Colorado Immunization Information System (CIIS)

System Overview and Status Update

December 2007

System Description

The Colorado Immunization Information System (CIIS) is a confidential, population-based, computerized information system that collects and disseminates consolidated immunization information for Coloradoans. The system is operated by the University of Colorado Health Sciences Center on behalf of the Colorado Department of Public Health and Environment. CIIS enables any immunization provider in Colorado to electronically track immunizations a person has received, thereby maintaining an ongoing and complete record to ensure that the person receives all recommended shots in a timely manner and is not over-immunized.

An immunization information system is an important tool to increase and sustain high immunization coverage by consolidating immunization records from multiple providers, allowing providers to generate recall notices for individuals who are not up-to-date, and producing official school forms. CIIS meets guidelines for immunization information system functionality developed by the Centers for Disease Control and Prevention.

Core Functions of the Colorado Immunization Information System

•  Web-enabled data base for data entry and access

•  Interoperable with electronic health records

•  Consolidates all immunizations into one easily accessible record for each individual

•  Provides an official record of immunization for school, child care and camp

•  Provides decision support to providers by displaying the immunizations recommended under current guidelines based on the individual's age and immunizations already received

•  Enables providers to easily screen for immunizations at each visit

•  Enables providers to notify parents if a child has missed an immunization

•  Enables individuals/parents to opt out of the immunization system or recall notices

•  Allows state and local public health officials to make assessments of populations that are un- or under-immunized and the geographic distribution of those children in order to target interventions

The Colorado Immunization Information System is central to a strategy to immunize Colorado children, ensure the prevention of vaccine-preventable disease and reduce health care costs to individuals and the State . CIIS is endorsed by the Colorado Children's Immunization Coalition and the Colorado Chapter of the American Academy of Pediatrics as the statewide information system in Colorado .

  Status of Participation

Since its inception in 1996, CIIS has systematically rolled out operations across the state to meet its primary goal of regular reporting by all providers of childhood immunizations and complete immunizations for all children under the age of six in Colorado .

CIIS receives regular downloads of demographic information for all children born in Colorado and immunization information directly from health care providers. CIIS currently has immunization records for 78% of all children under the age of six in Colorado . These records are not, in all cases, complete because CIIS has not had sufficient funding to implement in all provider offices. Currently, 100% of publicly funded clinics, 70% of pediatric practices, and 25% of family practice sites participate in CIIS. In addition, CIIS receives immunization data from Kaiser Permanente, Rocky Mountain Health Plans, Anthem BC/BS and United Health Plans.

Recall

CIIS is being used by several practices and local public health agencies to send notices to children who are overdue for immunizations. Recall is a proven strategy to improve immunization rates. With adequate access to care, recall improves immunization rates 8% to 12%, depending on the age group recalled.

Funding

The primary sources of funding for the development and operation of CIIS are federal (the annual immunization grant from the Centers for Disease Control, through a contract with the Colorado Department of Public Health and Environment), grants from private foundations, and in-kind contributions from the University of Colorado Health Sciences Center, integrated health plans and health care providers. The Colorado Legislature appropriated $250,000 in 2005, $386,400 in 2006 and $470,060 in 2007 to support expansion of CIIS to additional providers and recall of children who have not received recommended immunizations.

The budget for full development and expansion of CIIS is 1.25 million each year. In addition, the costs to an office to implement CIIS range from zero to $5000 for computer hardware, if necessary, and to put existing immunization information into CIIS. Additional, long-term funding sources will be required for maintenance of CIIS as a state-wide immunization information system.

Confidentiality of System

Information in the Colorado Immunization Information System can be released only to:

The individual or parent/guardian

	The individual/child's physician
	A school or child care where the individual is enrolled
	A managed care organization or health insurer where the individual is enrolled
	Hospitals
	Persons or entities who have an agreement with the State of Colorado for immunizations
	The Department of Health Care Policy and Financing for children enrolled in Medicaid