KEYWORDS:
Immunization registries/systems, adult immunizations, reminder, recall

BACKGROUND:
Southern California Kaiser Permanente serves 3 million members in 10 medical centers and 90 medical office buildings throughout Southern California. A centralized immunization tracking system (KITS) is accessible from all departments, and currently contains over 19 million immunization entries. In spite of community and in-house immunization awareness campaigns, the immunization rate for persons 65 years and older Kaiser Permanente members remained unacceptably low.

OBJECTIVE(S):
To ascertain and improve immunization rates in persons aged 65 and older.

METHOD(S):
a. The Kaiser Permanente Membership System and KITS were matched by computer in order to obtain Pneumococcal, Td, and influenza vaccination status forpersons aged 65 and over.
b. Clinical charts were reviewed for these who were not up-to-date and when immunizations were found, they were "back-entered" into KITS.
c. Influenza immunization clinics also offered pneumococcal immunizations to appropriate patients.
d. The KITS system was modified to print out an alert to providers when persons 65 years of age or older who did not have pneumococcal immunization, presented for care.


RESULT(S):
The initial computerized matching of members with KITS records indicated that only 56 percent of persons aged 65 and older were appropriately immunized with Pneumococcal vaccine. However, KITS was first implemented in 1995, and immunizations given before then were only entered into KITS when persons subsequently showed up for care. Chart review increased the pneumococcal vaccination rate to just over 80%. During flu season, pneumococcal and influenza immunizations were both offered and the provider reminders were printed routinely. This combined effort resulted in an immunization rate of 90%.

CONCLUSIONS(S):
An immunization register/tracking system plus reminder and recall are valuable tools for increasing adult immunization rates and documentation thereof.

LEARNING OBJECTIVES:
Participants will be able to discuss and use methods to increase adult immunization rates.