1. Presented by Anne Cordon, SDIR Manager
Don’t Be A Bad Shot! Registry Data Quality Review & Immunization Practice
Presented by
Anne Cordon, SDIR Manager
Session K3
March 9, 2006

2. Acknowledgements
Kathleen W. Gustafson, MPH & Sue Hunt, PHN: Immunization Branch, County of San Diego, Health & Human Services Agency
Wendy Wang, MPH, Robert Grieger, Tracy Healy, Med, Mark H. Sawyer,M.D., Michelle DeGuire, MPH, MSW: San Diego Immunization Partnership, University of California San Diego (UCSD)

3. SDIR Background Approx. 10 years old
Standalone  Client Server  Web-based application (June 2004)
Web version has more data entry checks than previous versions
Records have been added consistently
Review of record complete

4. SDIR at a glance 302 sites and approx. 600 active users
All public health centers and community clinics
Private providers
9 school districts
Potential universe of SDIR sites and users:
20 hospitals
+250 private providers
5,000 child care providers
40 more school districts
100 state licensed skilled nursing facilities

5. Quality measures for immunizations
Hep A given before 1995
Hib given above age 5
Influenza dose before 6 months of age
More than 3 does of MMR
PCV7 given after age 5
PPV23 doses for children under 2 years of age
Td < Age 7
Varicella dose given before 12 months of age and/or 1995

6. Some Data Review Details
MMR
More than 3 doses of MMR, which is defined as is a dose before one year of age and two valid doses after a year of age
More than 3 doses before Age 2.
PPV 23
Given before Age of 1
Given before Age 2 as of 2/6/06
Varicella
Given before 1995.
Given < age 13 Months.
Given < 12 mths and before 1995

7. Test conditions
Important to define and review report criteria/exceptions.
Example:
Test cond.: Demographic and shot date_mod <= ’31-Dec-2005’ as applicable.
Results: Minimum and Maximun vacc_date
Results: Counts: ipid, Shot and avg shots/ipid
Results: Min and Max Age shot

8. Hepatitis A results
Data Checks
1B=1C + 1D (active only)

9. Data Checks Vaccine Min/Max= range of shot dates
Min/Max Age=range of ages
Ipid=distinct patient demographic records
Shots/ipid= can be more than 1 since there can be more than one recording of a vaccine and date

10. Hib results

11. Influenza

12. Next steps: Internally review the data summaries
Run queries to get client data
Organize data by provider
Follow protocol for giving data to provider for chart review and data clean-up
Follow-up with provider
Check data for correction

13. Issues to consider Age of shot data Age of patient
How to address paperless systems
Ability to retrieve archived records
Importance of correcting old data vs. addressing current data entry or vaccine practices

14. SDIR role Inform provider of data issues
Be a resource in data clean-up
Doesn’t correct data without a record or chart copy with correct data
Use Help Desk staff to work on clean-up
Report back to provider on cleaned data

15. Future data quality assurance
Start regular and periodic reviews from last data review on forward
Design application enhancements to decrease or eliminate future data entry errors
Enhance training to alert users to use registry ‘real-time’

16. For more information Anne M. Cordon, MPH, CHES
SDIR, Immunization Branch
County of San Diego HHSA
P.O. Box 85222, MS P-511B
San Diego, CA
(619)