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IIS BEST PRACTICES
This education initiative is an opportunity to learn from the experiences of other IIS around the country -- both what worked and what didn't. What have other IIS done to effectively realize improvement in the areas of data quality, funding, provider relations, data use, integration, technical capacity, and privacy and confidentiality? What practices have been tried but were not successful in reaching their goals? There are lessons to be learned and knowledge to be shared from both.
Click here for information on submitting your best practice, successful strategy or lesson learned..
AIRA's latest BEST PRACTICES come from New York State and South Dakota, two of the three 2008 PROW Center of Excellence awardees. South Dakota focused on data use and New York State on provider participation.
South Dakota -- Data UseSubmitted by Tammy LeBeau, South Dakota IIS (SDIIS) Background One of the CDC's immunization program priorities is to utilize stateweide immunization registries along with the GIS mapping software to identify pockets of need, and determine solutions to improve statewide immunization rates. South Dakota's immunization information system (SDIIS)includes a statistical function that produces statewide immunization coverage rates. The results produced from the assessment function are utilized with GIS to mapping software to plot SDIIS coverage results and determine pockets of need. Measurement Difficult-to-recruit private provider offices were contacted by phone with the goal of scheduling a VaxTrack demonstration. Project Description In 2004 South Dakota began utilizing the assessment function in the registry to produce statewide immunization coverage results. The statewide baseline coverage rate in 2004 was 50% for the 24-35 month age cohort, for the 4:3:3:1:3 series. These coverage reports are produced quarterly at the central level to determine individual clinic progress as well as statewide progress toward achieving the 90% immunization coverage goal. By July, 2007, the coverage rate for this age cohort was at 86%. This increase is due in large part to utilizing the IIS coverage data in combination with the GIS mapping software to identify pockets of need and identify areas as well as individual providers with low immunization rates. The data was plotted on a statewide map by county. The county immunization rates were broke down into 4 categories: <= 75%, 76-85%, 86-95%, and 96-100%. Each of these categories is represented on the map with a different color. Innovation The results identified counties and clinics with low immunization rates, as well as county and clinic specific pockets of need. In early 2007 South Dakota used this data to identify solutions and began providing incentives by: 1) Promoting the administration of the 1st hep B at birth when a child is born. Providing "onsies" and "baby bags" to birthing hospitals. 2) Promoting administration of the 4th DTaP (by the age of 2) - Provide "Beary Safe" Bear, I got my 4th DTaP on time. 3) Promoting the entry of demograpic information in the registry. EFFECTIVENESS/IMPACT The data produced from the SDIIS and the GIS software is used at the end of each year to recognize and honor provider's who have maintained, improved or exceeded the 90% immunization coverage level. The annual "Awards of Excellence" luncheon is a great motivator for providers and emphasizes the importance of team work and a job well done. In July of 2007 our largest awards luncheon ever was held with over 250 attendees (compared with 2005 luncheon with 68 attendees. The number of awards presented each year continues to grow, and it has become a competition as well as an honor for the providers to attend. SUSTAINABILITY/REPLICATION The SDIIS used in combination with the GIS mapping software is a very valuable tool in identifying individual as well as county level pockets of need in South Dakota. As a result, our immunization rates have increased and we have been able to identify specific problem areas as well as provide solutions. This data has also been used in other areas of the immunization program to determine vaccine usage, over ordering, vaccine wastage, and completing the annual provider profile. In early 2009 we plan to evaulate the effectiveness of these incentives to determine if they are making a differnce and perhaps identify other areas that need improvement. We fully intend to continue this process as well as looking at ways to make improvements. This process would be easy to replicate for another immunization programs if they have the assesment function and the GIS software.
New York State -- Provider ParticipationSubmitted by Loretta Santilli, New York State IIS (NYSIIS) BACKGROUND Provider participation in New York State’s voluntary, regional, server-based immunization registry had plateaued in 2007 and we faced significant challenges in increasing our provider participation rate. However, with the passage of legislation mandating immunization reporting for persons less than 19 years of age as of January 1, 2008 and the launch of the new web-based New York State Immunization Information System (NYSIIS) on February 25, 2008, we were poised to become a fully functioning population-based system. We needed to closely monitor the NYSIIS data during the rigorous implementation period and communicate the progress to build and maintain momentum among providers. MEASUREMENT We defined several key measures to evaluate our progress. These included the number of trainings and participants, the number of organizations electronically submitting data, the number of patients and immunizations recorded, the number of participating providers (VFC providers in particular), and the number of children less than 6 years of age with two or more immunizations recorded in NYSIIS. We monitored progress weekly during the first few months post launch, then monthly thereafter. We established ambitious quarterly benchmarks. INNOVATION The NYS implementation strategy was multi-faceted — focusing on outreach, technological support, and user training. Communication with key stakeholders was critical. Technical assistance facilitated linking electronic medical record (EMR) or billing systems to NYSIIS. Data were important to monitor the success of each of these components but were used in the most innovative way in the development of an intensive statewide training effort including regional classroom sessions, instructor led and pre-recorded webinars, and self-guided online tutorials. Due to a compressed timeframe, staggered implementation was planned with providers beginning to report the first of the month following completion of training in their region. Analyzing the provider data for current and new users was instrumental in maintaining a plan that would make training accessible to as many users as possible. EFFECTIVENESS/IMPACT During the first year of implementation 201 classroom sessions and 109 live webinars were held and trained nearly 2,600 participants. In addition, 109 participants listened to pre-recorded webinars and 547 users accessed the on line training tools. Staff assisted 24 different vendors representing 149 organizations in electronically submitting data to NYSIIS. With the aggressive implementation strategy and an annual cohort of 126,883 births in New York State, outside of New York City, we expected the NYSIIS database to build rapidly. Within the first year of launch, NYSIIS contained more than 2 million patient records and nearly 21 million immunizations. There were nearly 5,300 users from nearly 1,400 health care provider organizations and more than 500 schools. The percentage of children less than six years of age with two or more immunizations in NYSIIS more than tripled in a little over one year, from 15.0 percent in October 2007 to 49.7 percent in January 2009. SUSTAINABILITY/REPLICATION It will be essential that we continue to use these data to monitor provider participation rates. As implementation progresses, we will be able to analyze additional data elements to further target our training, outreach, and technical support efforts.
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Do you have a best practice that you would like to share with AIRA and other IIS? We would love to hear about it and possibly declare it our "Best Practice of the Month." Click here to download a template (.doc) to help you document your best practice, successful strategy or lesson learned.
Click here to email a completed best practice template to AIRA.
Questions? Click here.
What is a Best Practice?
A best practice is a process, technique, or innovative use of resources (technology, equipment, personnel, data) that has resulted in outstanding and measurable improvement in the operation or performance of an immunization information system.
This best practice will have demonstrated success by significantly and measurably improving such factors as cost, data quality, provider participation, coverage rates, integration with other health care systems, ease of use, compliance with standards, or functionality.
A best practice should be able to be documented to allow other IIS to adapt this practice and realize success in their own environment.
What is a Successful Strategy?
A successful strategy is any intervention that does not quite meet the bar for being a best practice but did lead to success in addressing a barrier, problem, or need in a particular IIS.
What is a Lesson Learned?
A lesson learned is an experience or outcome of a particular course of action -- either positive or negative -- that is important enough to be communicated to one's peers.