Immunization Rates in Your Practice: Do You Know How You are Doing?

Immunization Rates in Your Practice: Do You Know How You are Doing?

It seems like everywhere we turn, more and more organizations are using our immunization rates to measure our quality of care. For some of us, this feels like a runaway train. Is this a manageable problem? I would argue that not only is it manageable, we should own this and leverage it for the good of our patients, ourselves and our communities. Let’s break this down to understand what is going on.

Why use immunization rates as a measure?  Vaccine schedules are evidence-based, and rates are easily measured. Since there are age ranges in the early ACIP immunization schedule, many entities (like Meaningful Use) base their measurements on the Every Child by Two campaign. Some are adding childhood and adolescent immunization rates as well. This should not frighten you. This is powerful information.

Why do insurance companies and other third parties care about these rates? Vaccines have transformed medicine in the 20th century in profound ways. They have reduced costs, improved quality of life, and dollar for dollar are one of the best investments for our limited healthcare resources. We should care because it’s good medicine.   Many payers also care because of HEDIS mandates. HEDIS who you may ask?  Health Effectiveness Data and Information Set are set by the National Committee on Quality Assurance (NCQA) and more than 90% of America’s health plans are measured on important dimensions of care which are defined them. It’s why it matters to insurers and one of the reasons why it should matter to you.

Data is POWER. If you have good information, you can use that to improve care, remove barriers, and negotiate with payers! Most insurance companies base their vaccine rates on claims data. We know this data is often incomplete. Hepatitis B vaccines administered in the nursery (usually bundled into the global hospital fee charged to the mother’s insurance), often times don’t find their way to the insurance company. Children may change insurance plans a few times, or move on and off Medicaid or CHIP. You may be the ONLY one who has the complete vaccine history!

How can we get everyone on board?  Some states are beginning to implement real-time bidirectional exchange of vaccine information between their electronic registry and your EHR. When more providers report this information to the registries and we can share this data, that will be awesome! We are only beginning this journey, and the Meaningful Use criteria on reporting helps to move both the states and the EHR vendors to adopt this technology.  There will still be growing pains and barriers to sharing information across state lines but it’s worth doing if we know the end result will benefit our patients and improve care.  Each state has their own contact information and each has different capabilities. Find out where your state is in that process, and ask your state AAP Chapter what you can do to help.  Get involved and get connected.

Part Two:  Using Your Immunization Data to Improve Patient Care