379 MEASURING PRACTICE IMMUNIZATION RATES IN THE ERA OF HIPAA: A STUDY FROM PROS. (1st January 2005)

• Record Type: Journal Article
• Authors: Lemon, H. M.; Slora, E. J.; Wasserman, R. C.; Bocian, A. B.; Clegg, H. W.; Norton, D. P.; Darden, P. M.
• Is Part Of: Journal of investigative medicine. Volume 53:Number 1(2005)
• Page Start: S320
• Page End: S320
• Publication Date: 2005-01-01
• Subjects: Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.2310/6650.2005.00006.378
• Languages: English
• ISSNs: 1081-5589

Abstract

Abstract : Background: Measuring practice-specific immunization rates has become more complicated with HIPAA. Objective: To validate a new, HIPAA-compliant method for tracking immunization rates. Methods: Five practices in the AAP's practice-based research network, Pediatric Research in Office Setting Network (PROS), collected immunization data on 50 consecutive patients aged 8-35 months using two methods. The reference standard method used two trained research nurses independently examining photocopied patient Vaccine Administration Records with resolution of any disagreement. In the quick-count (QC) method, each office staff recorded counts of the number of patient vaccine doses without submitting patient identifiable information. Up-to-date immunization status (UTD) at 8 months of age was assessed for each patient. Vaccines assessed were DTaP, Hib, Hep B, and polio vaccines. UTD was defined as 3 DTaP, 2 Hib, 2 Hep B and 2 polio vaccines. Measures examined included kappa, sensitivity, specificity, positive predictive value, and negative predictive value. Results: Both methods were used to assess 237 patients. The mean percentage of patients' UTD by 8 months of age using the reference standard method was 93% (practice range 85%-98%). The mean percentage of patients UTD by the QC method was 92% (practice range 83%-98%). No significant difference was found between the methods in assessing an individual's UTD immunization status (McNemar's test p > .18). Agreement with the reference standard was excellent (kappa = 0.85). QC was highly sensitive in determining up-to-date immunization status (99.5%) and had a specificity of (79%). QC had a positive predictive value for up-to-date immunizations of (98%) and negative predictive value of (94%). A debriefing survey demonstrated that all practices found the QC data collection form easy to follow. Conclusion: We found the QC method to be a valid, reliable, and HIPAA-compliant tool for assessing practice immunization rates. In this era of increased patient privacy concerns, this new method of efficiently extracting immunization information will be a valuable tool for research and quality improvement directed at improving immunization rates.