Wednesday, May 12, 2004 - 11:15 AM

WellCareTracker™ – linking pre-school and child (day) care centers with medical homes – a technology-based ”Push” strategy to improve immunization completeness

Jerold Aronson, PA Chapter - American Academy of Pediatrics (Pediatric Advisor), 605 Moreno Road, Narberth, PA, USA, Stuart T. Weinberg, PA Chapter - American Academy of Pediatrics (Consultant), 2221 Windsong Dr, Findlay, OH, USA, and Susan S. Aronson, PA Chapter - American Academy of Pediatrics, 605 Moreno Road, Narberth, PA, USA.

Public/private sector collaboration is required to attain the USPHS Healthy People 2010 Goal of 95% immunization completeness for all vaccines for children enrolled in child (day) care. Primary care reliance upon a “Pull Strategy” to increase immunization completeness (e.g. compliance with “Standards for Immunization Practices”) is not sufficient. Providing early educators with computer tools (e.g. WellCareTracker™) to track preventive care on enrolled children complements vaccine registry initiatives, and adds a “Push Strategy” to medical homes for vaccine update.

1. Annually measure immunization completeness of children attending child (day) care.
2. Pilot in child (day) care an internet-based software application to track preventive care, provide recall/reminders, and refer children to medical homes for overdue services.

Six years of statewide child care immunization data on a 10% sample of children (2002 = 13,645 children in 3,500 child care programs) was assessed. Field-testing of WellCareTracker™ (, a web-application for educators to track health record data for 100% of enrolled children began in 2003. Changes in immunization documentation are measured.

Enrolled children in licensed centers are more completely immunized than similar age children in the general population. While some individual antigen completeness (2002-03) exceeds USPHS 2010 Goals, 4:3:1:3:3:1 completeness is only 74.5% for children ages 19-35 months. Trend data over six years show continual improvement, including varicella, and PCV-7. Child care programs are interested, willing, and able to use computer tools to track preventive care.

Improving immunization performance for children attending child (day) care is achievable using a combination of public/private “Push-Pull” initiatives. As a tracking tool, Web-based WellCareTracker™, optimizes the use of limited resources.

1. Present 6 years of immunization data of children in PA child (day) care centers.
2. Describe an internet-based software application enabling educators to track and refer children with immunization documentation deficiencies to their medical homes.

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