KEYWORD1:
Registries, data warehouse, reminder/recall, inter-agency cooperation

BACKGROUND:
Southern California Kaiser Permanente serves 3 million members in 11 medical centers and 90 medical offices throughout Southern California. A centralized immunization tracking system (KITS) was developed and implemented in 1994. Over the years, KITS has been enhanced and currently contains over 21 million immunization entries.

OBJECTIVE:
The objective of this paper is to show how an immunization register must be continually evaluated and upgraded in order to be useful in all aspects of improving immunizations.

METHOD:
The history/enhancement of KITS use for reminder/recall and provider reminder is presented, showing before and after immunization rates of children aged 2, 13; adults 65 and over; and special groups such as infants born to HepB surface antigen positive mothers. Also discussed is registry use in vaccine safety studies, vaccine recall, the 2002 placement of KITS data into the Kaiser Permanente Data Warehouse, and cooperation in the development of the California State Immunization Registry.

RESULT:
Cooperative efforts by clinical providers, administration, and information technology personnel has developed an interactive, evolving registry which is used daily to assist in improving immunization rates. (Southern California Kaiser Permanente's 2 year old immunization rates now average at least 90%.) Placing the immunization register into a data warehouse has improved data accessibility of individual practitioners for their patients. Cooperation with the state immunization registry development group has benefited both KITS and state registry development.

CONCLUSION:
Immunization registries are tools which by themselves have limited ability to improve immunization rates. Innovative use of registry data by well-trained personnel, however, will improve immunization rates and maximize registry efficiency and usefulness.

LEARNINGOBJECTIVES:
Persons attending will learn effective uses and applications of registry data; and cooperation with local, state and national agencies in order to improve immunization rates for all ages.