MAKING AN IMPACT

Collaborations Are Key to the Growth of Your Registry

ODH logo

Laurie Dietsch, MPHProject L.O.V.E.

Love Our Kids…Vaccinate Early!

Mark Sulzman, BAOhio Department of Health

Immunization Rates for Children 19-35 Months of Age

National Immunization Survey, Q1/2001-Q4/2001

4DTaP:3Polio:1MMR*

4DTaP:3Polio:1MMR*:3HIB

Ohio 76.3 74.7

Cuyahoga 74.0 72.8

Franklin (Columbus)

79.3 78.3

Rest of State 76.2 74.5

OHIO

• Population of State = 11.4 million*– Cleveland = 478,000– Cincinnati = 331,000– Columbus = 702,000

• Annual Birth Cohort = 155,700**– Franklin County (Columbus) = 17,400

* U.S. Census Data 2000, ** Ohio Department of Health Vital Statistics

Historical Timeline IMPACTSIIS • The ODH immunization registry began

collecting data from public health clinics in 1997

• Public health clinics have entered data into their PC’s using special front end software (private or ODH designed)

• Data forwarded via batch uploads using modems 1-4 times a month

• Registry access was via telephone using interactive voice response (IVR)

• Key Issue: At least 60%-65% is administered in private sector

Changing Climate Lessons Learned Since 1997– Servicing front end software for 88 counties impractical– Data extracted from PC’s can be corrupted or lost in

transmission via modem batch uploads– Extracts from billing systems met with resistance Current Trends– 2000 NVAC adopts minimum core standard for all US

registries– HL7 protocol mandated by HIPAA– ODH recognizes web offers best option for public and

private providers

Project L.O.V.E. (Love Our Kids...Vaccinate Early!) is a unique

partnership between Franklin County hospitals, area physicians,

City of Columbus and Franklin County Health Departments, local

businesses and community organizations, whose goal is to

assure that Franklin County 2 year-olds are fully immunized.

•Market an Immunization Registry among central Ohio physicians in order to establish a centralized source of individual immunization records across the county and state•Maintain and improve current immunization levels throughout the general population of Franklin County

Project L.O.V.E. Two Primary Goals

Project L.O.V.E. Partners• Hospitals (Mount Carmel, Doctors, Grant, Riverside,

St. Ann’s, Ohio State University and Children’s)• Foundations (Columbus Medical Association

Foundation and The Columbus Foundation)• Ross Labs• 2 Health Departments (Franklin County Board of

Health and Columbus Health Department)• Pharmaceutical Companies (Merck, Wyeth & Glaxo

Smith Klein)• Columbus Compact Corporation (Empowerment Zone)• Media (NBC4)• Political Officials (Mayor and Representatives)

Franklin County’s Quest for a Registry

• 1993-1997– Focus Groups– Planning

• 1997-2000– Pilot Central Repository (Public Health)– Talking Relationship With ODH– 3 Options

• Develop a registry locally• Buy an existing system• Partner with ODH

Three Options• Develop System Locally

– Money to develop AND sustain– Technical upkeep

• Buy HII or STC?– Money to purchase AND Maintenance– Not “our” system– Web-based

• ODH– “Free” for us– Our input made the system– Strengths and Weaknesses Fit

STRENGTHS

• State – ODH– IMPACT SIIS– National/CDC

Support– Technical Staff

and Resources– Sustainability– Privacy/Security/

Confidentiality– Power and

Influence

• Local – PLOVE/CHD– Local Contacts– Local Name

Recognition for Coalition and Marketing Capability

– Funding for Marketing– End User Perspective– Not as Many Funding

Constraints– Incentive Due to Low

Immunization Rates

PLIRAC Project L.O.V.E. Immunization

Registry Advisory Council• HD Immunization Program Staff • Health Commissioners – CHD and FCBH• Project LOVE Director and Registry

Coordinator• Ohio Department of Health Staff• Legal Representatives• Paul Werth Marketing Firm• Technically Inclined Members• Partner Representatives• Parents

Web Design Group

• Made up of Representatives from:– Development Staff from Keane (GSA

Contract)– Ohio Department of Health– Columbus Health Department– Office Managers and Physicians

Statewide– Interested members of the POINT

Team

Design Team

• Functionality– What needs to be in the registry– Web page layout

• Usability– Developer versus user viewpoint

POINT TeamPhysician Office Impact INTeraction Team

• Made up of representatives from around the state– ODH and Columbus Health Department– Other Local Health Departments– Hospitals– American Academy of Pediatrics (AAP)

President - Ohio Chapter (Chris Rizzo, MD)– Managed Care Organizations

POINT Team

• Privacy, Security and Confidentiality

• Legal Issues• Policy Development• HIPAA

Negatives– Negative History (Trust Issues)– Change in Leadership– Getting to Know Each Other– Communication Difficulties

Technical vs Non-technicalTunnel VisionMisunderstandings

– Limited Staffing– Different Perspective

State vs Local

– Fear of Making “Another” Mistake

Positives+Successful State and Local Partnership+Immunization Registry+Complimenting Strengths and

Weaknesses+Communication is More Open+Different Perspectives

State vs Local

+Improved Relations+System That is User-Friendly and FREE

If the registry is implemented

successfully it will occur quietly.

However, if the registry is not implemented

successfully, it will be heard loudly.

Columbus Health

Department