The most important factors in immunization are that a greater than optimum ratio of a total population receive vaccinations, and that they receive vaccinations while maintaining proper immunization intervals for the appropriate age brackets so that every individual can have optimum immunity. In order to determine and maintain precise immunization rates and the timeliness of immunization, every individual’s immunization record should be registered and accessible in real time for use in succeeding immunizations. Computerization is necessary for managing these records. An online system of information exchange where the same records can be shared in real time would be much more efficient. The lack of individual immunization information makes optimal management difficult. This can become an obstacle in the prevention of infectious disease, making us unable to expect to achieve complete immunization. For this reason, as a preparatory step towards the management of target groups and elimination of infectious disease through precise immunization information, the Korea Centers for Disease Control and Prevention has developed a program to computerize and manage all immunization records and has been promoting the National Immunization Registry Information System (IRIS) since 2002. In its beginning stage, IRIS was promoted in all public health centers nationwide, and starting from 2004, it was expanded quantitatively and qualitatively to include private medical institutions.
Despite efforts to develop and spread the registry program in order to promote participation by private medical institutions in IRIS, their participation is still not satisfactory. The main reason why the National Immunization Registry is not up and running is the lack of participation by private medical institutions, which provided about 40% of routine immunizations nationwide until 2009. The government body in charge of this project recognized the necessity of enhancing the quality of immunizations by collecting immunization records through IRIS. In order to motivate private medical institutions to participate in the National Immunization Registry the government has begun paying the vaccination fees of private hospital and clinic users. 2009 was a seminal year for Korea's national immunization project, with the introduction of the ‘reimbursement system for medical institutions’. An opportunity to address many of the weaknesses that had been observed over the years, this policy was able to solve problems stemming from a low level of participation by private medical institutions such as incomplete immunization records and the inability to measure the exact immunization rate.
2. Project Promotion Strategies
The National Immunization Registry is operating in order to carry out six main functions: ① Monitoring individual immunization levels, ② monitoring immunization levels in a given population group, ③ reminding recipients and their guardians of necessary vaccinations, ④ recalling recipients for necessary vaccinations, ⑤ reminding medical staff if vaccinations are needed when patients visit medical institutions, and ⑥ identifying recipients of newly introduced vaccines.
Likewise, in South Korea, IRIS systematically collects and manages immunization-related data such as vaccines’ demographic characteristics, inoculation period, and type of vaccinations with the aims of qualitative enhancement of, record keeping for, supervision of, assessment of, and research on immunization services. There are three main strategies for ongoing advancement.
The first strategy is to help with the quantitative and qualitative enhancement of immunization rates.
The second strategy is to help improve the timeliness of immunization rates through IRIS. In other words, IRIS distinguishes between the vaccinated and non-vaccinated, makes a list of recipients needing vaccinations, and utilizes it to trace and vaccinate them. With IRIS established, the immunization rate increases due to non-vaccinated individuals feeling a psychological burden from not being immunized and the reminder/recall function automatically notifying them about their children's immunization schedule.
The third strategy is to provide base data for vaccine effectiveness assessments and immunization policy. In other words, with the linking of the National Immunization Registry Information System (IRIS) and the Infectious Disease Outbreak Monitoring System, we are able to determine the difference in the rates of infectious disease between vaccinated and non-vaccinated groups. This offers crucial information for examining the effect of any given vaccine as well as the necessity of certain policies. Moreover, this can be an important tool for securing the reliability and quality of vaccines by collecting and analyzing adverse reactions in a timely manner.
3. Project Promotion System
There are two main ways for private medical institutions to register immunization records in the computer database. The first way is to login to the immunization registry of the ##3D_LAYER##web-based Portal System of the KCDC.##3D_TEXT:Portal System of Korea Centers for Disease Control and Prevention##3D_LINK:http://is.cdc.go.kr##3D_LAYER_END## The second method involves linkage of the Electronic Medical Records System(EMR) used by private medical institutions to the standardized module. After logging in to the Portal System of the KCDC, whenever previously registered immunization information is accessed, records from the medical office are simultaneously registered in the computer database along with it. Since the Portal System of the KCDC can only be used by medical institutions that have been authorized access, institutions must apply for registration online. After the public health center with jurisdiction approves the registry, the institution is authorized to use the system. When this process is done, institutions can use the system by logging in with their ID/password and officially recognized authentication certificate.##MORE_LAYER_BOX##
[Screenshot from the Portal System of the KCDC's Immunization Registry Information System]
[Screenshot of an Immunization Record Registry Accessed through the Immunization Registry Information System]
[Screenshot of an Immunization Record Registry Accessed through a Private Medical Institution’s Electronic Medical Recording System (EMR)]
The data collected in the National Immunization Registry consists of three sets: the vaccinee's information, the guardian's information, and immunization history. The vaccinee’s information, content that verifies the vaccinee’s identity, and the administrative district with jurisdiction over the vaccinee, includes the name, ##3D_LAYER##personal identification number,##3D_TEXT:This number is similar to the social security number used in some other countries.##3D_LAYER_END## zip code, address, home phone number, and cell phone number of the vaccinee. The guardian's information, including name and resident registration number, is temporarily used in order to distinguish among newborns before they have been issued resident registration numbers. Immunization history data is used to verify whether all the core vaccinations were given, if any other shots are needed, and which vaccines caused adverse reactions. This data includes the vaccine name, date of vaccination, body part vaccinated, method of vaccination, dosage, which does in the vaccine series, and vaccine's lot number. ##MORE_LAYER_BOX##
[Types of Information Gathered in the Immunization Registry Information System]
|Type of information||Kinds of data|
|Vaccinee information||Name, personal identification number, zip code, address, home phone number, cell phone number, e-mail|
|Guardian information||Name, personal identification number|
|Vaccination information||Vaccine name, date of vaccination, body site vaccinated, method of vaccination, dosage, which does in the vaccine series, vaccine's lot number|