BACKGROUND:
The San Antonio Immunization Registry System (SAIRS) had been in existence on an OS290 Mainframe computer for over twenty years. Once a state-of-the-art system, the operations had become outdated and surpassed by newer, server-based systems. Functional limitations of the Mainframe included limited reporting, inadequate data de-duplication and the need for a third party to manage the system.

OBJECTIVE:
1. Utilize existing resources to their fullest potential.
2. Take advantage of benefits of relational database structure including more detailed analysis of data.
3. Take advantage of web based application.
4. See benefit of being able to automatically bill for services to Medicaid enrolled clients.
5. Cost savings by maintaining database in-house.

METHOD:
In March 2004 the San Antonio Metropolitan Health District (SAMHD) Immunization Division decided that the benefits presented by migrating to a more standardized, web-based registry system were too great and decided to retire the legacy mainframe system in favor of a more robust, more dynamic Microsoft SQL Server database.

RESULT:
Among the benefits seen in implementing the new system, SAMHD is now able to electronically bill for services to Medicaid patients. Information from other divisions within the department are now shared within the same database, allowing for more detailed identification of pockets of need within the Metro area and real ad hoc reports can be generated by a variety of staff.

CONCLUSION:
The SAMHD move to a more flexible, more usable database and have seen the benefits of updating their registry. This is a work in progress and further benefits should be seen in the future.

LEARNING OBJECTIVES:
Understand all facets of evolving immunization information systems.
Demonstrate the benefits of good planning.