Immunization Toolkit

The Georgia Registry of Immunization Transactions and Services

GRITS Program

The Georgia Registry of Immunization Transactions and Services (GRITS) Program was established in June, 2004 with the initial intent to meet the objectives set by the Centers for Disease Control and Prevention (CDC):

• Decrease the number of incomplete records due to fragmentation of health care delivery
• Eliminate/decrease the number of large and cumbersome files of paper records
• Create a mechanism to assess immunization needs due to complex and dynamic immunization schedules.

In support of the objectives outlined by the CDC, the Immunization Registry Legislation, 31–12-3.1, was signed into law on April 8, 1996. This law states, “The department (DHR), for purposes of establishing and maintaining a single repository of accurate, complete, and current vaccination records to be used in aiding, coordinating, and promoting effective and cost-efficient childhood disease prevention and control efforts, shall establish and maintain a childhood vaccination registry.”

The law also outlines that the department establishes the registry in consultation with the United States Centers for Disease Control and Prevention, the Georgia chapter of the American Academy of Pediatrics, and the Georgia Academy of Family Physicians. The Georgia law mandates that “any person who administers a vaccine or vaccines licensed for use in children by the U.S. FDA to a citizen of the State of Georgia shall, for each such vaccination, provide to the department such data as are deemed by the department to be necessary and appropriate for purposes of the vaccination registry.”

On July 1, 2004 House Bill HB-1526 was signed into law, which modified the original legislation to mandate that any provider who administers an immunization vaccine to anyone in the State of Georgia must report these encounters to the statewide registry.

Background Information
More than 4 million children are born each year in the United States. Each of these children should receive 14 to 15 doses of vaccines by their second birthday, and 16 to 18 doses by school entry. Immunizations may be obtained from private physicians, public health clinics, hospitals, and a variety of other health services facilities. Approximately 95% of all U.S. children begin the recommended series of vaccination, but only about 75% complete the series by 2 years of age-- a critical period for childhood disease prevention. Approximately 40% of children receive their preschool immunizations from two or more facilities.

Ensuring that children complete the recommended series of immunizations at the appropriate time is the main problem facing immunization programs. However, since many children receive vaccines from more than one provider and since many parents do not maintain accurate records of their children’s immunizations, it is difficult to evaluate the immunization status of individuals. Without this information, efforts to identify and aggressively pursue children who are incompletely immunized are severely hampered.

To address this problem the National Immunization Program within the CDC has developed a set of guidelines for the development of systems or registries for the collection and assessment of immunization data. In addition, the CDC has given the states the objective of ensuring that at least 90% of children under the age of two and 95% of children under the age of 18 are adequately immunized. These guidelines were developed to address the areas that the CDC felt were the greatest obstacles to reach this objective, including:

• Incomplete records due to fragmentation of health care delivery
• Large and cumbersome files of paper records
• Difficulties in assessing immunization needs due to complex and dynamic immunization schedules.

In May 2003 the GRITS went into production with a scheduled release project plan that would be completed in June 2004 at which time the system would be made available statewide to all partners and stakeholders that had signed a Software Use Agreement with DHR.

Project Objectives and Scope
Project Introduction
The Immunization Registry Legislation, 31–12-3.1, was signed into law on April 8, 1996. The Georgia Law mandates that a registry system be implemented in which to report all vaccinations provided to children ages 18 and under. Any provider who administers an immunization vaccine to children ages 18 and under must report these encounters to a statewide registry.

On July 1, 2004 House Bill HB-1526 was signed into law, which modified the original legislation to mandate that any provider who administers an immunization vaccine to anyone in the State of Georgia must report these encounters to the statewide registry.

ACCESSING GRITS
To request access to GRITS, contact the GRITS Training Coordinator at (404) 657-3166 and request an enrollment package. Once the request is received, an enrollment package will be mailed to the facility. Once the Organization receives the enrollment package, the Administrator/Director of the facility must sign and return the original Software Use Agreement. When the Training Coordinator receives the Software Use Agreement, the facility will be set-up in GRITS and a request for training is sent to the district Immunization Program Consultant (IPC). At that time, the IPC will contact the facility, and set up mutual convenient time for training.

USER ROLES
When the IPC comes to train the facility, the Administrator on the account will designate “User Roles”. These roles will determine what type of access to GRITS the individual user will have. The role of Administrator gives full access, which includes adding and or deleting Users and Inventory Control. The role of Typical User gives access to look up patients, add vaccinations and run reports. The ‘Typical User’ also has access to all forms that need to be printed for school entrance. The role of ‘Reports Only’ will allow the user to look up patients and give access of all patient reports. This role will not give access to administer vaccinations into GRITS.

TRAINING
The IPC will conduct an on-site informal training at the facility. This will include training staff on Inventory Control, GRITS access, ACIP Schedule and requirements to maintain GRITS access. Once the IPC has finished the training, the organization will receive a GRITS CD-ROM for future reference as well as a training instrument for new staff.

If you are having trouble accessing these resources, please contact us at: pha@gha.org