Toward an Integrated Immunization Program Using Immunization Information System Data, Features, and

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Toward an Integrated Immunization Program Using
Immunization Information System Data, Features,
and Functions to Drive Immunization Program
Activities

• Bob Swanson, MPH
• Michigan Department of Community Health

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MCIR Background

• Web-based application
• Populated with electronic birth records (within 2
  weeks)
• Operational with a regional approach
• Majority of the funding from the Healthy Michigan
  Fund (tobacco tax)
• First rolled out in 1998

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MCIR Activity

• 2.8 million children
• Over 38 million shot records
• 5,000 user log-ins to MCIR every day
• 500 simultaneous users during the day
• 2,203 provider sites submitted data in 2004

MCIR
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MCIR Historical Perspective
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REGION 1
1100 provider offices 62 provider
participation
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REGION 2
540 provider offices 93 provider
participation
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REGION 3
345 provider offices 95 provider
participation
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REGION 4
344 provider offices 93 provider
participation
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REGION 5
254 provider offices 80 provider
participation
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REGION 6
240 provider offices 95 provider
participation
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Profile Screen
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WIC Cooperation

• Profile reports distributed monthly to WIC
  clinics
• Listing of kids not up to date distributed to
  each clinic
• Reached 70 immunization levels for WIC children.
  12 higher than the rest of the population

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Medicaid Cooperation

• Monthly load of Medicaid numbers and Health Plan
  information
• Display Medicaid Health Plan on child record
• Generate Health Plan profile reports
• Provide Health Plans with immunization data for
  HEDIS reporting

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Health Plan HEDIS LevelsCombination 1
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Health Plans Become Part of the Solution

• Health Plans have become our partners
• Health Plans now monitor provider data
• Reduced cost to health plans with less chart
  reviews

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Health Plan Success

• Pay for Performance 3 health plans are
  currently paying physicians 30 per completed
  record in the MCIR for 2 year old and 15 year old
  children.
• PHP of West Michigan recorded the highest
  immunization levels of 2 year old children in the
  country at 95 for HEDIS.

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Lead Data Results

• Added a lead pop-up window
• Medicaid enrolled
• Mapped to HR zip code
• 23 increase in lead testing as compared to the
  same period in 2003.
• Increased provider participation because of the
  lead pop-up

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Recall Options
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Regional Recall Successes to Increase
Immunization Levels
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School and Child Care Reporting

• Schools and CCCs receive and report immunization
  records using the MCIR
• All electronic reporting of immunizations
• Easy monitoring of compliance

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Perinatal Hepatitis B

• EBC records loaded
• Tracking of immunizations
• Follow-up on children born to HbsAg mothers
• Outreach workers monitor birthing hospital
  submission of hepatitis B birth dose

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Vaccine Accountability

• Approximately 70 of our VFC providers report
  doses administered through the registry.
• Approximately 50 of our VFC providers generate
  VFC profiles to estimate vaccine need.
• LHDs track vaccine usage and distribution data
  using the registry to detect misuse of VFC
  vaccine.

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Clinical and Research

• Universities, CDC and MDCH utilize MCIR data for
  research studies, i.e. Asthma studies
• Michigan is a CDC Sentinel site
• Use in the Perinatal Hepatitis B program for
  follow-up

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Future Objectives

• Integrate the MCIR with other databases which are
  accessible to providers
• Lead
• Newborn hearing
• Newborn screening
• Reporting beyond age 20
• Asthma

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