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Acad Pediatr. 2012 Mar-Apr;12(2):104-9. doi: 10.1016/j.acap.2012.01.002. Epub 2012 Feb 8.

Feasibility of initiating and sustaining registry-based immunization recall in private practices.

Author information

  • 1Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, 48109-5456, USA. kjd@med.umich.edu

Abstract

OBJECTIVE:

To assess the feasibility of initiating and sustaining immunization recall by private practices, including the barriers and costs, using a statewide immunization information system (IIS).

METHODS:

Private practices in southeast Michigan were recruited in 2007 to perform IIS-based immunization recalls. Enrolled practices were provided with training and asked to conduct 4 recalls during the course of 12 months of children 19 to 35 months of age. Each practice recorded the time they spent performing recall-related activities; labor costs were estimated. Formative and summative evaluations with semistructured interviews were conducted to identify barriers.

RESULTS:

Of 97 eligible pediatric and family medicine practices, 44 declined to participate, 32 did not respond to repeated contacts, and 20 agreed to enroll in the study (21%). A total of 56 recalls were conducted during the study period, with 9 practices completing at least 4 recalls and 7 practices completing 1 to 3 recalls; 4 practices conducted no recalls. Common barriers reported included time constraints and executing all steps of the recalls. Practice costs per patient recalled ranged from $0.05 to more than $6 and were primarily driven by the type of personnel who performed recalls. The costs of creating a roster of current patients comprised nearly one-half of total labor costs.

CONCLUSIONS:

Few private provider practices that we contacted were willing to participate in this study of IIS-based recall, and less than one-half of enrolled practices completed the desired 4 recall cycles in 12 months. Time constraints and other real-world problems should not be underestimated in determining the feasibility of practice-based immunization recall. Efforts to increase the use of a statewide IIS for recall in private practice settings should emphasize ongoing training and technical support to practice staff. Improved interoperability with electronic health record systems may foster practice-based recall by reducing the labor intensity of roster building and other recall activities.

Copyright © 2012 Academic Pediatric Association. All rights reserved.

PMID:
22321815
[PubMed - indexed for MEDLINE]
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