Thinking Outside the Box: Linking an Immunization Registry with Schools

1. Thinking Outside the Box: Linking an Immunization Registry with Schools Tina Ellis Coyle RECIN Immunization Registry Marshfield Clinic Marshfield, Wisconsin

2. Recognizing the Need for a Registry • Barriers to children getting immunizations • Parental barriers • Physician barriers • System barriers • Fragmentation of immunization care across the public/private sector • Development of RECIN began in1994 2002  Marshfield Clinic

4. RECIN Background • One of the few registries developed in the private sector • Collaborative development team of private and public providers • Electronic recording and tracking network that all immunization providers use to record and assess the immunization status • Web based, live immunization registry 2002  Marshfield Clinic

5. RECIN Statistics • 3.2 million immunization records • 430,000 unique patients • Facilities using RECIN: • 41 Marshfield Clinic sites • 15 Public Health Departments • 21 Private Facilities • 8 Hospitals • 14 School Districts • 8 Daycare Facilities • 1 Retirement Community 2002  Marshfield Clinic

7. Immunizations in the Schools • In Wisconsin, schools must enforce immunization requirements for all students • Immunization dates are public domain data in Wisconsin • Students must have minimum immunization requirements to attend school • Schools must report on students who are not immunization current within the first 40 days of school to the health department 2002  Marshfield Clinic

8. Immunization Requirements • For new Kindergarten students, and new students must have • 4 DPT/DTaP/DT • 4 Polio • 2 MMR • 3 Hep B • 1 Varicella (or history of disease) • Personal conviction, medical, religious conviction, and history of waivers 2002  Marshfield Clinic

9. What Schools Need from RECIN • Schools are being asked to do more with less • Both schools and health care facilities must track immunization data • Duplication of record keeping results in wasted time and money spent locating patient’s history by chart pulls, phone calls, etc. • Most schools still have manual tracking systems • Automated schools required data entry of immunizations already in RECIN • Not always accurate from parents 2002  Marshfield Clinic

10. It’s About Time! • In 1999, one school district in Wausau, WI spent before RECIN: • 56 hours sending out immunization cards to parents • 90 hours entering immunizations reported by the parents into their own system • 25 hours filing cards • 95 hours generating non-compliant letters to parents • 30+ hours calling immunization providers 2002  Marshfield Clinic

11. Getting Started • Public health officials, and school board representatives saw the benefit of linking the two systems together • Taking advantage of work already done and maximize their immunization system • The goals were to: • decrease administrative time tracking immunizations tracking • gain more accurate immunization histories 2002  Marshfield Clinic

12. Development of RECIN in the Schools • Fall 1999: Gave selected schools view rights to RECIN • PROBLEM: still had to maintain other system to run reports…………Dual Entry • December 1999-February 2000: Formed work group to design a system that would integrate RECIN with school immunization law requirements 2002  Marshfield Clinic

13. Development Cont. • Funds were secured via a grant from the Family Health Center of Marshfield to cover the programming costs • Winter 1999 to Summer 2000 - Specification, design, programming, and testing • Fall 2000 - Implementation of the RECIN school module Integration of data 2002  Marshfield Clinic

14. System Features • Includes all school district demographics • School, grade, admission date • Access to student records 3 to 21 years of age • Generates reports of children who are behind schedule, in process, no record, and waivers • Prints all required legal notices to parents and the District Attorney • Calculates and prints reports to local health department 2002  Marshfield Clinic

15. System Benefits • Schools • Enormous time savings • Centralized work flow • More accurate data, reports, and letters • Providers • Fewer phone calls and chart pulls • More complete records • Parents • Less paperwork when registering students. No more repeated requests for data • Time savings 2002  Marshfield Clinic

16. Unique Stories • Shift in programming • Immunization providers rely on age of the child • schools track students by the grade they are enrolled • Complexity of school immunization laws • Schedule is more accurate • Catching missed MMR • Fluidity of school populations 2002  Marshfield Clinic

17. Unique Stories • Centralizing • The “guilt factor” • Before RECIN, it took 95 hours to produce the 15-day letters • Post implementation workflow was centralized • 15-day letters generated in under 1 hour • Loss of control • Learning to trust, and question, RECIN • The first year’s immunization rates 2002  Marshfield Clinic

18. In Summary • School Districts are being asked to do more with less • Registries can equip school personnel with an efficient tool to: • Track their students more accurately • Reduce administrative time spent generating reports • More accurate data, reports, and letters • Providers can focus on better patient care due to: • Fewer telephone calls and chart pulls • More complete records 2002  Marshfield Clinic

19. It Takes a Community! Tina Ellis Coyle RECIN System Coordinator Marshfield Clinic 715.221.8133 ellis-coyle.tina@marshfieldclinic.org 2002  Marshfield Clinic