A BUSINESS CASE FOR ELECTRONIC IMMUNIZATION REGISTRIES

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A BUSINESS CASE FOR ELECTRONIC IMMUNIZATION
REGISTRIES

• University of California, San Diego,CA
• John Fontanesi, PhD
• CDC Award U1W/CCU914714-01Award

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GOALS

• Articulate strategic long-term capitalization
  requirements of an electronic immunization
  registry
• Develop realistic Business case scenarios for
  budget justification and planning
• Develop cost/benefit modeling using standard
  bottom up parametric estimating principles

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GOALS
Provide benchmarks for the cost effectiveness of
technical and personnel strategies Describe the
contribution of individual and clustered registry
functions to cost/benefit structure Describe
who may benefit from system functions
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Developing a Cost Model

• Must be accurate in predicting costs of planning,
  developing and maintaining
• Must be anchored by performance requirements
• CDC 12 core functions
• CPU usage, Transaction times, etc
• Must be verifiable

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PARAMETRIC MODELS

• Examine statistical relationships between
• Dependent variables (costs, schedules)
• Independent variables(Core Functions, SLOC base
  size, complexity)
• Preferred method in military and industry
• Permits benchmarking

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STANDARD PARAMETRIC COST MODELS

• Proprietary
• REVIC
• PRICES
• SASET
• SEER-SEM
• SLIM

• Public
• COCOMO (87 and II)
• DOD MIL STD 2167/498
• DOD MIL STD 499A
• DOD MIL STD 1703

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Immunization Registries A Special Case

• Traditional Software applications are not
  required to
• track items that change names
• track items effected at different times by
  unrelated organizations
• have accurate records of these effects widely
  available and constrained by confidentiality

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Work Breakdown Structure (WBS)

• Process tree composed of hardware, software,
  services and, data types
• Defined by Technical objectives
• Used to assign management and technical
  responsibilities
• Monitors costs, engineering efforts, schedules,
  technical objectives,

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STATISTICAL ANALYSIS

• Standard Regression Analysis
• Can Use Null Hypothesis
• R, R2, F and T Statistics appropriate
• Generates Cost Estimating Relationship
  (CER)
• Children 0-6, SLOC, End-users, Core Functions,

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Break-even Point and Cash Flow Summary
Cumulative Cost
Cumulative Benefits
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Major Cost-effective Offsets

• Chart Pulls
• minimum 20 increase in staff productivity
• targeted re-immunization on lot recalls
• Immunization record print
• VFC/CASA/HEDIS reporting

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Major Benefit Activities

• improved targeting
• rapid response
• change in I.T. culture
• QA activities
• practice oversight
• review of procedures
• improved client relations

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REGISTRY COST/BENEFITS

• labor savings
• improved quality
• greater product variety
• better customer service
• faster response time

• PRACTICE PATTERN

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REGISTRY COST/BENEFITS

• MISSED OPPORTUNITIES

• labor savings
• improved quality
• greater product variety
• better customer service
• faster response time

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OPERATIONAL COST MODELING

• OUTPUT (Q)
• PRODUCTION FUNCTION (F)
• COMPUTER CAPITAL (C)
• NON-COMPUTER CAPITAL (K)
• I.T. STAFF (S)
• OTHER LABOR/EXPENSES (L)
• QF(C,K,S,L,I,t,) (1)t

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Lessons Learned

• To maximize ROI
• record Prints
• Accessibility of terminals
• Workflow dynamics
• Standard reports
• VFC
• Billing
• HEDIS
• CASA

• To maximize Immunization Rates
• Provider Profiles
• AFIX
• QA

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John Fontanesi, Ph.D.

• For Copies of slides or general inquires Please
  contact Christine Sullivan
• Phone [phone]
• Fax [phone]
• jfontanesi_at_ucsd.edu
• chsullivan_at_popmail.ucsd.edu