Plenary

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Plenary 2 -- Grow Promoting Registry Growth
through Programmatic Collaboration and Data
Quality Improvement Initiatives
4th Annual National Immunization
Program Immunization Registry Conference Atlanta,
GA Thomas M. Moss State of Georgia Immunization
Registry Manager
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• PROW Effort to Implement
• LEVEL I
• Relatively easy to implement
• LEVEL II
• Moderately advanced to implement
• LEVEL III
• Challenging or resource-intensive to implement

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• PROW Plan to Meet
• FULLY
• Has fully implemented or exceeded
• PARTIALLY
• In the process of being implemented or partially
  implemented
• COULD
• Could be implemented within the next 2 years with
  moderate resource investment, policy chagnes, or
  application enhancements
• CANNOT
• Cannot be considered at this time or would take a
  prohibitive amount of resources
• NO PLAN TO
• Not a priority or no plans to implement in the
  future

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• Vaccine Management
• Principle
• Immunization registries provide users with
  information and functions that support proper
  storage and handling of vaccines, and can
  internally support management of the VFC program.
• IPOM Activity Areas
• Vaccine Ordering, Distribution, and Storage
  Systems
• Vaccine Accountability (Provider Level)

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• Vaccine Management
• Level I Standards - FULLY
• GRITS implements from its main page a series of
  URL Links to various sites providing ordering,
  distribution and storage information
• GRITS implements from its main page an
  announcement section that provides us the
  capability to post storage and handling procedure
  tips
• As part of the registry and immunization program
  training, this information is provided

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• Vaccine Management
• Level II Standards - FULLY
• GRITS inventory management includes the
  capability to adjust doses due to wastage,
  transfer, error, etc
• GRITS displays on its main page any lots that are
  due to expire within the next 10 days
• GRITS captures VFC eligibility status and
  reporting information
• GRITS contains a link to the VFC Home Page for
  registration
• GRITS offers communications with providers for
  alert/broadcast messaging
• Vaccine Accountability Activities
• Vaccine Usage, Doses Administered by Eligibility
  Reports

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• Vaccine Management
• Level III Standards - PARTIAL
• VFC Providers are able to report lost doses
  directly from the registry
• GRITS providers as part of the Reminder/Recall
  functionality to call-back clients deferred due
  to vaccine shortages
• GRITS contains a link to the VFC Home Page for
  registration and surveys
• GRITS as no plans at this time to automatically
  order supports via VACMAN

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• Provider Quality Assurance
• Principle
• By enabling access to complete immunizations
  records, immunization registries support
  providers in delivering age-appropriate and
  timely immunizations, and in reducing both under-
  and over-immunization.
• IPOM Activity Areas
• Provider education
• Provider Site Visits
• Perinatal Hepatitis B Prevention

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• Provider Quality Assurance
• Level I Standards - PARTIALLY
• GRITS data is used as part of CASA / AFIX visits
• GRITS is used to identify clinic-specific
  practice issues for training
• GRITS provides an announcements section during
  login
• GRITS provides link to VIS and other information
• GRITS has no plans at this time to send recall
  notices to providers for patients who are behind
  in their shots.

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• Provider Quality Assurance
• Level II Standards - PARTIAL
• GRITS is used to monitor provider trends
• GRITS is used to send reminder notices to
  parents/patients when vaccines are due
• GRITS ACIP Wizard incorporates the 4-day grace
  period as well a highlight invalid shots
• GRITS data is used to prioritize AFIX/VFC visits
• GRITS currently receives immunization shot
  information from birthing hospitals to capture
  HBV, HBIG information given at birth
• GRITS currently tracks the most resent version of
  the VIS documents, but does not track older
  versions. There is no plan to implement this
  enhancement at this time.

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• Provider Quality Assurance
• Level III Standards - FULLY
• GRITS is able to display the reason for an
  invalid dose
• GRITS is able to run clinic-specific VFC reports
• GRITS received HBV and HBIG data fields via the
  EBC system during Vital Records uploads
• The Immunization program works with long-term
  care facilities to track influenza and
  pneumococcal coverage levels

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• Service Delivery
• Principle
• Immunization Registries are an effective tool for
  identifying and reaching under-served
  populations, and for supporting the delivery of
  immunizations in a childs medical home.
• IPOM Activity Areas
• Underserved Populations
• Medical Home Promotion

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• Service Delivery
• Level I Standards - FULLY
• WIC has been established with access to the
  immunization information available in GRITS
• In 2004 School and Daycare facilities will be
  allowed to access the information in GRITS
• GRITS generates coverage reports for public
  immunization clinics to identify pockets of
  under-immunization
• GRITS is being used to identify high-volume
  immunization providers that are not part of the
  VFC program

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• Service Delivery
• Level II Standards - PARTIAL
• GRITS is used to identify immunization-delayed
  individuals for outreach
• GRITS is used to identify children without a
  medical home
• GRITS provides remind notices on vaccines coming
  due by provider organization

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• Service Delivery
• Level III Standards PARTIAL
• As part of the Immunization Program audits of
  child care facilities, rosters are used to
  identify children not up to date.
• GRITS provides individual immunization reports to
  WIC based on a list of names supplied.
• The Immunization Program plans to use GRITS to
  team with long term care facilities once the age
  limitation is remove from the registry.

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• Consumer Information
• Principle
• Immunization Registries are a source of credible
  immunization information and official
  immunization records.
• IPOM Activity Areas
• Information Development and Dissemination
• Vaccine Benefit and Risk Communications

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• Customer Information
• Level I Standards - FULLY
• GRITS is the official source of the State of
  Georgia Immunization Program for generating
  immunization records for consumer use
• GRITS notification and promotional materials
  include immunization information

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• Consumer Information
• Level II Standards - FULLY
• GRITS Main page contacts links to the Vaccine
  Information Statements and CDC Question/Answer
  sheets

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• Consumer Information
• Level III Standards COULD
• GRITS could be enhanced to send parents or
  guardians electronic reminder notices with the
  appropriated VIS documents.
• By using the State of Georgia Portal Environment,
  direct access to GRITS could be provided for
  school and other enrollment purposes
• GRITS could be enhanced to send consumer alerts
  to inform the public of important events,
  outbreaks, etc

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• Surveillance
• Principle
• Immunization Registries support the reporting and
  investigation of Vaccine-Preventable Diseases.
• IPOM Activity Areas
• Disease Surveillance and Response
• VPD Reporting
• Perinatal Hepatitis B Screening
• Vaccine Safety

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• Surveillance
• Level I Standards - FULLY
• GRITS is available to provide immunization
  histories to disease investigators
• Disease investigators can be enabled to add
  immunization histories to the registry

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• Surveillance
• Level II Standards - PARTIAL
• GRITS currently tracks limited adverse events for
  the purpose of contraindicating vaccines to
  individuals
• GRITS tracks the provider and date that each shot
  was given
• GRITS provides a link to the CDC VAERS
  application
• There is no plan to provide links from the
  registry to the NEDSS application

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• Surveillance
• Level III Standards COULD
• Currently the registry team is working with the
  developers of the 5 different Clinical
  Information Systems used by the 159 counties
  Public Health Clinics to identify and build
  portals through which information can be shared.
• Currently the registry team is working with
  vendors such as JMJ, MiSys, IDX, and others to
  identify and build portals through which
  information can be shared.

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• Assessment
• Principle
• Immunization Registries are a primary source of
  accurate assessment data on children.
• IPOM Activity Areas
• General Population Assessments
• Special Population Assessments

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• Assessment
• Level I Standards - FULLY
• GRITS will be used to provide immunization
  information to the schools to validate the
  reports that schools must submit as part of the
  state school immunization law
• GRITS data will be used to generate coverage and
  exemption rates for childcare facilities
• GRITS data will be used to conduct, supplement,
  and/or verify population coverage and exemption
  rates
• GRITS creates an CASA extract to identify
  geographic pockets of under-immunization

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• Assessment
• Level II Standards - PARTIAL
• GRITS will be used to assess coverage levels
  among WIC participants
• GRITS data is available to medicaid and HMO
  organizations. We currently have a working
  relationship with Kaiser Permenente, and
  Childrens Healthcare of Atlanta
• GRITS is limited to children under the age of 18,
  adult immunization assessment is not possible
  through GRITS
• There is not plan to use GRITS to track vaccines
  given for occupational reason

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• Assessment
• Level III Standards NO PLAN
• There is no plan to provide Geographic
  Information System capability to GRITS
• GRITS has the capability to assess Hepatitis B
  coverage at STD, HIV, correctional, and other
  high-risk settings. We are currently working
  with the Department of Juvenile Justice
• GRITS has the capability to assess Hepatitis B
  coverage information among various races.

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• Thank You for your time.