Feedback Incentives eXchange (AFIX)
Immunization providers have a tendency to overestimate their practice coverage levels. Accurate assessments at the provider level, however, can identify overall coverage and reveal possible service delivery problems in the practice. Understanding and accepting the assessment results are the first steps to implementing changes in policies and practices that will improve patient care.
The objective of a good assessment is to help providers identify obstacles to immunization series completion and get their “buy-in” to make needed changes. In the real world, the selection of an appropriate assessment method depends on
The three types of Assessment Methods supported by CDC fall into two categories: Chart Based Assessments and Registry Based Assessments. Each method has advantages and weaknesses (basically a trade-off between speed and diagnostic information) that must be weighed before selecting the “right” option for your program. The three Assessment Methods are described below within their respective category.
The Comprehensive Clinic Assessment Software Application (CoCASA) is a tool for assessing immunization practices within a clinic, private practice, or any other environment where immunizations are provided. CoCASA has data entry and import capabilities.
Immunization coverage assessments are essential for vaccination programs because they indicate how well immunization recommendations are being implemented. Assessments also provide early indicators of the presence of significant barriers to immunization and stimulate the development of improvement plans.
In order to expand the benefits of AFIX to the private sector, which now vaccinates nearly 80% of children in the US, the National Immunization Program (NIP) launched an initiative to incorporate assessment and feedback activities during Vaccines For Children (VFC) provider site visits. This initiative links two highly successful programs - AFIX and VFC - and focuses on increasing quality assurance activities within provider offices enrolled in the VFC program.
VFC is a federal program that purchases vaccines for eligible children who meet one of the following requirements: enrolled in Medicaid; no insurance; Native American or Alaska Native; or underinsured. All states are participating in this program, which enjoys broad physician support. Over 44,000 provider sites participate in the program, primarily in the private sector. The VFC program benefits providers as well as children by reducing cost as a barrier to immunization and encouraging kids to stay in a medical home.
VFC provider site visits are conducted to review compliance with VFC eligibility requirements and to evaluate vaccine storage and handling procedures. These VFC site visits provide an excellent opportunity to introduce and include assessment and feedback of immunization service delivery practices.