Providers' perceptions of an immunization registry

Objective: To determine providers' perceptions of a statewide immunization registry. Design: Mail survey. Setting: King County, Washington. Methods: A random sample of 700 pediatricians, family physicians, and RN/NPs were surveyed. In addition to their perceptions of registries, respondents reported their immunization procedures in the absence of immunization histories. Results: Of 544 eligible participants, 344 returned surveys (63% response rate). Seventy-seven percent of RN/NPs, 60% of pediatricians and 47% of family physicians (p < 0.001) responded that they thought that electronic immunization registries represented the "best chance to solve the lack of documentation problem." Fifty-seven percent of RN/NPs, 61% of pediatricians, and 43% of family physicians reported that the incompleteness of registry data presented a barrier to their using one (p < 0.01). Fewer than 14% of all specialties had concerns about potential compromises of patient confidentiality as a result of registries, although RN/NPs were more concerned about this possibility than both pediatricians and family physicians (p = 0.02). In a multivariate analysis, pediatricians were 43% less likely (p = 0.15) and family physicians were 73% less likely (p < 0.01) than RN/NPs to think registries are the solution to the lack of documentation problem, Familiarity with the existing registry was associated with a significant decrease in the likelihood of thinking that registries are the solution (OR .49 [.26-.90]) and an increase in the likelihood of thinking that registries will take a long time to become of practical value (OR 2.21 [1.09-4.29]), Conclusions: Specialties differ with respect to their opinions regarding the promise immunization registries hold. Immunization registries appear to be well regarded in theory but may disappoint in practice. Incompleteness of immunization data may be the largest obstacle for registries to overcome.