Immunization Record – Room for Improvement?

From Apr 21 to 28, it’s National Immunization Awareness Week in Canada. So I think it is timely to share this story on immunization record. I have received few “threatening” letters from Public Health that my daughter would soon be expelled from school because her immunization records were incomplete.

According to my records, she has received all the required immunizations.

What went wrong?

Well, the first time when this happened, there was a typo in the record. Therefore one of the vaccines appeared to have been given too soon and deemed invalid. But it was a typo.  I called the physician’s office who fixed it. I tried updating the Public Health record electronically but it would not accept my information. I had to call, I had to leave a message and waited for a Public Health Nurse to call back. Eventually, she fixed the typo and it was fine. So my daughter didn’t get expelled from her school. It felt incredibly exhausting to deal with this ordeal.

Then few years later, I got another letter. It said my daughter was missing the following immunization:

Diphtheria, Measles, Mumps, Pertussis, Poliomyelitis, Tetanus, Varicella

I am a healthcare professional and it took me awhile to figure out exactly what they want. It turns out Public Health has not received my daughter’s immunization for Tdap-IPV and MMRV when she turned four.  She did receive them but again, I didn’t update Public Health with the record at the time.

The doctor’s office has all my records. Why can’t they just talk to each other directly? I get it. Consent is needed before you can transfer any confidential information. But this go-about seems very inefficient.  Afterall, I am making all the arrangements to ensure my daughter can receive all the immunizations as recommended by Public Health and mandated by the educational institution. Isn’t it implied consent to share this information with Public Health directly?

Now that pharmacists have expanded scope of practice to offer immunizations in Ontario, it would  add another layer of complexity to ensure the immunization record   is complete and available from one central source. If we need to track down where the patient has received a specific vaccine, it seems that we have to search through many more possible locations.

Patients can update Public Health directly of the immunization record online via the internet. But the process is complicated and requires that you know the specific details of the various vaccines – many of which are too complicated for a lay person to understand.   You can also fax in the information or call it in. But nowadays, who has a fax machine? Calling or navigating through a automated phone system can also be challenging for many people.

I feel the burden is unfair to the patient or to the parent when our system is broken and inefficient to deal with such sensitive and confidential information of our immunization record. And certainly the threatening letter from Public Health is not welcoming and makes it sound like we have done something terribly  wrong.

Isn’t there a way to update Public Health more seamlessly of the immunization record? Can our electronic medical record transmit this information directly if written consent is given at the time of the immunization? Likewise, should our pharmacy software be able to do this when it is already set up to send electronic claims to various insurance adjudicators?

I came across this document on parents’ perspectives on immunization record from Canada Health InfoWay. It’s a good read. In the meantime, I think there is definitely room for improvement on how we can better share immunization records with Public Health.

Thank you for reading my post.

 

 

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drugopinions

My name is Cynthia Leung and I am a practicing pharmacist in Kingston Ontario, Canada. This blog is for me to share my ideas, opinions and perspectives on how medications are used in our health care system. Note that these posts are my own opinions and do not represent the opinions of my current or former employers and / or organizations that I may belong to. Any possible case scenarios described in my posts would be modified to maintain patient confidentiality. This blog is not a platform for professional advise for patients or health care providers and the content is not meant to support any clinical decisions or replace professional opinions. Also the images are either taken or created by the author, or adapted with permission. I hope you will enjoy reading my posts!

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