title: Completeness and accuracy of the wisconsin immunization registry: an evaluation coinciding with the beginning of meaningful use.
abstract: BACKGROUND
  Vaccination coverage rates can be improved through the application of complete and accurate immunization information systems (IISs).
  
  
  OBJECTIVE
  Evaluate the completeness and accuracy of Wisconsin's IIS, the Wisconsin Immunization Registry (WIR).
  
  
  METHODS
  Cross-sectional evaluation, comparing vaccination medical records (MRs) from provider clinics with WIR records.
  
  
  METHODS
  Medical records of patients born during 2009 were randomly selected from 251 Wisconsin clinics associated with the Vaccines for Children Program.
  
  
  METHODS
  Completeness: percentage of patients with client records in the WIR, percentage of patients up-to-date (%UTD) with the 4:3:1:3:3:1:4 vaccination series, and percentage of patients' MR vaccinations matched by administration date (±10 days) and type to vaccinations documented in the WIR. Accuracy: percentages of matched vaccinations with the same administration date, same trade name (TN), and same lot number.
  
  
  RESULTS
  Of the 1863 selected patient MRs, 98% (n = 1833) had WIR client records and 97% of their 30 899 vaccinations were documented in the WIR. The %UTD was 49.3% using the MR only, 76.5% using the WIR only, and 75.2% as estimated by the National Immunization Survey. Among matched vaccinations, 99% had the same administration date, 96% had the same TN, and 95% had the same lot number. Compared with patients from clinics that entered data into the WIR using data exchange from electronic health records, patients from clinics that entered data using the Web-based user interface were less likely to have client records in the WIR (odds ratio: 0.3; 95% confidence interval: 0.1-0.9) and less likely to have accurate TNs (odds ratio: 0.3; 95% confidence interval: 0.1-0.5).
  
  
  CONCLUSIONS
  The WIR was complete and accurate among this sample of children born during 2009 and provided a vaccination coverage assessment similar to the National Immunization Survey. Our results provide support for the expectation that meaningful use and other initiatives that increase data exchange from electronic health records to IISs will improve IIS data quality.
authors.affiliation: Bureau of Communicable Diseases, Wisconsin Division of Public Health, Madison (Mss Koepke, Petit, and Ayele, Dr Schauer, Messrs Verdon and Hopfensperger, and Dr Davis); Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison (Mss Koepke and Ayele and Dr Conway); and Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison (Dr Eickhoff).
authors.forename: Ruth
authors.initials: R
authors.lastname: Koepke
authors.forename: Ashley B
authors.initials: AB
authors.lastname: Petit
authors.forename: Roman A
authors.initials: RA
authors.lastname: Ayele
authors.forename: Jens C
authors.initials: JC
authors.lastname: Eickhoff
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Schauer
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Verdon
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Hopfensperger
authors.forename: James H
authors.initials: JH
authors.lastname: Conway
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Davis
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D006801:Humans; D017589:Immunization Programs / Q000379:methods / Q000592:standards*; D007223:Infant; D007256:Information Systems / Q000592:standards; D008499:Medical Records / Q000592:standards / Q000706:statistics & numerical data; D015397:Program Evaluation / Q000379:methods*; D012042:Registries / Q000592:standards* / Q000706:statistics & numerical data; D014922:Wisconsin