Implementing a Scanning System to Report H1N1 Vaccine Doses Administrated to the North Dakota Immunization Information System

Background: In October 2009 novel H1N1 influenza vaccine became available for states to order.  The North Dakota Department of Health (NDDoH) required providers to report all doses of H1N1 vaccine administered to the North Dakota Immunization Information System (NDIIS) within seven days of administration.

Setting: Approximately 290 providers in healthcare setting received H1N1 vaccine in North Dakota.  Over 200 vaccine providers reported doses administered to the NDIIS.

Population: Health care providers administering H1N1 vaccine in North Dakota.

Project Description: To provide an alternative to manual data entry for providers, the NDDoH implemented a scanning system to receive H1N1 vaccination information during the 2009-2010 flu season. NDDoH contracted with a scanning software vendor to create a scanning system to facilitate reporting of H1N1 vaccine. Vaccine providers downloaded a software program from the internet then scanned the vaccine administration records at their facility. The immunization information was transmitted to the NDDoH where validators corrected errors before the information was loaded into the NDIIS. 

Results/Lessons Learned: Early data quality procedures resulted in only 40% of records being successfully loaded into NDIIS on the first attempt. The validation procedures were changed to catch more errors and the NDIIS loader program was reprogrammed to only require name, birth date, dose date, and lot number. After three weeks of changes in data quality procedures, 55% to 75% of records were able to be loaded on the first try.  The multiple levels of validation resulted in many H1N1 vaccine records not being entered into the NDIIS in a timely manner, which caused a lack of knowledge about coverage and inventory throughout the state. Using a scanning software decreased data quality in the NDIIS compared to manual data entry and required much more verification by the NDDoH than manual data entry. Many providers gave up scanning immunization records and chose manual data entry to ensure data quality and timeliness.