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First published June 7, 2004 as JAMIA PrePrint; doi:10.1197/jamia.M1516
Journal of the American Medical Informatics Association 2004;11(5):377-379
© 2004 American Medical Informatics Association

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Submitted on December 15, 2003
Accepted on April 4, 2004

A comparison of multiple data sources to identify vaccinations for veterans with spinal cord injuries and disorders

Frances M. Weaver PhD1*, Michael Hatzakis MD, PhD2, Charlesnika T. Evans MPH3, Bridget Smith MPA4, Sherri L. LaVela MPH, MBA5, Carolyn Wallace PhD6, Marcia W. Legro PhD7, and Barry Goldstein MD, PhD8

Affiliation of the authors: 1 Research Director, Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI) and Deputy Director, Midwest Center for Health Services and Policy Research, Hines Veterans Administration (VA) Hospital, Hines, IL; Research Associate Professor, Institute for Health Services and Policy Research, Northwestern University, Evanston, IL; 2 Assistant Professor, Department of Rehabilitation Medicine, Adjunct Assistant Professor, Department of Biomedical and Health Informatics, University of Washington School of Medicine, Seattle, WA; Attending Physician, Rehabilitation Care Services Puget Sound VA Health Care System (PSVAHCS), Seattle, WA; 3 Research Coordinator, SCI QUERI, Hines VA Hospital, Hines, IL; 4 Social Science Analyst, SCI QUERI, Hines VA Hospital, Hines, IL; 5 Project Manager, SCI QUERI, Hines VA Hospital, Hines, IL; 6 Research Health Scientist, SCI QUERI, VAPSHCS, Seattle, WA; 7 Implementation Research Coordinator, SCI QUERI, VAPSHCS, Seattle, WA; 8 Clinical Co-coordinator, SCI QUERI, Associate Chief Consultant, Spinal Cord Injury and Disorders Strategic Healthcare Group, VAPSHCS, Seattle, WA; Associate Professor, Department of Rehabilitation Medicine, University of Washington, Seattle, WA

* To whom correspondence should be addressed.

Monitoring vaccination activity requires regular access to information about patient vaccination status. This paper describes our experience using multiple Department of Veterans Affairs (VA) data sources to determine availability and completeness of vaccination information for veterans with spinal cord injuries and disorders (SCI&D). Administrative and clinical databases were limited to coding vaccine administration, undercounted vaccinations and were unable to account for whether the vaccine was offered and reasons for non-receipt. Medical record review provided more detail, but was labor-intensive and costly. Patient surveys provided the richest information, but were costly, time-consuming and based on a sample of patients. Agreement was poor between data sources. This paper suggests that while VA is well positioned to use national databases for clinical care decisions and to inform policy, vaccination data were incomplete. Electronic records must include data that are consistently entered and validated before they can be useful for care management and decision-making.






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