The Journey towards Compliance Excellence

Background:   Immunization status is one of the most commonly used measures of child health status and the adequacy of preventive care.   Though the majority of US children are compliant with immunization recommendations, the national immunization compliance rate of 77% and the Washington, DC rate of 85% still remain below the Healthy People 2010 goal of 90% coverage.  In an effort to improve health outcomes, the federal government has a goal of creating an electronic medical record (EMR) for every American by 2014.  However, the transition to an EMR system presents short term challenges on the journey towards compliance excellence for meaningful use.

Setting:  The setting for this project was Unity Health Care (Unity).  Unity is a Federally Qualified Health Center (FQHC) network which provides comprehensive health and human services to the medically underserved residents of Washington, DC regardless of race, ethnic background, or ability to pay.

Population:  The target population for this project was a racially and ethnically diverse group of preschool children with substantial health disparities and poor health outcomes.

Project Description:  The goal of this project was to implement a quality improvement initiative that optimizes health information technology in immunization data collection and reporting for a bi-directional data exchange with the DC immunization registry.  Additionally, the implementation of the eClinical Works (eCW) EMR was expected to enhance the immunization delivery system by minimizing missed opportunities, reducing documentation errors, and improving immunization compliance rates.

Results/Lessons Learned:  Immunization compliance rates from the DC immunization registry were compiled on a monthly basis before and after the implementation of the EMR.  It was discovered that Unity’s compliance rate rose from 67% to 70% one year after the implementation of the eCW EMR system.  Some of the challenges that may have prevented a greater compliance increase included reduced patient care access due to staff training and discrepancies in the reporting system.