379 MEASURING PRACTICE IMMUNIZATION RATES IN THE ERA OF HIPAA: A STUDY FROM PROS

• Published in: Journal of investigative medicine Vol. 53; no. 1; p. S320
• Main Authors: Lemon, H. M., Slora, E. J., Wasserman, R. C., Bocian, A. B., Clegg, H. W., Norton, D. P., Darden, P. M.
• Format: Journal Article
• Language: English
• Published: London Sage Publications Ltd 01.01.2005
• DOI: 10.2310/6650.2005.00006.378
• ISSN: 1081-5589

BackgroundMeasuring practice-specific immunization rates has become more complicated with HIPAA.ObjectiveTo validate a new, HIPAA-compliant method for tracking immunization rates.MethodsFive 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.ResultsBoth 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.ConclusionWe 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.