KEYWORDS:
CASA, Immunization Registry, Evaluation, Quality Assurance

BACKGROUND:
The Tennessee Immunization Registry contains records on all children born in TN since 1994, with immunization data on all children seen in public health clinics plus children enrolled in the largest TennCare managed care organization. Multiple data sources can contribute to incomplete or duplicated data entry. Each TN county has at least one health department site.

OBJECTIVE:
The purpose of this study was to examine the quality of immunization data in the TN Immunization Registry, determine areas of incomplete or duplicated entry, and assist clinics in identifying the cause for underimmunization.

METHOD:
Immunization registry data was filtered to assure that the child was place within the correct county. The filtered data was run through CASA to assess immunizations. All children's registry records identified as missing immunizations through CASA were examined.

RESULT:
CASA assessed 9,468 records containing immunization histories on children 24-27 months of age and identified 5,624 children missing one or more vaccines in the 4-3-1-3-3-1 series. Each record missing immunizations was reviewed. Twenty percent of records were missing DTAP4 only and were considered as due to restrictions placed on that vaccine. 24/95 clinic sites entered all historical data, the remaining 71 clinic sites ranged from 1% to 29% of all immunization records missing a previous dose of vaccine. Multiple records were found in 3% of children in the study.

CONCLUSION:
On-going quality assurance of registry data can identify problems caused by human error and caused mechanically. The ability to pinpoint where problems occur prompts local solutions.

LEARNING OBJECTIVES:
The participant will see an example of how to use CASA to assess data in a statewide immunization registry. The participant will be offered data assessment options to determine gaps in immunizing and data collection.