Tuesday, March 18, 2008

Private Provider Use of Recall: Practical Considerations

Kevin J. Dombkowski1, Wendy Nye2, Kris Lyons2, Ericka Hudson1, Laura Harrington1, and Sarah Clark1. (1) Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, 300 North Ingalls, Ann Arbor, MI, USA, (2) MCIR Region 1, 250 Elizabeth Lk Rd, Pontiac, MI, USA

Learning Objectives for this Presentation:
By the end of the presentation participants will be familiar with the practical considerations and issues associated with interventions to initiate the use of immunization recall among private providers.

The degree of training, technical support, and ongoing communication necessary to successfully initiate the use of immunization reminder and recall by private practices is not well understood.

Private practices in metropolitan Detroit, Michigan that agreed to participate in an intervention to initiate the use of immunization reminder and recall notices through the statewide immunization information system, the Michigan Care Improvement Registry (MCIR).

A total of 21 private practice sites agreed to participate, none of which were using MCIR for immunization recall at the time of recruitment.

Project Description:
Participating practices received hands-on training from MCIR regional staff based upon each site's unique needs, including building patient rosters, generating recall notices, and generating patient profile reports. Periodic face-to-face and phone contacts were made with staff at each site to ascertain recall problems, identify solutions, and to assess the degree to which previously identified issues had been successfully resolved.

Results/Lessons Learned:
Most practices experienced multiple problems with conducting recall, although two sites encountered no difficulties. The number and complexity of problems was not associated with practice size; problems commonly encountered by practices were difficulties with staff shortages or insufficient time to generate, review, and mail recall notices. Half of the practices experienced some degree of difficulty correctly generating and mailing recall notices, while others generated inaccurate recalls due to incomplete data entry or electronic transfers. Staff turnover and lengthy lapses following initial training necessitated the need for additional MCIR recall training at several sites.