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December, 2005 Forging a state public health—education
partnership Imagine a world in which nearly 100 percent of your state’s children are current on their immunizations, and those records are available anytime—along with up-to-date records from other child health programs—through a secure Web portal. That’s the world Michigan plans on entering in 2006 if a key bill allowing the integration of child health data passes into state law. Once implemented, the integrated infrastructure now on the drawing board would provide an interface displaying information from several child health programs with a single sign-on. Michigan would join the ranks of very few states offering such comprehensive integrated child health information systems. “The Michigan Association for Local Public Health is supportive of this, of course,” says Therese Hoyle, coordinator of the Michigan Childhood Immunization Registry (MCIR, pronounced micker). “And all of our managed care organizations have pushed for this, too. They’ve written legislators and even the governor to get this passed. It’s a bipartisan bill introduced by four representatives, so it should go right through.” At issue is Bill 728, which is expected to pass easily as early as January 2006, allowing Michigan to integrate MCIR with other child health data, and to become a lifespan immunization registry. Once passed, the Michigan Department of Community Health can move forward with its plans to provide access to immunizations, newborn screening, hearing screening, and lead testing – all at one easily accessible, secure Web site. This expansion will also be the catalyst for MCIR to change its name to Michigan Care Improvement Registry, while keeping the same acronym for continuity. Hoyle’s optimism stems from the enormous success of MCIR, which is approaching nearly 100 percent immunization compliance throughout most of the state. Although MCIR officials are quick to point out that Michigan state law requires physicians to report immunizations, the high compliance rate also reflects comments they hear from private providers about the benefits of a two-way information exchange. Providers report being able to access accurate patient immunization schedules and records online at the point of service, improving care while saving time and money. They can also print out individual immunization schedules for the convenience of their patients. Since MCIR provides the Web interface and secure registration, the system’s infrastructure for integration is already in place, making the transition to linking with other health data sets far easier than if it had to be built from scratch. Not only will the interface be familiar and easy to use, the new data it will provide is very much in demand by schools, managed care organizations, and private providers. Partnering with the Department of Education Michigan Department of Community Health Immunization Division worked with the DOE, providers, local health departments, schools, and childcare facilities for two years to plan how to design and implement the new system and train its users. DOE provided the Immunization Division with a data file that included information on all the state’s K-12 school facilities attended by the 1.7 million children registered in Michigan public schools, along with the demographics of each school district. This information helped customize each school’s Web application. In 2005, over the course of a few months, six regional immunization field representatives conducted MCIR trainings for personnel from the state’s 5,000 schools and about 3,000 of the 5,000 childcare facilities. Local health departments invited their schools’ support staff to MCIR group training provided by field representatives who supplemented the sessions with PowerPoint presentations and hands-on training with live, online demonstrations of the system. Because school secretaries and nurses are especially computer savvy, adapting to a new electronic reporting system was not difficult for them. Early on they saw the value of getting student immunization records online rather than on hand-written cards from clinicians’ offices. Instead of keying in information from each card brought to the school by parents, they can now directly import MCIR records when preparing their school’s immunization report. Whether schools use MCIR online or type in data from immunization cards, they are required to hit a 95 percent immunization rate by their second reporting deadline each February—or risk losing five percent of their state education funding. DOE leadership has been so pleased with the results of their MCIR partnership that they want to add vision and hearing screening results to the system. During the planning and launch of MCIR, the only real skeptics seemed to be the technical staff that administers the computers and networks for the school districts. “The tech staffs couldn’t believe we could make this work,” says Hoyle. “They were absolutely amazed at how easy it was to transfer data electronically to MCIR. But we’ve been working on the registry a long time, and we knew what we were doing.” A surprising adoption rate “It was insanity,” recalls Hoyle of the time from August, just before school started, until the first reporting deadline November 1st. “We were just wildly busy, getting 250 help desk calls a day. The hardest part was getting everyone registered with their unique ID. There wasn’t a lot of press … just word-of-mouth. It was like we jumped on a roller coaster and it took off.” For more information HOME | SITE MAP | CONTACT US | SEARCH | PRIVACY POLICY
©2005 Public Health Informatics Institute
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