KEYWORDS:
private providers, immunization registry, childhood vaccinations

BACKGROUND:
Physicians in private practice administer most immunizations in the US. Their participation is critical to sustaining immunization registries.

OBJECTIVE(S):
To assess the use of a private immunization registry at private physician offices in a low-income community in New York City.

METHOD(S):
In 2000-2001, we recruited 13 volunteer physicians, serving primarily Medicaid patients, for free deployment of a private immunization registry in NYC. Selling points were VFC reporting, automated reporting to NYCDOH Citywide Registry (instead of paper forms), and printing school forms. We offered free hardware, DSL connection, training, technical assistance, and monthly reports. Most physicians (11) were 40-60 years of age, 10 were pediatricians, 3 family physicians; all had hospital appointments. Most (12) were in solo practices with 1-2 staff and saw 80 children/week. Only 3 were computer literate, 6 had office computers.

RESULT(S):
In 8 months, only 8 (62%) ever used the registry. Satisfaction among users was high. Two pediatricians used the registry consistently, (30-57 patients/month) and reported successful integration of the registry into their practice flow. Six others had erratic use (2-10 patients/month). Among non-users, 1 had poor DSL connection, the rest claimed lack of time and staff. Registry use was associated with higher patient volume but not with physician age or computer literacy.

CONCLUSIONS(S):
A private immunization registry was deployed at private practices in New York City with variable success. Further studies are needed to identify barriers to adoption of immunization registries in private inner city offices.

LEARNING OBJECTIVES:
Identify factors affecting use of registries in private inner city offices