PROWPROWCharting New Charting New Waters in Best Waters in Best PracticesPractices for for

Immunization Immunization RegistriesRegistries

What is the purpose of What is the purpose of PROW?PROW?

To identify ways registries can To identify ways registries can effectively and integrally support the effectively and integrally support the other core program components of other core program components of an immunization program.an immunization program.

To encourage and support adoption To encourage and support adoption of those activities by all registries.of those activities by all registries.

What are the products of What are the products of PROW?PROW?

Standards of ExcellenceStandards of Excellence in each of in each of six program areas:six program areas:• AssessmentAssessment• Consumer InformationConsumer Information• Provider Quality AssuranceProvider Quality Assurance• Service DeliveryService Delivery• SurveillanceSurveillance• Vaccine ManagementVaccine Management

Dynamic peer learning through a Dynamic peer learning through a mentoring networkmentoring network

PROW Standards of ExcellencePROW Standards of Excellence

Comparable to Best PracticesComparable to Best Practices Standards as a ceiling to shoot for Standards as a ceiling to shoot for

versus a floor or set of minimum set versus a floor or set of minimum set of requirementsof requirements

Concrete and tangibleConcrete and tangible Organized by Core Program Organized by Core Program

Components.Components. Cross-referenced to recommended Cross-referenced to recommended

activities in the IPOMactivities in the IPOM

PROW Standards of ExcellencePROW Standards of Excellence Organized into three levels, from relatively Organized into three levels, from relatively

easy to implement to challenging/resource easy to implement to challenging/resource intensiveintensive

Useful for:Useful for:• Identifying enhancementsIdentifying enhancements• Upgrading your current application Upgrading your current application • Developing requirements for a new application Developing requirements for a new application

or RFPor RFP Seen as an essential companion to Seen as an essential companion to

minimum registry functions (NVAC), IPOM, minimum registry functions (NVAC), IPOM, and the new certification process.and the new certification process.

What can the PROW standards What can the PROW standards do for you?do for you?

Greater integration and synergy Greater integration and synergy across your staff/teamsacross your staff/teams

More efficient use of 317 and other More efficient use of 317 and other funds.funds.

More fully functional, highly featured More fully functional, highly featured registry applicationregistry application

Meeting user needs in a more Meeting user needs in a more seamless wayseamless way

Registries

Provider QA

Registry Support of Core Program Components

Provider Quality AssuranceProvider Quality Assurance

““By enabling access to complete By enabling access to complete immunization records, registriesimmunization records, registries support providers in delivering age-support providers in delivering age-appropriate and timely appropriate and timely immunizations, and in reducing immunizations, and in reducing under- and over-immunization.”under- and over-immunization.”

Provider Quality AssuranceProvider Quality Assurance

Level I:Level I: Export to CASA or otherwise use Export to CASA or otherwise use

registry data as part of AFIX visits.registry data as part of AFIX visits. Use registry data to highlight general Use registry data to highlight general

or practice-specific practice issues or practice-specific practice issues that can be incorporated into that can be incorporated into provider trainings, newsletters, or a provider trainings, newsletters, or a “tip-of-the-month” web link.“tip-of-the-month” web link.

Provider Quality AssuranceProvider Quality Assurance

Level II:Level II: Highlight invalid doses when Highlight invalid doses when

displaying a history.displaying a history. Use registry data to prioritize AFIX or Use registry data to prioritize AFIX or

VFC site visits.VFC site visits. Use the registry to track series Use the registry to track series

completion for children born to completion for children born to surface antigen-positive moms.surface antigen-positive moms.

Provider Quality AssuranceProvider Quality Assurance

Level III:Level III: Be able to display the reason for an Be able to display the reason for an

invalid dose.invalid dose. Include HBV and HBIG data fields in Include HBV and HBIG data fields in

birth records or other mechanisms, birth records or other mechanisms, and regularly upload to the registry.and regularly upload to the registry.

Registries

Provider QA Vaccine Management

Registry Support of Core Program Components

Vaccine ManagementVaccine Management

““Immunization registries provide Immunization registries provide users with information and functions users with information and functions that support proper storage and that support proper storage and handling of vaccines, and internally handling of vaccines, and internally can support management of the VFC can support management of the VFC program.”program.”

Vaccine ManagementVaccine Management

Level I:Level I: Use the registry to direct users to Use the registry to direct users to

information on vaccine storage and information on vaccine storage and handling.handling.

Incorporate messages about the Incorporate messages about the importance of proper vaccine importance of proper vaccine management into registry materials management into registry materials and training.and training.

Vaccine ManagementVaccine Management

Level II:Level II: Support a vaccine inventory feature Support a vaccine inventory feature

capable of adjusting doses due to capable of adjusting doses due to wastage or transfer.wastage or transfer.

Generate a doses administered or Generate a doses administered or other report(s) to support vaccine other report(s) to support vaccine accountability activities.accountability activities.

Capture VFC eligibility status and Capture VFC eligibility status and generate annual reports.generate annual reports.

Vaccine ManagementVaccine Management

Level III:Level III: Incorporate a feature that alerts Incorporate a feature that alerts

users to lots due to expire or already users to lots due to expire or already expired.expired.

Incorporate a link to VACMAN for Incorporate a link to VACMAN for automated ordering as supplies run automated ordering as supplies run low.low.

Incorporate a call-back feature for Incorporate a call-back feature for deferred shots due to shortages.deferred shots due to shortages.

Registries

Provider QA Vaccine Management

Surveillance

Registry Support of Core Program Components

SurveillanceSurveillance

““Immunization registries support the Immunization registries support the reporting and investigation of reporting and investigation of vaccine-preventable diseases.”vaccine-preventable diseases.”

SurveillanceSurveillance

Level I:Level I: Provide histories to investigatorsProvide histories to investigators

Level II:Level II: Track adverse eventsTrack adverse events Show which provider gave what shot, Show which provider gave what shot,

in case investigators need to F/Uin case investigators need to F/U Link to VAERS and to NEDSSLink to VAERS and to NEDSS

SurveillanceSurveillance

Level III:Level III: Create a common portal through Create a common portal through

which users authenticate once, then which users authenticate once, then get access to any application get access to any application (registry, NEDSS, vital records, etc.) (registry, NEDSS, vital records, etc.) they have rights to.they have rights to.

Registries

Provider QA Vaccine Management

Assessment

Surveillance

Registry Support of Core Program Components

AssessmentAssessment

““Immunization registries are a Immunization registries are a primary source of accurate primary source of accurate assessment data on children and assessment data on children and adults.”adults.”

AssessmentAssessment

Level I:Level I: Generate coverage and exemption Generate coverage and exemption

rates on behalf of schools.rates on behalf of schools. Conduct, supplement, or verify Conduct, supplement, or verify

population coverage and exemption population coverage and exemption reports.reports.

Generate reports, or export to CASA, Generate reports, or export to CASA, to identify geographic or to identify geographic or demographic PONs.demographic PONs.

AssessmentAssessment

Level II:Level II: Use registry data for adult Use registry data for adult

immunization assessmentsimmunization assessments Enroll LTC facilities for assessing Enroll LTC facilities for assessing

pneumococcal coveragepneumococcal coverage Provide registry access to Medicaid Provide registry access to Medicaid

and MCOsand MCOs Track occupational vaccinesTrack occupational vaccines

AssessmentAssessment

Level III:Level III: Use GIS to monitor trends in specific Use GIS to monitor trends in specific

geographic areas.geographic areas. Assess HBV coverage at STD, HIV, Assess HBV coverage at STD, HIV,

correctional, or other settings serving correctional, or other settings serving high risk populationshigh risk populations

Registries

Provider QA Vaccine Management

Assessment

Surveillance

Consumer Education

Registry Support of Core Program Components

Consumer InformationConsumer Information

““Registries are a source of credible Registries are a source of credible immunization information and official immunization information and official immunization records.”immunization records.”

Consumer InformationConsumer Information

Level I:Level I: Use registry notification or Use registry notification or

promotional materials to include promotional materials to include general immunization information.general immunization information.

Level II:Level II: Generate or link to a variety of Generate or link to a variety of

consumer materials, including VISsconsumer materials, including VISs

Consumer InformationConsumer Information

Level III:Level III: Provide direct, secure, on-line Provide direct, secure, on-line

consumer accessconsumer access Send reminder-recall notices through Send reminder-recall notices through

e-mail, automatically attaching the e-mail, automatically attaching the appropriate VISs for the next visitappropriate VISs for the next visit

Registries

Provider QA Vaccine Management

Assessment

Surveillance

Consumer Education

Service Delivery

Registry Support of Core Program Components

Service DeliveryService Delivery

““Immunization registries are an Immunization registries are an effective tool for identifying and effective tool for identifying and reaching under-served populations, reaching under-served populations, and for supporting the delivery of and for supporting the delivery of immunizations in a child’s medical immunizations in a child’s medical home.”home.”

Service DeliveryService Delivery

Level I:Level I: Enable WIC access for assessing UTD Enable WIC access for assessing UTD

status of WIC clients.status of WIC clients. Enable school access for recording Enable school access for recording

shots given on site.shots given on site.

Service DeliveryService Delivery

Level II:Level II: Use registry data to identify seriously Use registry data to identify seriously

immunization-delayed individuals so immunization-delayed individuals so that outreach can be conductedthat outreach can be conducted

Identify children without a medical Identify children without a medical homehome

Service DeliveryService Delivery

Level III:Level III: Use enrollment rosters from child Use enrollment rosters from child

care facilities to ID children not UTD.care facilities to ID children not UTD. Use electronic WIC rosters to Use electronic WIC rosters to

generate individual immunization generate individual immunization reports for cert/recertreports for cert/recert

Recruit LTC, tracking pneumococcal Recruit LTC, tracking pneumococcal coverage and conducting educational coverage and conducting educational outreach to those with low levelsoutreach to those with low levels

How do we use theHow do we use the PROW standards? PROW standards?

We include a self-assessment We include a self-assessment worksheet that includes all the worksheet that includes all the Standards of Excellence.Standards of Excellence.

Can either either rate where you are Can either either rate where you are today in terms of each standard or today in terms of each standard or how important each standard is to how important each standard is to where you want to go.where you want to go.

The standards help identify desirable The standards help identify desirable enhancements/features.enhancements/features.

What’s next?What’s next?

Submitted to CDC for approval.Submitted to CDC for approval. Recommendations included an Recommendations included an

analysis of possible linkages with analysis of possible linkages with other planning or reporting activities:other planning or reporting activities:• 317 grant application317 grant application• Annual registry reportAnnual registry report• Certification processCertification process• No linkageNo linkage

Developing the PROW standardsDeveloping the PROW standards

Core Core GroupGroup

Review Review GroupGroup

1.1.Survey;Survey;draftdraft

2.2.Review and Review and commentcomment

CDCCDC

Core Core GroupGroup

3.3.FinalizeFinalize

4.4.ApproveApprove

Core Core GroupGroup

5.5.ImplementImplement

What’s next?What’s next?

Final Standards of Excellence are Final Standards of Excellence are published on the webpublished on the web• Check out AIRA membership!Check out AIRA membership!

PROW Work Group establishes a peer PROW Work Group establishes a peer learning/mentoring group learning/mentoring group

Continual revising and growing of the Continual revising and growing of the Standards based on their use and the Standards based on their use and the growing maturity of registries.growing maturity of registries.

Thank you to the members!Thank you to the members!

Gary Buckett, CDCGary Buckett, CDC

Sam Crosby, WVASam Crosby, WVA

Lorraine Duncan, ORLorraine Duncan, OR

KC Edwards, CDCKC Edwards, CDC

Kathy Fredrickson, AZKathy Fredrickson, AZ

Karen Fowler, CDCKaren Fowler, CDC

Ayesha Gill, CAAyesha Gill, CA

Steve Levy, BostonSteve Levy, Boston

Jim Lutz, PhiladelphiaJim Lutz, Philadelphia

Tom Maerz, WITom Maerz, WI

Amy Metroka, NYCAmy Metroka, NYC

Bob Salcido, NVBob Salcido, NV

Sue Salkowitz, PASue Salkowitz, PA

Kim Salsibury-Keith, RIKim Salsibury-Keith, RI

Susan Shepardson, RISusan Shepardson, RI

Cindy Sutliff, NYCCindy Sutliff, NYC

Karen Turner, CAKaren Turner, CA

Ellen Wild, AKCEllen Wild, AKC

For more information…For more information…

www.immregistries.orgwww.immregistries.org