Learning Objectives for this Presentation:
By the end of the presentation participants will be able to describe:
1. Differences in immunization coverage levels in economically challenged Chicago neighborhoods as indicated by medical records and the TOTS electronic registry system.
2. Types of discrepancies between medical chart and TOTS electronic registry;
3. Clinical practices associated with greater accuracy in TOTS electronic registry system.



Background:
The Illinois TOTS database contains approximately one million participants 4 months through 5 years of age with at least 2 immunizations recorded. These data account for 74% of the geopolitical (statewide) area for children 0 through 5 years of age. Little was known about the accuracy of the electronic registry, especially in economically challenged neighborhoods


Setting:
Private clinics located in the Engelwood neighborhood of Chicago


Population:
Clinics located in economically challenged communities serving low-income children with high mobility rates.


Project Description:
To examine the nature of discrepancies between the medical chart and the TOTS electronic registry independent audits were conducted to assess accuracy figures for each sampled record for each NVAC core element. Each case is labeled Fully Accurate, Partially or Mostly Inaccurate based on comparisons of the TOTS registry medical record for following elements: patient birth date, patient gender, patient birth state/country, mother's maiden name , vaccine type, vaccine manufacturer, vaccination date and vaccine lot number. TOTS data entry protocols are reviewed with clinic staff.



Results/Lessons Learned:
. Preliminary data suggests a broad range of TOTS data quality across the private clinics. There is some indication that greatest accuracy occurs for patient information such as patient birth date, patient gender, patient birth state/country, while elements least likely to be accurately reflected in the TOTS registry are vaccine manufacturer and lot number. Clinical practices associated with greater accuracy in TOTS electronic registry system include incorporating routine data entry times into support staff scheduling.