Registries as tools for provider quality

assurance and clinic assessment

Diana Bartlett

National Immunization Program

Immunization Registry Support Branch

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

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

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

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

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

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

Results: Generating reports

30/31 grantees responded

77% generate reports by exporting data to CASA

23% generate reports directly by registry software

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

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

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

Percent Difference between Coverage Levels based on Clinic-based vs. Registry-based Data,

San Antonio, 1998-99, n=92 clinics

02468

101214161820

# o

f clin

ics Conclusion:

Registry-based coverage > clinic-based coverage

Percent coverage difference

Discussion

Data quality assurance

Complete data for population

Inactivating records- medical home

Training of providers and VFC-AFIX staff on using the registry

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