Opening Comments

1
Opening Comments

• Alan R. Hinman, MD, MPH
• AIRA Awards Recognition Reception Program
• March 7, 2006

2
Healthy People 2010

• Increase to 95 the proportion of children (lt6
  years of age) participating in fully operational,
  population-based IIS.
• Participation as of 2004
• 48 of American children lt6
• 76 of public vaccination provider sites
• 39 of private vaccination provider sites

3
Demonstrated usefulness of immunization registries

• Sending reminder/recall notices to children
• Generating official immunization records
• Assessing immunization levels (HEDIS)
• Reducing missed opportunities
• Preventing unnecessary immunization
• Recall for re-vaccination
• Vaccine inventory management

4
Barriers to provider participation in IIS - 1

• Cost /or time of data entry retrieval
• Practices are too busy to consider a new
  procedure, resist change, anticipate difficulty
  integraing registry use into business processes
• Cost /or time to train staff to participate in
  registry, including clinic staff turnover
• Concerns about privacy, confidentiality, and HIPAA

5
Barriers to provider participation in IIS - 2

• Providers do not see any value to their practice
  of the new information they can get from the
  registry
• Issues relating to interfacing with other
  systems, including difficulty working with
  vendors cost to providers of creating data
  downloads
• Coordination required between clinical,
  administrative information systems departments
• Source AIRA Survey, 2005

6
What do you mean by integration?

• Integration - providing a range of information to
  authorized users in a simple, comprehensive
  format to facilitate all indicated actions
• Integration relates to the presentation of
  information to the user, not to the underlying
  hardware or software

7
Role of public health in integrated CHIS

• Information from a variety of programs about an
  individual child (child health profile)
• Population-based information
• Health alerts
• Identification of potential high-risk areas/hot
  spots
• Information about availability of vaccines, etc.
• Information about new recommendations, recalls,
  etc.

8
Conclusions

• Lack of timely, complete, and accurate
  information impedes optimal health/health care
• Individual information systems have been
  demonstrated to improve coverage/quality
• Experience is not yet large enough to demonstrate
  that integrated health information systems/HIEs
  will improve quality further but it is reasonable
  to believe they will

9
Some remaining policy issues

• Establishing the societal/legal/regulatory
  framework for exchanging information who has
  access and for what purposes?
• Opt in vs opt out participation
• Agreeing on standards
• Sustainable funding

10
Conclusions (2004 NIRC)

• Integrated information systems are both essential
  and inevitable
• Immunization registries have been in the
  forefront of developing functional information
  systems meeting needs of medical care, public
  health, and individuals
• Registries have the opportunity (and obligation)
  to take a leading role in developing integrated
  information systems

11
The words of Chairman Mao

• Walk on two legs
• Put prevention first
• Serve the people