BACKGROUND:
Computerized immunization registries are increasingly utilized, and can be a valuable tool in improving immunization coverage rates; however incomplete and inaccurate data have hampered their effectiveness. High rates of immunization coverage among Indian Health Service (IHS) beneficiaries have been highlighted at the National Immunization Conference and in the August 2003 MMWR, and may be attributed in part to the implementation of immunization registry software within IHS’s computerized Resource Patient Management System (RPMS) and efforts to improve data quality.

OBJECTIVE:
Identify strategies and software enhancements to improve completeness of immunization records in a computerized registry.

METHOD:
Health providers and users of the software worked with RPMS and MDA programmers to improve the RPMS Immunization software and increase use by health care facilities.

RESULT:
Reducing delays in data entry and coding errors were identified as the most important factors in improving the quality of immunization records. Changes to the software facilitated implementation of point-of-service data entry as a strategy. In addition, standard HL7/CVX immunization codes and manufacturers’ codes were adopted and combination vaccines were incorporated. Other features of the package designed to increase provider use of the registry included ten customized immunization forecasting options based on minimal or recommended ages of vaccination; customizable immunization due lists and letters; and standard immunization audits.

CONCLUSION:
Immunization data quality has improved dramatically with the implementation of point-of-service data entry and increased utilization of the IHS immunization registry. As a result, uses of the immunization data have expanded to include automated immunization due reminders on patient encounter forms, monthly reports to providers on the immunization status of their patients, and comparison of immunization rates by providers.

LEARNING OBJECTIVES:
This illustrates that a user-driven process can result in a robust immunization registry which can help meet population-based goals for immunization coverage.