Network (RECIN) Producing and Measuring Quality Outcomes for At-Risk Children Tina Ellis Coyle Marshfield Clinic Marshfield, WI
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October 28, 2005Copyright @ 2005 Marshfield Clinic2 Why Do We Need Registries? Immunizations may have been the #1 public health advancement in the 20th Century, however... Barriers to children being properly immunized include – complex immunization schedule – fragmentation of care – Calls from provider to provider are time consuming and costly
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October 28, 2005Copyright @ 2005 Marshfield Clinic3 Requirements of a Successful Registry Centralized repository accessible to both public and private immunization providers Provide one common immunization record for each patient Collect and retain all data required for giving an immunization Assess and intervene on patients who are not immunization current
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October 28, 2005Copyright @ 2005 Marshfield Clinic4 RECIN Background Web based, real-time registry Developed in the private sector, Marshfield Clinic Development team collaboration of private and public providers Electronic recording and tracking network that all immunization providers could use to record and assess immunization status of shared patients Captures immunizations across the lifespan First deployed in 1995
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October 28, 2005Copyright @ 2005 Marshfield Clinic5 Mission The mission of RECIN is to provide a shared population based immunization recording, tracking and intervention repository that assists communities in raising childhood and adult immunization rates.
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October 28, 2005Copyright @ 2005 Marshfield Clinic7 Intervention: It Takes a Collaborative Spirit Crosses competitive barriers Promotes a common vision by encouraging unique community-wide partnerships Outreach to under-immunized children Public/private collaboration designed to raise immunization rates
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October 28, 2005Copyright @ 2005 Marshfield Clinic8 Wood County Intervention 75,555 total population (2000 U.S. Census Bureau) 100% provider participation 0-2 year old population December 1999 67% UTD February 2001 93% UTD October 2005 92% UTD Objective: Raise immunization rates of 0-2 year olds to 95% UTD
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October 28, 2005Copyright @ 2005 Marshfield Clinic9
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October 28, 2005Copyright @ 2005 Marshfield Clinic10 Tiered Intervention Background 2001 task force of public/private providers met with a goal to develop countywide campaigns to raise immunization rates Identified barriers to immunizations and developed methods to overcome them Through RECIN, they developed an intervention process
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October 28, 2005Copyright @ 2005 Marshfield Clinic11 Tiered Intervention Comprehensive reminder system involving all providers in a demographic area collaborating to raise immunization rates Allows providers to track and document individual patient’s intervention history Moves patients through an automated intervention process Prevents duplication of notices/contacts Automatic transition of non-compliant patients to Health Departments if desired
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October 28, 2005Copyright @ 2005 Marshfield Clinic12 Tiered Intervention Method Determine which immunizations and population to target Set Goal Assess population Proactive vs. Overdue Tiered vs. non-tiered approach Identify age group to target Set geographic parameters Customize letters to fit individual practices Begin intervention
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October 28, 2005Copyright @ 2005 Marshfield Clinic13 Marathon County Intervention 125,834 total population (2000 U.S. Census Bureau) 12 immunization facilities in Marathon County – 100% participation 0-2 year old population May 2001 – 81% UTD May 2002 reached 93% UTD November 2005 – 90% UTD
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October 28, 2005Copyright @ 2005 Marshfield Clinic15 Marshfield Clinic FHC Results (patients 24-35 Months UTD) Communicate Results: Utilization of balanced scorecard Center20012005 Phillips74.193.8 Cadott66.7100 Colby/Abby84.9100 Athens33.3100 Chippewa Falls88.094.2 Marshfield Clinic85.791.1
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October 28, 2005Copyright @ 2005 Marshfield Clinic16 Improving the Quality of Health Care: Lessons Learned You need to first start You need the right tool: – Increase provider participation – Facilitate community wide intervention efforts Set a goal and communicate performance measures Take what we’ve learned and expand to other regions You need champions Goal: Protect patients from immunization preventable disease
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October 28, 2005Copyright @ 2005 Marshfield Clinic17 Promotes Community Partnerships Wisconsin Department of Health and Human Services Local Health Departments Private Providers Schools Daycare Facilities Retirement Communities Service Organizations Parents/Patients
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October 28, 2005Copyright @ 2005 Marshfield Clinic18 State and National Recognition 2001 Paul Harris Rotary Award 2002 National Immunization Registry Protect Award – Presented on behalf of the American Academy of Pediatrics and the National Immunization Program of the CDC 2002 Legislative Citation
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October 28, 2005Copyright @ 2005 Marshfield Clinic19 In Summary The IOM Quality Chasm report says: “The current care systems cannot do the job.” “Trying harder will not work.” “Changing care systems will.”
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