Increasing Registry Value Through Partnerships

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Increasing Registry Value Through Partnerships

• National Immunization Registry Conference
• Atlanta, Georgia
• October 28, 2003
• Debbie McCune Davis
• The Arizona Partnership for Immunization

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A Statewide Registrythe original vision

• Improve interaction between providers and
  families to increase immunizations of children.
• Establish a single site for storage of childhood
  immunization information.
• Complete records available of childs
  immunization status.
• All providers participate, and have access to up
  to date immunization records.

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Partners

• Arizona Department of Health Services
• Arizona Health Care Cost Containment System
  (AHCCCS)
• County Health Departments
• Arizona Community Health Centers
• Commercial Health Plans
• Private Providers
• Municipal Fire Departments
• Department of Economic Security
• Schools and Day Care Centers

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Expand sphere of influence through partnerships
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Medicaid Managed Care431 78.1 2001

• Mercy Care
• 80.7
• 1,280 Sample size

• Phoenix Health Plan
• 83.5
• 558 Sample size

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Annual Trend in Immunization Rates and Well-child
Visits, Children Enrolled in AHCCCS (TXIX)
Percent
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Community Health Centers

• Mountain Park Community Health Center
• May 2002
• 1,276 AHCCCS Kids
• 94 coverage levels
• Uses ASIIS for quarterly assessments
• Identifies high risk patients for recall during
  flu season - 384 children.
• Coordination with school nurses resulted in 25
  fewer referrals of 10 14 year olds.

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WIC/Immunization Collaboration

• Shared Vision
• To Improve Immunization Coverage Rates
• Develop Strategies that Manage Barriers
• Maximize Cost Effectiveness
• Present a Model that works in diverse WIC settings

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The Learning Curve
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Getting Down to Business
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Commercial Managed Care

• CIGNA Medical Group Adolescent Initiative

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Results/Benchmarks/Goals Adolescents
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School Nurses

• The first time I used the ASIIS website, I
  resolved 37 student immunization issues. That
  meant students whose school registrations were
  not delayed because of problems with their
  immunization record. With a daily enrollment of
  over 750, I can use all the help I can get!
• Suzanne Boyd, MS,RN
• Tucson Unified School District

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SE Maricopa County
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Phoenix Fire Baby Shots Program

• In 2002, we saw 6317 children and provided
  13,376 immunizations in our clinics. The majority
  of children are from Spanish speaking households.
  All shots were entered into the registry.

• Sheri Gibbons, Phoenix Fire Department

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County Health Departments

• To date we have saved 13,780.75 by searching
  ASIIS for missing immunizations.
• This total represents a one month tally at three
  of our locations.
• Machrina Smith, RN Maricopa County

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Child Protective Services

• We average 2-5 requests a day from CPS workers
  for immunization records. Children have been
  removed from their homes and must be placed in
  foster care. Having easy access to immunization
  records makes it easier to place children with
  foster parents because there is no barrier to
  school or day care and no need for a doctors
  appointment to get unneeded shots
• Andie Denious, RN

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Rural County in Crisis

• Rodeo-Chedeski Fire Navajo County Summer
  2002
• Roughly 25,000 residents were displaced as the
  fire destroyed 250 homes and burned 468,000
  acres. Community health workers used the registry
  to organize tetanus shot clinics. Parents were
  provided with documentation of past immunizations
  to ensure re-admittance of children to school.

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Arizona State Immunization Information System

• Total patients 2,058,909
• Total immunizations 16,115,939
• Compliance with Healthy People 2010 95 patients
  under 6 in registry
• Enrollment 3,251 users/497 sites
• School/Day Care 1355 users/100sites

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Changing Medical Practice to Change Lives

• Current medical environment
• Rising Costs
• Population Growth
• Change in Demographics and utilization patterns
• Workforce issues
• Emergency Department 15 increase
• Increased medical expectations
• Registries play a role in meeting every challenge!

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