Immunization Information Systems (IIS) Sentinel Site – Implementation Grant
	Minnesota Department of Health

The Minnesota Immunization Information Connection (MIIC) is Minnesota’s immunization information system.  Starting in 2008 Hennepin County will be our site for the Sentinel Site Implementation Grant.  The population estimate for 2005 for Hennepin County was 1,150,912, whose county seat is Minneapolis, and it is by far the most populous county in Minnesota as more than one in five Minnesotans live in Hennepin County. 
As of the 2000 census², there were 1,116,200 people, 456,129 households, and 267,291 families residing in the county. The racial makeup of the county was 80% White, 9% Black or African American, 1% Native American, 5% Asian, 0.05% Pacific Islander, 2% from other races, and 2% from two or more races. 4% of the population is Hispanic or Latino of any race. 23% were of German, 12% Norwegian, 8% Irish and 7% Swedish ancestry according to Census 2000. 
Hennepin County, as a sentinel site, represents many types of populations that can be seen across the entire state.  Minneapolis has a population characteristic of the urban setting with diverse racial/ethnic makeup and socioeconomic status.  Suburban areas of Minneapolis are less diverse, with a mostly white middle-class population.

Table 1- Patients with 2 + shots in MIIC by Age Group , Hennepin county, 1/1/2008

Age Group, Hennepin County, 1/1/2008
Age Group (years):0-5
# Vaccinated with 2+ shots: 91,166
Population:96,652
Percent:94.32

Age Group (years):6-10
# Vaccinated with 2+ shots:77,031
Population: 80,117
Percent: 96.15

Age Group (years):11-12
# Vaccinated with 2+ shots: 31,585
Population: 32,749
Percent:96.45

Age Group (years):13-15
# Vaccinated with 2+ shots: 45,104
Population:47,674
Percent:94.61

Age Group (years):16-18
# Vaccinated with 2+ shots:47,290
Population: 49,956
Percent: 94.66

Age Group (years):Total
# Vaccinated with 2+ shots:292, 176
Population: 307,148
Percent: 95.13
(end Table 1)

Population Participation:  

As seen in Table 1, 95% percent of Hennepin County residents age 0-18 have 2 or more shots in MIIC.  Birth certificate data have been imported into MIIC on all children born in Minnesota since 1995.  Residents who have moved into Minnesota since birth have had their records created on import of batch data or through direct data entry by participating providers.  The records are fully populated for up to 12 years of age. 

Provider Enrollment:  Hennepin County maintains an accurate list of all clinics, including pediatrics, family practitioners, OB/GYN, school-based clinics, internal medicine and Planned Parenthood clinics, from which they base provider enrollment.  As of February 2008, the provider participation was at 85% (Table 2).  

Table 2- Hennepin County Provider Enrollment, Public vs. Private Sector
Public Providers:
N=13
Number in MIC= 13
&= 100
Private Providers: 
N= 159
Number in MIIC=133
%= 84

Combined Public and Private:
N=172
Number in MIIC= 146
%=85
(end Table 2)

Table 3-Time from Vaccination Unit, 
Vaccination Event is Recorded in MIIC Hennepin County, Oct-Dec 2007
Time from Vaccination to Entry into MIIC (days): 0-30
Frequency:81,093
Percent:80.56

Time from Vaccination to Entry into MIIC (days):31-60
Frequency:14,587
Percent:14.49

Time from Vaccination to Entry into MIIC (days):61+
Frequency:4,987
Percent:4.95
(end Table 3)

Timeliness:  Past analysis has shown that MIIC’s direct data entry users often enter shots within 7 days and even on the same day as a vaccination is given.  Batch data providers are not as timely in submitting data (Table 3).  Follow-up with batch shot providers during 2008 will address timeliness issues as well as other data completion problems with the goal of 90% of shots entered into MIIC within 30 days of vaccination.

On-going Data Quality Procedures:  Provider organizations that submit data in batch mode must pass an initial audit that looks at test files for proper formatting, how well the test files match paper records and whether appropriate vaccination types are submitted for age groups.  Also, monthly feedback reports that show similar tests on submitted shots for that month are monitored by Regional Coordinators.  Organizations that have large numbers of inappropriate codes are contacted to determine whether there are systematic coding problems or if there are data entry problems that might be solved by educational means.

Data Quality Objectives:  Over the next 5 years, Sentinel Site Grant activities will include work on data quality activities for Hennepin County provider organizations to 1) increase the completeness of core data elements; especially lot number and manufacturer fields, 2) implement MIROW data quality, MOGE and shot level de-duplication guidelines, 3) improve timeliness of vaccination record entry into MIIC and 4) determine the reasons why up-to-date rates  from the NIS appear to be different from those calculated using MIIC.

This document can be found on the CDC website at:
http://www.cdc.gov/vaccines/programs/iis/activities/downloads/MN-sentinel.rtf