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Use of Immunization Information Systems in Primary Care

  • Allison Kempe
    Correspondence
    Address correspondence to: Allison Kempe, MD, MPH, Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children’s Hospital Colorado, 13199 E. Montview Boulevard, Suite 300, Aurora CO 80045
    Affiliations
    Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado

    Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
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  • Laura P. Hurley
    Affiliations
    Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado

    Division of General Internal Medicine, Denver Health, Denver, Colorado
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  • Cristina V. Cardemil
    Affiliations
    National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Mandy A. Allison
    Affiliations
    Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado

    Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
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  • Lori A. Crane
    Affiliations
    Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado

    Community and Behavioral Health, Colorado School of Public Health, Denver, Colorado
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  • Michaela Brtnikova
    Affiliations
    Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado

    Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
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  • Brenda L. Beaty
    Affiliations
    Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado
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  • Laura J. Pabst
    Affiliations
    National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Megan C. Lindley
    Affiliations
    National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Published:September 16, 2016DOI:https://doi.org/10.1016/j.amepre.2016.07.029

      Introduction

      Immunization information systems (IISs) are highly effective for increasing vaccination rates but information about how primary care physicians use them is limited.

      Methods

      Pediatricians, family physicians (FPs), and general internists (GIMs) were surveyed by e-mail and mail from January 2015 to April 2015 from all states with an existing IIS. Providers were recruited to be representative of national provider organization memberships. Multivariable log binomial regression examined factors associated with IIS use (October 2015–April 2016).

      Results

      Response rates among pediatricians, FPs, and GIMs, respectively, were 75% (325/435), 68% (310/459), and 63% (272/431). A proportion of pediatricians (5%), FPs (14%), and GIMs (48%) did not know there was a state/local IIS; 81%, 72%, and 27% reported using an IIS (p<0.0001). Among those who used IISs, 64% of pediatricians, 61% of FPs, and 22% of GIMs thought the IIS could tell them a patient’s immunization needs; 22%, 29%, and 51% did not know. The most frequently reported major barriers to use included the IIS not updating the electronic medical record (29%, 28%, 35%) and lack of ability to submit data electronically (22%, 27%, 31%). Factors associated with lower IIS use included FP (adjusted risk ratio=0.85; 95% CI=0.75, 0.97) or GIM (adjusted risk ratio=0.33; 95% CI=0.25, 0.42) versus pediatric specialty and older versus younger provider age (adjusted risk ratio=0.96; 95 CI%=0.94, 0.98).

      Conclusions

      There are substantial gaps in knowledge of IIS capabilities, especially among GIMs; barriers to interoperability between IISs and electronic medical records affect all specialties. Closing these gaps may increase use of proven IIS functions including decision support and reminder/recall.
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