title: Evaluation of immunization data completeness within a large community health care system exchanging data with a state immunization information system.
abstract: BACKGROUND
  Information systems are used by most states to maintain registries of immunization data both for monitoring population-level adherence and for use in clinical practice and research. Direct data exchange between such systems and electronic health record systems presents an opportunity to improve the completeness and quality of information available.
  
  
  OBJECTIVE
  Our goals were to describe and compare the completeness of the Arizona State Immunization System, the electronic health record at a large community health provider in Arizona exchanging electronic data with the Arizona system, and personal immunization records in an effort to contribute to the discussion on the completeness of state-run immunization registries and data exchange with these registries.
  
  
  METHODS
  Immunization histories from these sources were collected and reviewed sequentially. Unique dates of vaccination administrations were counted for each patient and tagged on the basis of comparisons across sources.
  
  
  RESULTS
  We quantified completeness by combining information from all 3 sources and comparing each source with the complete set. We determined that the state registry was 71.8% complete, the hospital electronic health record was 81.9% complete, and personal records were 87.8% complete. Of the 2017 unique vaccination administrations, 65% were present in all 3 sources, 24.6% in 2 of the 3 sources, and 10.4% in only 1 source. Only 11% of patients had records in complete agreement across the 3 sources.
  
  
  CONCLUSIONS
  This study highlights issues related to data completeness, exchange, and reporting of immunization information to state registries and suggests that there is some degree of deficiency in completeness of immunization registries and other sources. This study indicates that there is a need to strengthen links between electronic data sources with immunization information and describes potential improvements in completeness that such efforts could provide, enabling providers to better rely on state immunization registries and to improve research utilization of immunization information systems.
authors.affiliation: College of Medicine-Phoenix, The University of Arizona, Phoenix (Mr Hendrickson and Dr Panchanathan); Department of Biomedical Informatics, Arizona State University, Scottsdale (Drs Panchanathan and Petitti); and Department of Pediatrics, Maricopa Integrated Health System, Phoenix, Arizona (Dr Panchanathan).
authors.forename: Bryan K
authors.initials: BK
authors.lastname: Hendrickson
authors.forename: Sarada S
authors.initials: SS
authors.lastname: Panchanathan
authors.forename: Diana
authors.initials: D
authors.lastname: Petitti
mesh_terms: D000328:Adult; D001130:Arizona; D003153:Community Health Services / Q000379:methods*; D000068598:Data Accuracy; D057286:Electronic Health Records / Q000592:standards; D006801:Humans; D017589:Immunization Programs / Q000379:methods / Q000592:standards; D007256:Information Systems; D008297:Male; D011634:Public Health; D012042:Registries / Q000592:standards* / Q000706:statistics & numerical data