Impact of Hospital Based Immunization Information Systems

Background: A pilot study in Nevada identified time as a major challenge to providers’ participation in WEBIZ, a statewide immunization information system. In July 2009, the state mandated all immunization providers including hospitals, to record their activities in WEBIZ, hypothesizing that by establishing initial records with hepatitis B immunizations, providers would only have to update records, reducing time spent in establishing new records. We aimed to determine what impact the hospital-based IIS had on completeness of records in WEBIZ

Setting: A medical school outpatient clinic in Las Vegas, Nevada

Population: Children born in Nevada from July 1 through October 31, 2009 after the state immunization documentation mandate

Project Description: We reviewed all new records established in WEBIZ after the state mandate. We selected a sample of children born in Nevada after the state mandate aged 0 – 4 months. Medical charts of these children were reviewed and documented immunization activities were compared to documentation in WEBIZ.

Results/Lessons Learned: During the study period, 13,947 new records were established in WEBIZ for children aged 0-4 months. 54% (7538/13947) were established by hospitals. In our sample, 61% (60/98) of children had records established at birth by hospitals. 55% (33/60) of these patients had duplicate records created by providers. 15% (9/60) of children with hospital established records had complete record when only names were used to search WEBIZ even though 48% (29/60) had a complete record when duplicate records were merged. Although a significant number of children had hospital established immunization records in WEBIZ, providers did not take advantage of this to update records but rather created new ones leading to duplications. Information about hospital established records should be included in training programs for provider’s offices to avoid record duplications and potential over immunization