Data Quality Improvement:
Using Best Practice
Guidelines to Improve IIS
Operations
National Immunization Conference 2009
Presented by: Jodi Warren, RN, BSN
CHILD Profile Immunization Registry
Objectives
 Outline
the current statistics of the IIS
population, both patient and provider
 Describe the data quality
improvement process adopted
 Share key actions taken based on
process results
Background on CHILD Profile (IIS)
 Washington’s
population is: 6,587,600
 Number of records in IIS: 5,754,436
 Kids with 2 or more immunizations

19-35 months = 98% (117,317/119,109)
 Kids

with complete records
4:3:1:3:3 = 48% (56,581/119,107)
Provider Participation
100%
90%
80%
70%
60%
99%
96%
92%
100%
83%
73%
65%
55%
Private
Public
50%
40%
30%
20%
10%
0%
2005
2006
2007
2008
Provider Submission Types
HL7
8%
Manual
78%
Flat File
14%
How Data Comes In to IIS
Manual
6%
Flat File
81%
HL7
13%
Data Quality Improvement Process
1) Hired
Data Quality
Coordinator
2) Developed
Objectives
and Strategies
Project
Objectives
3) AIRA/MIROW
Document
Reviewed &
Analyzed
4) Implemented
Procedures
& Processes
Process Review Results
 AIRA/MIROW
Business Rule
Breakdown:



32 Total
Business Rules
22 Rules were
adopted/modified
10 Rules were
not adopted
 Key Areas
of
Improvement




Data Loading
Policy and
Procedure
documentation
Follow up on
provider data
quality
Internal Data
Quality monitoring
procedures
developed.
Action: Adopted Business Rule
 A patient



should not have more than:
50 vaccinations before 5 years of age.
35 vaccinations before 2 years of age.
70 vaccinations regardless of age.
Records with 50+ imms
101 Total
Records Found
71% were
Bad Merges
113 Records
Recovered
22% was Bad Data
Records with 40+ imms
(Excluding Influenza Vaccine)
265 Total
Records Found
70% were
Bad Merges
210 Records
Recovered
29% from Bad Data
Records with 30+ imms for <3 yr
(Excluding Influenza)
90 Total
Records Found
43% was
Bad Data
29% was
Bad Merges
26 Records
Recovered
20% had multiple
RSV-IGIM on
Record
Action: Modified Business Rule
 These
queries will be run semiannually.
 A patient should not have more than:


40 vaccinations or more between the
ages of 3-18 years old, excluding
influenza.
30 vaccinations or more for < 3 year
olds, excluding influenza and RSV-IGIM.
Action: Modified Business Rule
The
set of data items from the Electronic
Medicaid/Billing Records must include:




IRMS Patient ID/Medical
Record Number
Facility ID (Account Number)
Full Address
Additionally: (highly desirable)
• Patient Middle Name
• Gender
• Guardian First Name or Mother’s
Maiden Name
• Phone Number
• Email Address
• (Future – VFC Status)





Patient Name, First
Patient Name, Last
Patient Date of Birth
Vaccination
Encounter Date
Vaccine Type
(NOTE: These are the recommended data elements that the IIS would like.)
Action: Modified Business Rule
 For
administered vaccinations, Report
Submission Date (date file received)
should be within 30 days of
Vaccination Encounter date.
– Weekly: Large Providers
 OK – Bi-Monthly: Everyone else
 Minimum – Monthly: Smaller Practices
 Encourage Manual data entry for smaller
practices.
 Best
Action: Non-Adopted Rules
1)
2)
3)
4)
5)
Trade name, Manufacturer, CVX code, CPT
code, and Vaccine type should not contradict
one another
Vaccination Encounter date should be within
the Vaccine Product License Date range.
The percentage of vaccination events in which
the responsible party name is the same as the
patient name should be within an expected
threshold level (to be determined by each IIS).
A patient should not have more than 7 DTaP
Vaccinations by age 7.
A patient should not have more than 10
vaccinations per visit.
Action: Not adopted (cont.)
1)
2)
3)
4)
Vaccination Encounter date should not
be after the lot number expiration date.
A patient’s VFC eligibility should be
consistent with the funding source of the
vaccine administered (state specific).
An administered vaccine should not have
a medical contraindication for a patient.
Hepatitis B birth doses from the Vital
Records feed should be reported within
an agreed upon timeframe.
Keys to Success?
Have a
dedicated
person to
identify and
prioritize data
quality issues.
Use a team
approach in
working to improve
the data quality of
the IIS.
AIRA/MIROW
Document helpful
in pointing you in
the right direction.
Presenter: Jodi Warren, RN, BSN
Data Quality Coordinator for CHILD Profile
PHONE: 1-800-325-5599
or (206)-263-8322
Email: [email protected]
WEBSITE: www.childprofile.org
Presenter: Jodi Warren, RN, BSN
Data Quality Coordinator for CHILD Profile
PHONE: 1-800-325-5599 or (206)-263-8322
Email: [email protected]
WEBSITE: www.childprofile.org