2004-05 IISAR ONLINE Questions
1.1) Is your IIS populated by birth data? (Definition: information from vital records, birthing hospitals, perinatal or newborn screening programs and etc)
1.2) Which age groups are included in your IIS(Select one)?
a. birth through 5 years of age or under six years of age
b. birth through 18 years of age
c. all ages (including adults)
d. Other:
Child Participation (19-35 month olds)
19-35 month old Participation(queries for the series should only count valid doses and those with documented immunity or disease)
2.1) Number of children 19 through 35 months of age in your geopolitical area.
logic guidance: For children born from January 1, 2004 through May 31, 2005. (CensusData)
2.2) Number of children 19 through 35 months of age with 2 or more immunizations are both in your geopolitical area The area that contains the population of children residing in the geopolitical location covered by the II AND in your IIS (e.g., exclude children from other states)?
2.3) Proportion of children 19-35 months of age in the geopolitical area with 2 or more immunizations in the IIS.
2.4) How many of thesechildren have received 4 DTaP, 3 polio, 1 MMR, 3 Hepatitis B, & 3 Hib (4:3:1:3:3 series)?
2.5) How many of thesechildren are missing only one dose to be up-to-date for the 4:3:1:3:3 series?
2.6) Proportion of children 19-35 months of age enrolled in the IIS, who have received the 4:3:1:3:3 vaccination series.
2.7) Proportion of children 19-35 months of age enrolled in the IIS who are missing just one dose to be up-to-date for the 4:3:1:3:3 vaccination series.
2.8) How many of thesechildren have received 4 DTaP, 3 Polio, 1MMR, 3 Hepatitis B, 3 Hib, & Varicella (4:3:1:3:3:1 series)? When calculating VZV coverage level, please include those with history of disease.
2.9) How many of thesechildren are missing only one dose to be up-to-date for the 4:3:1:3:3:1 series?
2.10) Proportion of children 19-35 months of age enrolled in the IIS who have received the 4:3:1:3:3:1 vaccination series.
2.11) Proportion of children 19-35 months of age enrolled in the IIS who are missing just one dose to be up-to-date for the 4:3:1:3:3:1 vaccination series.
Child Participation (under six years of age)
<6 Child Participation(queries for the series should only count valid doses and those with documented immunity or disease)
3.1) Number of children < 6 years of age in the geopolitical area. (Census Data(
3.2) How many children in question 20 have 2 or more immunizations recorded in your IIS?
3.3)Proportion of children < 6 years of age in the geopolitical area with 2 or more immunizations recorded.
Provider Participation
Public Immunization Sites Definition:
1) Total Health Department Clinic: A state, district, county or city public health clinic where vaccines are administered. Health department clinics may or may not be federally Qualified Health Centers (FQHCs). Please report the total number of health department clinics as well as the number of clinics by type (non-FQHC and FQHC).
2) Community/Migrant Health Center/Rural Health Clinic: Primary care clinics partially funded by the Bureau of Primary Health Care (BPHC), as well as Federally Qualified Health Centers (FQHCs) and FQHC Look-a-Likes which are not funded by BPHC. Do not include health department clinics that are FQHCs in the total. A C/MHC may have multiple sites
3) Indian Health Service/Tribal Health Clinic: Primary care clinics for American Indians and Alaska Natives, including outpatient clinics in IHS hospitals. IHS/Tribal health clinics may have multiple sites.
4) Other Public Provider: Any other public clinic which provides immunization, such as a publicly funded non-profit neighborhood clinic
Private Immunization Sites Definition: MCO, private docs, private clinics
Provider Participation(only count providers who serve children under six years of age)
4.1) How many public immunization SITES (see definition above)are in your geopolitical area (The area that contains the population of children residing in the geopolitical location covered by the IIS)?
4.2) How many public immunization SITES in your geopolitical area have submitted data to your IIS in the last 6 months?
4.3) Proportion of public sites that have submitted data to the IIS within the last six months of the year.
4.4) Number ofprivate immunization SITES (see definition above) in yourgeopoliticalarea
4.4.1) VFC providers only.
VFC and non-VFC providers.
4.5) How many private immunization SITES in your geopolitical area have submitted data to your IIS in the last 6 months?
4.6) Proportion of private sites that have submitted data to the IIS within the last six months of the year.
Functional Standards
FS 2.1 Are the following data entry fields included in your IIS database? Core Data Element(for children under 6 years of age) / % data element in IIS(for children under 6 years of age)
a. Patient's first name / CY 2005 only
b. Patient's middle name / CY 2005 only
c. Patient's last name / CY 2005 only
d. Patient's birth date / CY 2005 only
e. Patient's sex / CY 2005 only
f. Patient’s birth state / CY 2005 only
g. If patient was born outside the U.S., can the IIS record the patient's birth country? / CY 2005 only
h. Mother's first name / CY 2005 only
i. Mother's maiden name / CY 2005 only
j. Mother's last name / CY 2005 only
k. Vaccine type / CY 2005 only
l. Vaccine manufacturer / CY 2005 only
m. Vaccination date / CY 2005 only
n. Vaccination lot number / CY 2005 only
o. Race (definition: American Indian or Alaskan Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White) / CY 2005 only
p. Ethnicity (definition: 1)Hispanic or Latino[A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race] OR 2) Not Hispanic or Latino) / CY 2005 only
q.address (yes/no and % in IIS for each element)
1) address 1
2) address 2
3) city
4) state
5) zipcode
(Logic guidance: exclude addresses with missing, illogical, or incomplete data) / CY 2005 only
r. phone number / CY 2005 only
FS 2.2 What is the average amount of time, in weeks, between a child's birth and the establishment of an IIS record?
FS 2.2.1 What % of newborn children have an IIS record established within 6 weeks of birth?
FS 2.3 Prior to a patient encounter, can a participating provider access immunization information in the IIS?
FS 2.3.1 During a patient encounter, can aparticipating provider access immunization information in the IIS?
FS 2.4 Does your IIS receive and process vaccine and other immunization encounter information within 1 month (1 month=30 days) of vaccine administration?
FS 2.4.1 For all of the vaccines administered during CY2006 and recorded in the IIS, what percentage of vaccine doses were reported to the IIS within the following time frames: Time from immunization to record entry into the IIS:
a. % equal to or less than 1 month (30 days)
b. %greater than 30 days - equal to or less than 60 days
c. %greater than 61 days
d. Cannot flag historical shot records and exclude them from this analysis / Cannot answer this question.
FS 2.5 Has a written confidentiality policy been implemented for your IIS? Please provide a copy of your confidentiality policy
FS 2.5.1 Has this policy been reviewed and found to be in compliance with federal, state, and local legislation?
FS 2.5.2 Has this policy been reviewed and found to be consistent with the minimum specifications contained in Chapter 2, Appendix B of the Community Immunization Registry Manual, except where superseded by state or local legislation?
FS 2.6 Has a written security policy been implemented for your IIS? Please provide a copy of your security policy
FS 2.6.1Has this policy been reviewed and found to be in compliance with federal, state, and local legislation?
FS2.6.2Has this policy been reviewed and found to be consistent with the minimum specifications contained in Chapter 2, Appendix D of the Community Immunization Registry Manual, except where superseded by state or local legislation?
FS 2.7 If we were to send your IIS a query today for a specific immunization record via an HL7 message, could your IIS process that message and return either an HL7 message showing multiple matches to the query orreturn the immunization record in an HL7 VXR message consistent with the specifications in the current version of NCIRD's HL7 implementationguide?
FS 2.7.1 If we were to send your IIS a new immunization record today via anHL7 VXU message, could your IIS process that message and upload the record into your database consistent with the specifications in thecurrent version of NCIRD's HL7 implementation guide?
FS 2.8 Is an automated IIS function in place, accessible at the provider level, that identifies needed immunizations, consistent with current ACIP recommendations, given an individual's immunization history to date?
FS 2.9 Can your IIS electronically generate reminder notifications (e.g., notices to be mailed, input to an automated telephone reminder system, lists for provider use)?
FS 2.9.1 Can your IIS electronically generate recall notifications (e.g., notices to be mailed, input to an automated telephone reminder system, lists for provider use)?
FS 2.10 By which of the following categories is your IIS able to produce immunization reports.
FS 2.10.1 For a given age group of children (e.g., 19-35 months of age, less than age6).
FS 2.10.2By geopolitical subdivision within the area covered by the IIS (e.g., county, zip code).
By individual provider or site.
FS 2.11 Is an IIS function in place that allows authorized users to print a copy of an individual's immunization history that serves as an "official immunization record"?
FS 2.12 Does the IIS have a data quality protocol to combine all available information relating to a particular individual into a single accurate immunization record?
Vaccine Management
6.1) Is your IIS used to track vaccine inventory at the provider level?
6.2) Is your IIS used to track vaccine inventory at the state level?
6.3) Is your IIS used as a part of your vaccine ordering process?
Reminder Recall
7.1) Is your reminder/recall function done centrally or at the local/provider level?
Central Local/Provider Both No reminder/recall done with the IIS
Data Sharing/Linkages
8.1) How are users accessing IIS data? (check all that apply)(2005 question)
System / Access TypeRead-only (view-only) / Update a Record (read/view, update, and exchange a record)
Hospitals
Daycare/Head Start
Elementary Schools (define)
High Schools (define)
Higher Education (trade schools, junior collage, college/university)
Correctional facilities
WIC
STD/HIV
Long-term care facilities
Health Plans
Indian Health Service
Veterans Administration
Juvenile facilities
Military
Family Planning
Medicaid
Medicare
8.2) Does your IIS collect immunization data from schools?(2004 question)
Data Use
9.1) Do you use the IIS to track children born to HBsAG unknown/positive mothers for intensified HepB surveillance?
9.2) Do you use the IIS to produce any VFC reports (e.g., doses administered, vaccine wastage, and/or provider profiles)?
9.3) Do you use the IIS to conduct provider level coverage assessment as part of your AFIX process?
9.4) Have you used the IIS to identify geographic pockets of need in your project area (e.g.,zip code, census tract)?
9.5) Have you used the IIS to identify demographic pockets of need in your project area (e.g.,WIC clients)?
9.6) Does your IIS provide information to managed care organizations to assist in HEDIS reporting?
9.7) Is the IIS linked to the VAERS reporting system?
9.8) Do you use the IIS to track adverse events?
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