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Canadian Journal of Public Health

, Volume 107, Issue 6, pp e575–e582 | Cite as

Immunization information systems in Canada: Attributes, functionality, strengths and challenges. A Canadian Immunization Research Network study

  • Sarah E. WilsonEmail author
  • Susan Quach
  • Shannon E. MacDonald
  • Monika Naus
  • Shelley L. Deeks
  • Natasha S. Crowcroft
  • Salaheddin M. Mahmud
  • Dat Tran
  • Jeffrey C. Kwong
  • Karen Tu
  • Caitlin Johnson
  • Shalini Desai
Mixed Research
  • 16 Downloads

Abstract

OBJECTIVES: Canada does not have a national immunization registry. Diverse systems to record vaccine uptake exist, but these have not been systematically described. Our objective was to describe the immunization information systems (MSs) and non-IIS processes used to record childhood and adolescent vaccinations, and to outline the strengths and limitations of the systems and processes.

METHODS: We collected information from key informants regarding their provincial, territorial or federal organization’s surveillance systems for assessing immunization coverage. Information collection consisted of a self-administered questionnaire and a follow-up interview. We evaluated systems against attributes derived from the literature using content analysis.

RESULTS: Twenty-six individuals across 16 public health organizations participated over the period of April to August 2015. Twelve of Canada’s 13 provinces and territories (P/Ts) and two organizations involved in health service delivery for on-reserve First Nations people participated. Across systems, there were differences in data collection processes, reporting capabilities and advanced functionality. Commonly cited challenges included timeliness and data completeness of records, particularly for physician-administered immunizations. Privacy considerations and the need for data standards were stated as challenges to the goal of information sharing across P/T systems. Many P/Ts have recently implemented new systems and, in some cases, legislation to improve timeliness and/or completeness.

CONCLUSION: Considerable variability exists among NSs and non-IIS processes used to assess immunization coverage in Canada. Although some P/Ts have already pursued legislative or policy initiatives to address the completeness and timeliness of information, many additional opportunities exist in the information technology realm.

Key Words

Immunization coverage immunization registries immunization registers vaccine-preventable diseases Canada 

Résumé

OBJECTIFS: Contrairement à d’autres pays (comme les États-Unis et l’Australie), le Canada n’a pas de registre d’immunisation national. Il existe divers systèmes d’enregistrement du recours aux vaccins, mais ils n’ont pas été systématiquement décrits. Notre objectif était de décrire les systèmes d’information sur la vaccination (SIV) et les processus autres que les SIV utilisés pour enregistrer les vaccins administrés durant l’enfance et l’adolescence, et d’en présenter les forces et les contraintes.

MÉTHODE: Nous avons recueilli auprès d’informateurs privilégiés des données sur les systèmes de surveillance utilisés par leur organisme provincial, territorial ou fédéral pour évaluer la couverture vaccinale. Les données ont été recueillies au moyen d’un questionnaire à remplir soi-même et d’un entretien de suivi. Au moyen d’une analyse de contenu, nous avons évalué les systèmes par rapport à des attributs trouvés dans la documentation.

RÉSULTATS: Vingt-six personnes issues de 16 organismes de santé publique ont participé à l’étude entre avril et août 2015. Douze des 1 3 provinces et territoires (P/T) du Canada et deux organismes intervenant dans la prestation des services de santé des Premières Nations dans les réserves ont participé. D’un système à l’autre, on nous a signalé des différences dans les processus de collecte de données, les capacités d’établissement de rapports et les fonctions avancées. Les difficultés couramment rencontrées concernaient l’actualité et l’exhaustivité des dossiers de données, particulièrement pour les vaccins administrés par les médecins. Les questions de confidentialité et l’absence de normalisation des données ont été indiquées comme faisant obstacle au partage de l’information d’un système P/T à l’autre. Bon nombre de P/T ont récemment mis en œuvre de nouveaux systèmes et, dans certains cas, des mesures législatives pour en améliorer l’actualité et/ou l’exhaustivité.

CONCLUSION: Il existe une variabilité considérable entre les SIV et les processus autres que les SIV qui servent à évaluer la couverture vaccinale au Canada. Quelques P/T mènent déjà des initiatives législatives ou stratégiques pour aborder l’exhaustivité et l’actualité des données, mais il existe de nombreuses possibilités de faire mieux dans le domaine de la technologie de l’information.

Mots Clés

couverture vaccinale registres d’immunisation registres de vaccination maladies évitable par la vaccination Canada 

References

  1. 1.
    Schouten H, Walop W. Functional standards and minimum (core) data sets for a National Immunization Registry Network and Vaccine Associated Adverse Events Surveillance system (VAAESS). Can Commun Dis Rep 2002; 28(Suppl 6):1–32 (Eng), 1–34 (Fre). PMID: 12666539.Google Scholar
  2. 2.
    Haimes K, Schouten H, Harris T, Belzak L. National standards for immunization coverage assessment: Recommendations from the Canadian Immunization Registry Network. Can Commun Dis Rep 2005;31(9):93–97. PMID: 15875328.Google Scholar
  3. 3.
    Government of Canada. National Standards for Immunization Coverage Assessment: Recommendations from the Canadian Immunization Registry Network. Ottawa, ON: Government of Canada, updated 2015. Available at: https://www.canada.ca/en/public-health/services/publications/healthy-living/national-standards-immunization-coverage-assessment-recommendations-canadian-immunization-registry-network.html (Accessed March 10, 2016).Google Scholar
  4. 4.
    Government of Canada. Immunization Coverage and Registries. Ottawa, ON: Government of Canada, updated 2016. Available at: https://www.canada.ca/en/public-health/services/immunization-coverage-registries.htm (Accessed December 21, 2015).Google Scholar
  5. 5.
    Health Canada. First Nations and Inuit Health Regional Offices. Ottawa, ON: Government of Canada, updated 2016. Available at: http://www.hc-sc.gc.ca/contact/fniah-spnia/fnih-spni/region-eng.php (Accessed December 21, 2015).Google Scholar
  6. 6.
    German RR, Lee L, Horan J, Milstein R, Pertowski C, Waller M. Updated guidelines for evaluating public health surveillance systems: Recommendations from the Guidelines Working Group. MMWR Recomm Rep 2001;50:1–35. PMID: 18634202.PubMedGoogle Scholar
  7. 7.
    Heidebrecht CL, Kwong JC, Finkelstein M, Quan SD, Pereira JA, Quach S, Deeks SL. Electronic immunization data collection systems: Application of an evaluation framework. BMC Med Inform Decis Mak 2014;14:5. PMID: 24423014. doi: 10.1186/1472-6947-14-5.CrossRefGoogle Scholar
  8. 8.
    Laroche J, Diniz A. Immunisation registers in Canada: Progress made, current situation, and challenges for the future. Euro Surveill 2012;17(17):17–22. PMID: 22551496.CrossRefGoogle Scholar
  9. 9.
    IBM. Panorama. Somers, NY: IBM Corporation, 2009. Available at: https://www-03.ibm.com/industries/ca/en/healthcare/files/panorama_application_overview_final.pdf (Accessed March 8, 2016).Google Scholar
  10. 10.
    Mantitoba eHealth. eChart Manitoba. Winnipeg, MB: Manitoba eHealth, 2006–17. Available at: http://www.manitoba-ehealth.ca/prog-echart.html (Accessed December 21, 2015).Google Scholar
  11. 11.
    Government of Alberta. Alberta NetCare EHR: Information Available. Edmonton, AB: Government of Alberta, 1995–2016. Available at: http://www.albertanetcare.ca/EHRData.htm (Accessed February 2, 2017).Google Scholar
  12. 12.
    Government of Saskatchewan. eHR Viewer. Regina, SK: Government of Saskatchewan, n.d. Available at: http://www.ehealthsask.ca/services/ehrViewer/Pages/default.aspx (Accessed December 21, 2015).Google Scholar
  13. 13.
    Public Health Agency of Canada. Final Report of Outcomes from the National Consensus Conference for Vaccine-Preventable Diseases in Canada. Can Commun Dis Rep 2008;34(Suppl 2):1–56. PMID: 18338443.Google Scholar
  14. 14.
    Public Health Agency of Canada. Report from the 1996 Canadian National Immunization Conference: “Immunizing for Health - Achieving Our National Goals”. Can Commun Dis Rep 1997;23(Suppl 4):1–50.Google Scholar
  15. 15.
    Public Health Agency of Canada. Canadian Consensus Conference on a National Immunization Records System. Can Commun Dis Rep 1998; 24(17):137–40. PMID: 9775478.Google Scholar
  16. 16.
    Eggertson L. Experts call for national immunization registry, coordinated schedules. CMAJ 2011;183(3):E143–44. PMID: 21242267. doi: 10.1503/cmaj.109-3778.CrossRefGoogle Scholar
  17. 17.
    Centers for Disease Control and Prevention. Progress in immunization information systems - United States, 2012. Morb Mortal Wkly Rep 2013; 62(49):1005–8. PMID: 24336133.Google Scholar
  18. 18.
    Centers for Disease Control and Prevention. IIS Functional Standards, 2013-2017. Atlanta, GA: Centers for Disease Control and Prevention, 2012. Available at: http://www.cdc.gov/vaccines/programs/iis/func-stds.html (Accessed December 21, 2015).Google Scholar
  19. 19.
    Public Health England. Output and Information Requirements Specification: For the Child Health Information Service and System. London, UK: Public Health England, 2015. Available at: https://www.gov.uk/government/publications/child-health-information-systems-information-requirements-and-output-specifications (Accessed March 10, 2016).Google Scholar
  20. 20.
    Hay K, Knight B. Standardized vaccine terminology to support interoperability across electronic health information systems. Oral Presentation at e-Health Conference, Toronto, ON, May 31-June 2, 2015. Available at: http://www.e-healthconference.com/pastpresentations/2015/20157997648/18841884eHealth_2015_vaccine_terminology-bk_kh.pdf?AF=Download&AA=202,1471&AD=DlFile (Accessed May 1, 2016).Google Scholar
  21. 21.
    Wilson K, Atkinson KM, Deeks SL, Crowcroft NS. Improving vaccine registries through mobile technologies: A vision for mobile enhanced immunization information systems. J Am Med Inform Assoc 2016;23(1):207–11. PMID: 26078414. doi: 10.1093/jamia/ocv055.CrossRefGoogle Scholar
  22. 22.
    Martin DW, Lowery NE, Brand B, Gold R, Horlick G. Immunization information systems: A decade of progress in law and policy. J Public Health Manag Pract 2015;21(3):296–303. PMID: 24402434. doi: 10.1097/PHH.0000000000000040.CrossRefGoogle Scholar
  23. 23.
    Hull BP, Deeks SL, McIntyre PB. The Australian Childhood Immunisation Register - A model for universal immunisation registers? Vaccine 2009; 27(37):5054–60. PMID: 19576945. doi: 10.1016/j.vaccine.2009.06.056.CrossRefGoogle Scholar
  24. 24.
    Australian House of Representatives. Australian Immunisation Register Bill 2015. Canberra, Australia: Parliament of Australia, 2015. Available at: http://parlinfo.aph.gov.au/parllnfo/se arch/display/display.w3p;query%3DId% 3A%221egislation%2Fbillhome%2Fr5526%22 (Accessed March 10, 2016).Google Scholar
  25. 25.
    Jacobson Vann JC, Szilagyi P. Patient reminder and patient recall systems to improve immunization rates. Cochrane Database Syst Rev 2005;(3):CD003941. PMID: 16034918. doi: 10.1002/14651858.CD003941.pub2.Google Scholar
  26. 26.
    Yukon Health and Social Services. Yukon Immunization Program Manual, Section 1 - Introduction, December 2014. Whitehorse, YK: Government of Yukon, 2014. Available at: http://www.hss.gov.yk.ca/pdf/im-manual.sectionl.pdf (Accessed March 21, 2016).Google Scholar

Copyright information

© The Canadian Public Health Association 2016

Authors and Affiliations

  • Sarah E. Wilson
    • 1
    • 2
    • 3
    Email author
  • Susan Quach
    • 1
  • Shannon E. MacDonald
    • 4
  • Monika Naus
    • 5
    • 6
  • Shelley L. Deeks
    • 1
    • 2
  • Natasha S. Crowcroft
    • 1
    • 2
    • 7
  • Salaheddin M. Mahmud
    • 8
  • Dat Tran
    • 9
  • Jeffrey C. Kwong
    • 1
    • 2
    • 3
    • 10
  • Karen Tu
    • 3
    • 10
    • 11
  • Caitlin Johnson
    • 1
  • Shalini Desai
    • 12
  1. 1.Public Health OntarioTorontoCanada
  2. 2.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  3. 3.Institute for Clinical Evaluative ServicesTorontoCanada
  4. 4.University of AlbertaEdmontonCanada
  5. 5.BC Centre for Disease ControlVancouverCanada
  6. 6.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  7. 7.Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada
  8. 8.Vaccine and Drug Evaluation CentreUniversity of ManitobaWinnipegCanada
  9. 9.Hospital for Sick ChildrenTorontoCanada
  10. 10.Department of Family and Community MedicineUniversity of TorontoTorontoCanada
  11. 11.Institute of Health Policy Management and EvaluationUniversity of TorontoTorontoCanada
  12. 12.Public Health Agency of CanadaOttawaCanada

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