“ THIS WILL TAKE JUST A MINUTE OF YOUR TIME ”

1. “THIS WILL TAKE JUST A MINUTE OF YOUR TIME” USE OF REGISTRY TO VERIFY RANDOM DIGIT DIAL SURVEY INFANT COVERAGE DATA San Diego Immunization Program

2. SDIPThe San Diego Immunization Program • Established in 1992 • County of San Diego HHSA the lead agency • Collaborative of community agencies and programs • Access and availability of immunization services • Community education and outreach • Assessment and evaluation

3. SDIRThe San Diego Regional Immunization Registry • Established in 1997 • Enhancements to web application • Data exchange with Imperial County • PROW assessment site • Health Plan interactions • Latest stats: over half million clients with IZ records

4. What is the RDD Telephone Survey? • Survey of immunizations of San Diego County residents • Ages 19 months and above • Provides additional information, wider age range, and larger sample size than National Immunization Survey data on San Diego

5. Methods of the RDD Telephone Survey • Random selected telephone numbers • Multi-language interviewers • Immunization dates from recall and records • Verification of information from providers • Weighted statistical coverage

6. BACKGROUND • RDD surveys assess vaccination coverage • 1995 – 1998 children’s vaccination dates reported by parents were verified only by directly contacting healthcare providers

7. VERIFICATION METHODS BEFORE REGISTRY ·  Surveyors called households, requested vaccination dates of children 19–36 months, and permission to verify dates with providers the parents listed. ·For children not UTD according to parent-reported vaccinations, staff members requested providers to report vaccination dates. ·Staff entered shot dates from parents & providers into database

8. VERIFICATION METHODS WITH REGISTRY AND PROVIDERS • Since 1999, the first year the Registry was available, children not UTD were looked up in the Registry to verify vaccination • If UTD in Registry, then the provider was not contacted • Children not UTD in the Registry were further verified by contacting their providers

9. VERIFICATION RESULTS WITH REGISTRY OR PROVIDER Before Registry With Registry

10. VERIFICATION RESULTS WITH REGISTRY

11. CHALLENGES OF USING REGISTRY • Misspelled names • Different names on different records • Wrong birth dates • Overcome by searching alternatives until find matching information • These problems are easier to solve with Registry than with providers

12. BENEFITS TO IMMUNIZATION STAFF • Verifying in the Registry is faster than by contacting provider • Easier to try alternate spellings and birth dates in the Registry • Finding discrepancies in data enables correcting Registry data • Registry always works, but some faxes to & from providers are lost in transmission • Able to verify more children with Registry + providers than with only providers

13. BENEFITS TO CLINICIANS • Need to verify fewer children’s vaccinations for the Immunization Program’s surveys • The average provider’s list of children decreased from 7 to 6 children; greater reductions for providers using Registry • Clinics who use only the Registry for vaccination record keeping need not verify any shot dates • Reduced requests for data from public health maintains relationships

14. CONCLUSIONS • As more providers increase the numbers of children in the Registry, it becomes more useful for verifying vaccination coverage • In future, Registry alone might be used to calculate vaccination coverage instead of conducting surveys