Learning Objectives for this Presentation:
By the end of the presentation participants will have a better understanding of the leading barriers to initiating the use of immunization recall by private providers and opportunities to potentially overcome those barriers.

Background:
The underlying barriers to use of immunization reminder and recall by providers in private practices are not well understood, nor are the mechanisms that encourage recall use among this group of providers.

Objectives:
To identify factors that facilitate or impede the use of immunization recall among private practitioners in a defined community and overcome such barriers using a statewide immunization information system.

Methods:
Private practices in metropolitan Detroit, Michigan were invited to participate in an intervention to increase the use of immunization reminder notices through the statewide immunization information system, the Michigan Care Improvement Registry (MCIR). Surveys were administered at participating practices (n=21) to office managers, physicians and nurses to characterize prior experience with immunization recall, as well as the perceived benefits and potential problems associated with recall use.

Results:
Sixty percent of responding practices (n=15) reported some degree of previous recall experience but none conducted recall on a routine basis. Only half of practices considered their patient address information to be very accurate. The issues most commonly cited by practices and providers at those sites (n=72) as “significant problems” in conducting recall was the cost and staff time and concern over the accuracy of MCIR address and immunization data. One-third of providers indicated that recall would not be beneficial in bringing in children due for immunizations. Each participating practice received hands-on MCIR training, technical support, and an option to customize mailed reminder and recall notices.

Conclusions:
Most private providers recognize the potential benefits associated with recall notification but important concerns exist regarding the cost implications to practices as well as immunization registry data quality.