Immunization Information Systems Update Gary Urquhart MPH Chief

Immunization Information Systems Update Gary Urquhart, MPH Chief, Immunization Information Systems Support Branch Immunization Services Division National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta, Georgia January 2010

“…perhaps in the rather distant future, the capabilities of electronic computers for storing and retrieving information could greatly facilitate our immunization programs…A nationwide computer system could put us well on the road to efficient national follow-up of births for maintenance of immunization levels. ” James L. Goddard, M. D. , M. P. H. , 8 th CDC Director, 1962 – 1966 CDC Public Health Image Library (PHIL) 2 nd National Immunization Conference, 1965

Thomas R. Frieden, MD, MPH 16 th CDC Director, June 2009 CDC Public Health Image Library (PHIL) Under Dr. Frieden′s leadership, the NYC Health Department also established the largest community electronic health records project in the country. The project provided prevention-oriented electronic health records to physicians caring for more than a million New Yorkers, including more than half of the doctors caring for patients in Harlem, the South Bronx, and Bedford. Stuyvesant. The Primary Care Information Project is a model for efforts to expand electronic health record use nationally.

Immunization Information Systems Age Groups Participating in an IIS Source: 2008 Immunization Information System Annual Report

Percentage of children aged < 6 years participating in a grantee immunization information system -- United States, and six cities, 2008 0%No Report (5) < 60% (9) 60 -79% (9) > 80% (33) Chicago, IL (< 60%) District of Columbia (> 80%) Houston, TX (< 60%) New York City, NY (> 80%) Philadelphia, PA (> 80%) National Participation: 75% (excluding Territories) Source: CY 2008 IISAR San Antonio, TX (60%– 79%)

Immunization Information Systems Provider Site Participation in IIS Source: 2008 Immunization Information System Annual Report

Immunization Information System Capacity to Track Adolescent and Adult Vaccinations Data from the 2008 Immunization Information System Annual Report indicate that: • About 82% (46 of 56 grantees) report that they include all ages in their IISs. Source: 2008 Immunization Information System Annual Report

Immunization Information System Status on Selected Data Quality Measures As of December 31, 2008 Of those grantees with an IIS reporting: • On average, 71% of newborn records are recorded in a grantee IIS within 6 weeks of birth • 66% of grantees receive and process vaccine and other immunization data from their IIS within a month of vaccine administration Source: 2008 Immunization Information System Annual Report

Effect of Completing 1 Missing Dose on 4: 3: 1: 3: 3: 1 Series Completion for Selected Immunization Program Grantees - IIS vs. NIS, 2008

IISSB Technical Assistance Team Summary Report August 1 – December 15, 2009 Technical Assistance Category Number of Requests Programmatic IIS Annual Report, Site visits, ETAP, Business Plan/Grant reviews, IIS orientation, Legislation/Policy, Contracts/SOW reviews, Data Quality/Data Use, ARRA funding to IIS 146 Technical HL 7 data exchange, CVX/MVX/CPT codes 17 Other Vaccine inventory, VTrck. S, project management, software/hardware issues, IISSB website 18 TOTAL Resolved 181 179

EHR- IIS Interoperability ● The 2008 IISAR requested information about the number of EHRs providing immunization data directly to your IIS through an electronic interface? ● Response: 1, 848 EHRs electronically reporting data to an IIS

EHR- IIS Interoperability EHR Vendor # Grantees with Product Allscripts – Touchworks 12 Connexin Software, Inc - Office Practicum 6 e. Clinical - e. Clinical Works 19 e. MD 4 Epic Systems – Epicare 12 GE Medical - Centricity (Logician) 11 Misys Healthcare Systems - Misys EMR 7 Netsmart – Insight 5 Next. Gen - Next. Gen EMR 11 PCC 5 RPMS 5

EHR- IIS Interoperability EHR data are significant because: • • EHRs are used by larger practices Larger practices are more likely to be high volume immunizers Enhancing EHR-IIS interoperability will improve data quality challenges by addressing: • Accuracy • Timeliness • Completeness

Gary A. Urquhart, MPH Chief, Immunization Information Systems Support Branch Immunization Services Division National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention 1600 Clifton Road, NE, MS-E 62 Atlanta, GA 30333 Tel: 404. 639. 8277 Fax: 404. 639. 8171 mailto: gau 5@cdc. gov