BACKGROUND:
The San Diego Immunization Program has conducted CASA assessments of the County’s 49 public clinics for 11 years. It was an intensive manual process that required pulling charts and entering the data into WinCASA for analysis. This process has been revolutionized by the development and utilization of the countywide immunization registry. Integrating data from the registry has been found to be both beneficial and challenging.

OBJECTIVE:
Ensure the quality of immunization assessment after integrating the information from the registry.

METHOD:
Population and sample selection were determined using billing data. When the registry generated immunization dates, it was merged with billing data electronically, and then imported to WinCASA. A list of clients with incomplete immunization histories or no information in the registry was generated from WinCASA and sent to each clinic to follow-up for additional information on immunization and MOGE status. Coverage rates were compared before and after the update.

RESULT:
For the 2003 audits, assessors needed to pull 35% of the charts and input the data into WinCASA. The coverage of 4-DTP, 3-Polio and 1-MMR was 67% based on the information from the registry, and 77% after the follow-up process. The 2004 audit is currently in progress. With the improvement in quality of registry data, a smaller percentage of difference between the registry-based assessment and the result of the follow-up is anticipated.

CONCLUSION:
Data integration and management were challenging; however, the savings in staff time and energy are tremendous after integrating use of the registry into the CASA assessment process.

LEARNING OBJECTIVES:
Describe the process and effort required in converting from a manual CASA assessment to an audit using registry data.