title: Tennessee's 3-Star Report: Using Available Data Systems to Reduce Missed Opportunities to Vaccinate Preteens.
abstract: All preteens should receive tetanus-diphtheria-pertussis vaccine (Tdap), quadrivalent meningococcal vaccine (Men-ACWY), and the human papillomavirus (HPV) cancer vaccine series. In Tennessee, HPV vaccination rates have stagnated at low levels for a decade. Three fundamental strategies to reduce missed opportunities for immunization include administering all recommended vaccines at the same visit, making strong recommendations for vaccines, and auditing and feedback. In Tennessee, during each summer, a surge of preteens visit local health departments (LHDs) to receive a required Tdap vaccine before entering seventh grade, presenting an opportunity to administer Men-ACWY and HPV. The Tennessee Immunization Program (TIP) coined the term "3-Star visit" for such encounters and developed a monthly report to track them using data from the Patient Tracking Billing Management Information System (PTBMIS) used by LHDs across Tennessee. Implementation of this quality improvement report has correlated with a substantial increase in 3-Star visits from 2013 to 2016, particularly during the summer months.
authors.affiliation: Tennessee Department of Health, Immunization Program, Nashville, TN, USA.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Moore
authors.affiliation: Tennessee Department of Health, Immunization Program, Nashville, TN, USA.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Fankhauser
authors.affiliation: Department of Medicine, Division of Epidemiology, Vanderbilt University Medical School, Nashville, TN, USA.
authors.forename: Pamela C
authors.initials: PC
authors.lastname: Hull
keywords: HPV vaccine; adolescent immunization; information systems; public health; quality improvement