Merging Data Sets to Support Public Health Strategies

Every time a family walks through the doors for Women's Infants, and Children's (WIC) appointments the window of opportunity is available to impact families. Countryside Public Health’s Med-technician uses a data report extracted from WIC, Immunization Registry, and Child and Teen Checkup data. This report helps families to receive services in cost efficient manner.

Countryside Public Health has a long history of using informatics staff to seek solutions to serve our population. Countryside Public Health recognized our agency was accessing three data systems that were overlapping the same population. The difficulty for Countryside Public Health was that it was taking staff a lot of time to go into each data system to access the client’s record. The Countryside Public Health program advisory committee met and sought out possible solutions. The informatics staff along with public health nurses determined the following:

• The WIC data includes an immunization assessment, but not necessarily based on actual history;
• The Child and Teen Checkup system identifies the medical assistance population and if the clients have sought a preventive well child exam;
• The Immunization Registry is current on the immunization status of the children seeking our services.

The Countryside Public Health informatics staff set out to develop a report template that temporarily consolidates data from the three separate datasets to create a cost-effective way to work with clients.

Countryside Public Health is a five-county fully integrated public health agency located in southwest Minnesota. The public health agency serves a population of 45,000 residents. The intent of merging the data sets is to support the coordination of services. The data extracted is from WIC clients coming into WIC, and then taking the data extract from the immunization database and the child and teen checkup database on those same WIC families. By blending these three datasets, a report is produced that lists the following for each client:

• If they are due or overdue for any immunizations, and, if so, showing which shots are needed;
• The date of their last child and teen checkup and medical home at which they had it done;
• Eligibility for dental varnishing on children in need;
• And a pre-printed letter to the parent if the child is behind on immunizations.

Coordinating the services improves quality care for the families, gain efficiencies in staff workflow and extends limited resources. This initiative is conducted by utilizing a Med-technician to work at each WIC clinic in the five counties.

Countryside Public Health has been using this report template that temporarily consolidates the data for approximately seven years. Throughout the seven years, Countryside Public Program Advisory Committee has analyzed the process and continues to improve the process every year. The outcomes in the last seven years have been positive upstream public health prevention services. The immunization rates of children ages 0-5 have increased in the last seven years. Children seeking access to preventive child and teen checkup exams have increased in the last seven years as well. The Med-technician has administered dental varnishing to 286 children in the last four years. The time study data has also demonstrated less staff time with needing access to only one report.

There is always a lesson to be gained when taking on any new initiative in public health. In the last seven years, Countryside Public Health has encountered many challenges. In any organization, the need for communication with staff as the changes occur is always a challenge. Keeping staff empowered and engaged to assist and navigate a change of this magnitude in all five counties is critical. The Minnesota Department of Health and the Department of Health and Human Services asked tough questions about data extract.