KEYWORDS:
Immunization Registry, Office Practice, Electronic Medical Record

BACKGROUND:
Immunization registry development is an ongoing process in every state of the US. Critical to the success of regional immunization registries is the involvement of office-based pediatric practices.

OBJECTIVE(S):
To describe one effort to maintain a practice-based immunization registry.

METHOD(S):
Pediatric Primary Care (PPC) is a pediatric resident continuity practice. This practice uses an electronic medical record (EMR). It has a separate immunization registry (IR) linked to the billing system. Medical personnel enter past immunizations not administered in PPC directly into the IR. Over a 6 month period from 1/1/2001 through 6/30/2001, for active patients in PPC, immunizations in the EMR were compared to those in the IR.

RESULT(S):
There were 4,895 active patients. The IR contained 5,145 immunizations to 1,151 patients. The EMR contained 4,666 immunizations to 1,076 patients. When the two datasets were combined, the resulting dataset contained 5,566 immunizations to 1,195 patients. The majority of these immunizations 4,439 (82.5%) were in children < 2 years old. There were 1,134 immunizations only in the IR (900) or EMR (234). IR only immunizations are immunizations administered outside PPC and comprised 10 to 21% of immunization entries per month. EMR only immunizations are immunizations administered but not billed and comprised 3.7 to 6% of entries per month.

CONCLUSIONS(S):
Maintaining an immunization registry requires ongoing manual entry of immunizations and validation of existing records. Close linkage of the recording of immunization delivery (eg, EMR) to the IR would help maintenance but substantial manual entry would still be required.

LEARNING OBJECTIVES:
To understand the complexities of maintaining immunization registries.