Identifying and Addressing Gaps in IIS Data from Electronic Sources

Background:
Minnesota's immunization information system (IIS), the Minnesota Immunization Information Connection (MIIC), has been in production since May 2002. Almost 92% of all children ages 0-6 have a record with 2 or more vaccines, and 89% of Minnesota VFC providers are enrolled in MIIC. Despite this level of maturity, MIIC data appear to be incomplete when used for assessment reports, since the MIIC up-to-date rates are consistently 15-20% lower than the NIS rates.

Setting:
Providers who submit electronic data to MIIC.

Population:
n/a

Project Description:
Surveys of providers who submit electronic data to the IIS were conducted. Using provider activity reports, providers were contacted when the frequency and/or timeliness of their batch loads diminished. Assessment reports run at a clinic level versus at the county or state level were compared. These efforts uncovered different causes for incomplete data in MIIC.

Results/Lessons Learned:
There were several areas where MIIC was not getting complete data, including data from billing systems that didn't capture historical or non-billed shots; some of the required data elements were incomplete as well. This held true for clinical and electronic medical record (EMR) systems as well. A provider's transition to an EMR tended to disrupt existing data flows. Problems with patient status of moved or gone elsewhere (MOGE) and incoming data from non-traditional providers also resulted in incomplete data. Numerous approaches are being discussed to fix these problems, including a promotional program to provide staff support to providers to hand enter historical data, re-education of providers on the importance of getting all their immunization data into the IIS, resuming regular data loads from the Department of Human Services, and establishing a state MOGE protocol.