Successful Strategies

Self-assessment Strategies

Self-assessment of your patient's records can be revealing. According to staff at the Centers for Disease Control and Prevention (CDC), a study of individual records showed that physicians who assumed their compliance levels were at 85%-100% were actually averaging 65%

AFIX, CASA, ACASA and Immunization Registries can assist your medical practice in assessing and improving its immunization rates.

AFIX

AFIX is a quality improvement strategy designed to raise immunization rates and improve standards of practices at the provider level. The acronym for this four-part strategy stands for:

Assessment of immunization coverage of public and private providers,

Feedback of diagnostic information to improve service delivery,

Incentives to recognize and reward improved performance, and;

eXchange of information among providers.

The purpose of AFIX is to move health care providers from a state of unawareness about the problem (low immunization rates in their practice) to one in which they are aware, concerned and knowledgeable; motivated to change; ready to try new behaviors/strategies; and capable of sustaining these new behaviors.

This immunization improvement strategy was first implemented by the Georgia Department of Public Health in 1986. This intervention was so successful in raising immunization rates that it has become a model program nationwide. By implementing the AFIX strategy, many states have shown gradual and consistent improvement in their public sector immunization rates

To learn more about AFIX and for step-by-step instructions on how to implement AFIX, visit the Centers for Disease Control and Prevention’s (CDC’s) website at http://www.cdc.gov/nip/afix/default.htm

CoCASA

The Comprehensive Clinic Assessment Software Application (CoCASA) is a free, menu-driven relational database developed by the National Immunization Program of the CDC to assist immunization clinics and providers in assessing pediatric and adolescent immunizations.

CoCASA is used when conducting a practice-based immunization assessment and will help providers understand current immunization rates and immunization practices in the facility being assessed. CoCASA provides an extensive body of data that can be accessed and organized to suit an individual practice’s needs. This database produces reports, such as HEDIS reports, from a menu and provides programmatic feedback that includes:

• Up-to-date status of the defined age group served by the clinic or practice
• Up-to-date status of children at critical age markers
• Antigen-specific levels
• Proportion of children who drop out of the vaccination schedule.
• Extent of missed opportunities.
• Reminder and recall letters and postcards.

The CDC also developed ACASA, the Adult (and Adolescent) Clinic Assessment Software Application. Like CoCASA, ACASA is a free tool for assessing immunization practices within a clinic, private practice, or any other environment where immunizations are provided. The purpose of ACASA is to facilitate obtaining immunization data on adults and adolescents.

To learn more about CoCASA and ACASA and download these free software programs, visit the CDC website at http://www.cdc.gov/nip/cocasa/

Utilize Your State’s No-Cost Immunization Registry (also known as Immunization Information System)-
Immunization registries are a no-cost tool to assist parents, providers and health plans in keeping track of vaccination histories. These confidential, computerized information systems contain immunization records and provide immediate access to a child's current immunization status to authorized providers. As families move in and out of public and private health care systems, parents and providers can use registries as a powerful tool to ensure that children receive timely immunizations and proper treatment.
In addition, participation in and support of registries by health plans can provide cost savings through improved immunization service delivery by plan providers who will have access to accurate immunization records, as well as cost savings by reducing the cost of conducting HEDIS audits. 

Registries offer many benefits to health plans and providers.  They can:

• Save time and money
• Increase HEDIS rates
• Reduce dollars spent in over-vaccination
• Reduce or eliminate the need for health plan staff to conduct manual chart pulls to collect immunization data in physician offices
• Facilitate disease prevention
• Generate timely immunization reports (e.g. HEDIS, CASA and other quality improvement initiatives)
• Support the concept of a medical home by making accurate immunization data available to primary care physicians
• Increase immunization data quality and completeness
• Improve quality of care and service delivery
• Increase provider and member satisfaction by providing accurate and timely immunization records
• Increase health plan purchaser (e.g., employer) satisfaction by reducing employee absences for care of sick children
• Allow for health plan comparison by benefits managers, increasing public relations value of registries
• Improve quality and timeliness of immunization delivery by providing up-to-date ACIP vaccine recommendations and intervals
• Provide official immunization documentation cards to parents for school, child care and camp enrollment, and for personal record keeping
• Provide appointment reminder and recall postcards
• Allow expeditious tracking of vaccines in case of vaccine shortages and during manufacturer recalls
• Registries are also working to integrate with other systems (e.g., newborn screening, lead screening, WIC and other electronic medical records).

To learn more about how you can begin benefiting from the immunization registry, click here to visit ECBT’s webpage on registries.

VFC

Enroll To Become a Participating Vaccines for Children (VFC) Program Provider - VFC helps families by providing free vaccines to eligible children.  The largest percentage of VFC vaccines are administered within private provider offices, a testament to the success of this program.  The VFC program is administered at the national level by the CDC’s National Immunization Program.

 In order to insure access to life-saving vaccines to all children regardless of their families ability to pay, it is imperative that all physicians participate in the Vaccines For Children Program.  This program has been hailed as one of the most successful public health achievements and receives positive feedback from participating providers and families throughout the nation.

SCHIP

State Children’s Health Insurance Program (SCHIP) – The State Children's Health Insurance Program (SCHIP), provides free or low cost insurance for eligible children without private insurance.  Providing information to families about SCHIP will help close the gap that results in lack of healthcare for low income families.