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Boston EMS, City to Track H1N1 Flu Vaccine Recipients


Boston EMS (BEMS) and the Boston Public Health Commission are partnering to create„one of the first patient tracking systems to track recipients of the seasonal and H1N1 flu vaccines.

"It's essentially a vaccine registry system," says Laura Williams, MPH, deputy chief of staff for BEMS. "Boston was particularly hard hit with the flu in the spring, which is one of the reasons why we're trying to be so proactive."

The CDC says that more than 200,000 people are hospitalized with the flu each year, and 36,000 die from it.

The technology, which was purchased in 2006 to track patients in disasters and emergency situations, has been used by BEMS during disaster exercises. It was also utilized in tracking injured runners at the Boston Marathon and at Fourth of July celebration aid stations. Now the technology will play a key role in tracking patients who get the flu vaccinations, and it will do it without any additional city spending.

"We are one of the few that are using it specifically as a flu vaccine registration system," says Williams. In the past, flu vaccine recipients have been tracked and managed on paper, but this technology will give Boston EMS real-time information that can be electronically organized and analyzed.

"We will know how many people we've processed, and we can also get a better idea in real time of whether or not we're targeting the sectors we want to be targeting," Williams says. "If we offer a vaccine clinic in a certain area, we can see if we've reached those high-risk groups, based on looking at geographically coded data."

Tracking Electronic Data

Information about each recipient Ï including name, age, gender, the site of the injection (whether it was in the right or left arm), the type of vaccine administered, and the batch number and dose of the vaccine -- is entered into the system. The batch number is particularly important, because it will alert public health officials if there's a problem with a particular batch.

In essence, for the first time, the technology will allow an EMS department to collect a large percentage of vaccine dispersal information in one place. Its ability to allow BEMS to analyze and interpret data will give officials an accurate picture of where the vaccine is being dispersed and where further efforts may be necessary. City health authorities hope to eventually create a citywide network that would allow public and private providers to add to the registry.

"It takes the paper-based system and puts it into an electronic format, so that we can run real-time reports and have a real-time look at the data," says Williams. "This will help us inform future clinics. If we recognize we're completely missing an area of the city, then we can schedule additional clinics in that neighborhood."

This technology doesn't manage actual case reports; another technology system does that. However, Williams says if BEMS finds a spike of seasonal or H1N1 flu in certain areas of the city, they can go back to the vaccine tracking system and analyze vaccination figures. "We can make sure we have targeted a neighborhood and then do future outreach to that neighborhood for the vaccine," she says.

Pinpointing age demographics will also be easier with this technology. "If we realize, for example, that our vaccines have gone to a disproportionate number of 65-and-older individuals, then we can restructure some of our outreach efforts to try to get more people of a younger demographic," Williams says. The CDC recommends children, pregnant women, the elderly, and those with chronic diseases all get vaccinated for both the seasonal and H1N1 flu.

Data collected from vaccine recipients will be restricted to the Boston Public Health Commission, which will manage the information. Data collection and dissemination will follow all normal HIPAA data management protocols. "The system is completely compliant with HIPAA and all data management standards," Williams stresses. "When we worked with the vendor early on, we included our Bureau of Communicable Disease Control in a lot of the conversations to make sure [the technology] was compliant with all the data standards."

Getting the Word Out

In addition to the flu vaccine tracking system, BEMS is actively working with partners in the public and private sectors on flu preparation and management. In August, the city held a flu summit, which was sponsored by Mayor Thomas Menino. "We brought in healthcare partners, business partners, hotels, unions, community health centers, universities and primary education representatives, so that everyone could be on the same page pushing a single message," Williams says.

Officials in the city of Boston feel that these partnerships, along with a structured and aggressive public awareness campaign, will better inform people and community groups about the importance of flu vaccination, as well as what to do in the event of flu infection. "The better we inform them, the better we'll be prepared," Williams says.

She adds, "We're trying to be proactive. The more proactive we are, the less likelihood we'll have something more serious."

Cynthia Kincaidis an award-winning writer who has written numerous articles for medical and health-care publications and organizatiosn. She was the recipient of a 2007 Excellence in Journalism award from the Society of Professional Journalists. Cynthia holds a bachelor's degree in journalism and a master's degree in public administration.


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