Child Health Integration Bob Swanson, MPH Division of Immunization Michigan Department of Community

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Child Health IntegrationBob Swanson,
MPHDivision of ImmunizationMichigan Department
of Community Health
Michigan Care Improvement Registry (MCIR)
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Michigan Care Improvement Registry

• Web-based application
• Populated with electronic birth records (within 2
  weeks)
• Operational with a regional approach
• Majority of the funding from the Healthy Michigan
  Fund (tobacco tax)
• First rolled out in 1998

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MCIR Activity

• 4.7 million records
• Over 57 million shot records
• 35,000 registered users
• 2,334 provider sites submitted data in 2007

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MCIR Regions

• Provider recruitment
• Provider training
• Help desk
• Advisory boards

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MCIR Tools

• Assessment of patient immunization status at the
  time of the visit
• Reminder/Recall Letters Coverage Level Reports
• High Risk Influenza/Lead Pop-up
• Lead Results
• Clinical Record
• All Hazard Component

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Schools and DaycaresUtilizing MCIR

• 4813 Schools
• 95 enrolled in MCIR
• 4235 Daycares
• 89 enrolled in MCIR

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Reporting Adverse Events (in development)

• Integrated VAERS form
• Auto populates data
• Transmission to CDC

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MCIR Electronic Interface Activityin February
2008

• 270,000 immunizations reported from provider
  offices
• 860,000 updates from Medicaid with beneficiary
  information
• 200,000 WIC ID updates
• 10,800 Electronic Birth Records

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MCIR Benefits

• High provider participation (gt90)
• Supports all programmatic functions of the
  Immunization program
• All Hazard tracking capabilities
• Population based system
• Reports to demonstrate pocket of need
• Flexibility to allow linkages with other public
  health systems
• Infrastructure setup with regional staffing model
  

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Population Based Reporting

• State Levels
• County Levels
• WIC Levels
• MEDICAID Health Plan Levels
• Clinic Site Levels
• School District Levels
• School Building Levels
• Migrant Schools
• Migrant Population

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Current Immunization Profile for 19 - 35 Month
Old Children
Based on MCIR Data
Keweenaw
Keweenaw
Houghton
Houghton
Otonagon
Otonagon
Baraga
Baraga
Luce
Luce
Gogebic
Marquette
Gogebic
Marquette
Alger
Chippewa
Alger
Chippewa
Schoolcraft
Schoolcraft
Iron
Iron
Mackinac
Mackinac
Dickinson
Dickinson
Delta
Delta
Cheboygan
Cheboygan
Emmet
Emmet
Menominee
Menominee
Presque Isle
Presque Isle
Charlevoix
Charlevoix
Alpena
Montmorency
Montmorency
Otsego
Antrim
Otsego
Antrim
0 - 29
Alpena
Leelanau
Leelanau
Grand
Crawford
Grand
Crawford
Oscoda
Alcona
Kalkaska
Oscoda
Alcona
Benzie
Kalkaska
Traverse
Benzie
Traverse
Manistee
Wexford
Iosco
Missaukee
Manistee
Wexford
Ogemaw
Iosco
Missaukee
Roscommon
Roscommon
30 - 49
Ogemaw
Arenac
Arenac
Gladwin
Gladwin
Mason
Lake
Osceola
Clare
Mason
Lake
Osceola
Clare
Huron
Huron
Midland
Oceana
Newaygo
Mecosta
Isabella
Midland
Bay
Oceana
Newaygo
Mecosta
Isabella
50 - 59
Bay
Tuscola
Sanilac
Tuscola
Sanilac
Montcalm
Gratiot
Saginaw
Montcalm
Muskegon
Gratiot
Saginaw
Muskegon
Lapeer
Kent
Lapeer
Kent
Genesee
60 - 69
St. Clair
Genesee
Shiawassee
Clinton
Ionia
Ottawa
St. Clair
Shiawassee
Clinton
Ionia
Ottawa
Macomb
Macomb
Allegan
Barry
Eaton
Ingham
Livingston
Oakland
Allegan
Barry
Eaton
Ingham
Livingston
Oakland
70 - 79
Van
Buren
Calhoun
Jackson
Washtenaw
Wayne
Detroit
Kalamazoo
Detroit
Kalamazoo
Calhoun
Jackson
Washtenaw
Wayne
Van
Buren
Monroe
Berrien
Lenawee
Cass
Hillsdale
St. Joseph
Branch
Monroe
Berrien
Lenawee
Cass
Hillsdale
St. Joseph
Branch
80 - 89
August 2008
January 2001
431331
90 - 100
431330
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Lead Data Results

• Added a lead pop-up window
• Medicaid enrolled
• Mapped to HR zip code
• 23 increase March May of 2004 in lead testing
  as compared to 2003 data.
• Increased provider participation

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Benefits

• High provider participation (90)
• Population based system
• Reports to demonstrate pocket of need
• Flexibility to allow linkages with other public
  health systems
• Infrastructure setup with regional staffing model
  

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Newborn Hearing
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EPSDT
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Newborn Screening
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Michigans BMI Surveillance Efforts

• On going discussions to add BMI to the MCIR

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Emerging Synergies
Surveillance
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Lesson Learned

• Health Plan Incentives
• Mandated Reporting
• Billing Data vs Medical Record
• Regional Training and Support