1. Texas Department of State Health Services
Immunization Resources
and Updates ImmTrac Program & HPV Updates
2016 HPV Seminar
February 26, 2016
James Loiselle, MPA
Legislative Liaison, IDCU

2. Outline ImmTrac Snapshot Registering for ImmTrac
ImmTrac Replacement Project
Project Update
Benefits for Providers
Reminder/Recall Functionality
HPV Update
Summary

3. ImmTrac Snapshot: Q4 2015 138.7 million immunizations recorded
7.3 million Texas children
2.3 million children under age 6 years
92.8% parents “grant” consent for their newborn babies
499,134 ImmTrac Adult Clients
202,343 immunization history reports generated per month (average)

4. ImmTrac Snapshot: Q4 2015 cont.
9,581 active online user sites
39,488 first responders or first responder family members 18 years of age and older
1,257,416 disaster-only clients

5. Immunization Records Total Vaccine Doses (Total as of this Quarter)
2012
2013
2014
2015

6. Immunization Records Total Vaccine Doses (Annual)

7. Active Online User Sites (Total as of this Quarter)
Number of user sites logging on to the web application during the previous 6 months.
ImmTrac - Texas Immunization Registry

8. Active Online User Sites
Number of user sites logging on to the web application during the previous 6 months.
ImmTrac - Texas Immunization Registry

9. Registering for ImmTrac www.immtrac.org
It’s Free
Register online at
It Helps Increase Vaccine Coverage Rates
It allows providers to search for immunization histories on new patients
It assists with lost records or records that are difficult to interpret
It provides a method for doctors to send recall and reminder notices of pending or overdue immunizations
It’s the Law
House Bill 1921 requires all health-care providers to report to ImmTrac all vaccines administered to children younger than 18 years of age

10. Registering for ImmTrac www.immtrac.org

11. Registering for ImmTrac www.immtrac.org

12. Registering for ImmTrac www.immtrac.org

13. ImmTrac2 Update Largely federally funded project with some GR funding
Estimated project expenditures for the complete system are $7.3M
Wisconsin Immunization Registry (WIR)-based system
Phase one rollout – Registry functionality scheduled for May 2016

14. Remaining Timeline Present – March 2016: March - May 2016 May 23, 2016
System Testing (internal and external users)
March - May 2016
Training Users
May 23, 2016
Registry Go-Live Date

15. ImmTrac2 Benefits for Providers
This new system will:
Provide more detailed immunization history and forecasting, making it easier to determine vaccine duplication and maintain an immunization schedule
Enhance user functionality by allowing providers to reset their own password
Allow ad-hoc report capability and simplify report development
Provide enhanced Reminder/Recall functionality

16. Current Reminder/Recall Functionality
Checks patients against the ACIP schedule
Reports can be run at set intervals (e.g., Daily, Weekly, Monthly, Quarterly, Yearly) or at custom intervals
Selectable Age or Date Range
Providers can choose by organization, with or without subordinates
Providers can choose County or ZIP code

17. Current Reminder/Recall Functionality cont.
Reports can be output to different formats
Hard Copy
CSV file
Letters
Labels
Letters are generated by the ImmTrac system and cannot be modified by providers

18. ImmTrac2 Reminder/Recall Functionality
Create specific reports and save them
Select vaccines (i.e., one, some, or all)
Ability to include subpotent doses
Choose Due Dates (Due Now, Past Due, or both)
Dates
Target Date Range
Date of Birth Range
Age Range

19. ImmTrac2 Reminder/Recall Functionality cont.
Occupation (First Responders and Families)
High Risk or Exemptions
Sorting Options (e.g., last name, first name, provider, county, etc.)
Output Options
Customizable letters that can be saved
CSV file
Hard Copy

20. ImmTrac2 Reminder/Recall Report

21. ImmTrac2 Reminder/Recall Report cont.

22. ImmTrac2 Reminder/Recall Report cont.

23. ImmTrac2 Reminder/Recall Letter

24. ImmTrac2 Summary ImmTrac2 is designed to:
Allow for existing functionality of ImmTrac to be enhanced to honor stakeholder feedback and provide improved functionality for system users
Meet CDC requirements
Uphold Modeling of Immunization Registry Operations Workgroup (MIROW) best practices

25. HPV Vaccine Availability
Texas Vaccines for Children Program
Uninsured or underinsured children
CHIP
Native American or Native Alaskan heritage
Medicaid
Adult Safety Net
Providers include FQHC’s, RHC’s, FPC’s, Community Health Centers, and STD/HIV clinics
HPV vaccine available for uninsured adults -

26. HPV Vaccine Uptake in Texas
2014 vaccine ordering data was analyzed to compare Tdap and HPV vaccine among TVFC providers
1.4 doses of HPV vaccine ordered for every dose of Tdap
Ideal ratio 3.0 (meaning for every 1 Tdap, 3 HPV are administered)
Customized adolescent vaccine ordering profiles were sent to over 2,300 providers
HPV Vaccine Orders Among TVFC Providers
Region
HPV:Tdap Ratio
PHR 01
1.2
PHR 02
PHR 03
1.4
PHR 04
1.3
PHR 05
0.9
PHR 06
PHR 07
1.7
PHR 08
PHR 09
PHR 10
1.9
PHR 11
1.6
Statewide

27. Customized VFC Provider HPV Ordering Mailout
Vaccine ordering data from iTEAMS assessed for all adolescent vaccines (HPV, Tdap, MCV4)
Examined ordering data from
Created customized profiles with HPV:Tdap ratio and overall ordering data
Sent customized reports to providers

28. HPV Customized Tables
Tables included in customized report sent to TVFC providers

29. HPV-Tdap Vaccine Ordering Ratios
Ideal Ratio: 1 Tdap:3 HPV
Jun-Sept 2014
1 Tdap:1.15 HPV
Total HPV orders: 215,769
Jun-Sept 2015
1 Tdap:1.35 HPV
Total HPV ordering: 231,158

30. Evidence-Based Strategies to Improve Vaccination Coverage at the Clinic Level
Reminder/recall system
Provider level
Parent/patient level (e.g., postcards, telephone calls, text messaging)
Standing orders
Provider assessment and feedback
Assessment of vaccination coverage levels within the practice and discussion of strategies to improve vaccine delivery
Utilizing an Immunization Information System, ImmTrac

31. A Call to Action for Texas Healthcare Professionals
Recommend HPV vaccine with the same strength and conviction used to recommend other adolescent vaccines
Educate yourself about HPV and HPV vaccines
Inform your colleagues and staff to ensure consistent, positive message delivery to patients, parents
Communicate vaccination benefits to patients, parents at every opportunity
Make vaccination procedures routine and focus on ways to reduce missed opportunities

32. Questions?
James Loiselle, MPA