TMA Testimony: SB 56 Immtrac Registry

 

Testimony: SB 56 Immtrac Registry

Senate Public Health Committee

Presented by Julie Boom, MD
 April 19, 2011  

Thank you, Madame Chair Nelson and Members of the Senate Health and Human Services Committee.

My name is Dr. Julie Boom. I am a general pediatrician at Texas Children’s Hospital where I am director of the Immunization Project and director of infant and childhood immunization for the Center for Vaccine Awareness and Research. I also bring with me the experience of having developed and implemented a local immunization registry.

I am testifying today in support of Senate Bill 56 on behalf of The Immunization Partnership, Texas Children’s Hospital, the Texas Pediatric Society, the Texas Medical Association, and the Texas Academy of Family Physicians. Collectively, these organizations represent more than 48,000 physicians across the state of Texas.

I am here today to provide you my first-hand experience as a pediatrician regarding the consent process for the Texas immunization registry, ImmTrac. 

At Texas Children’s, I encounter many new patients who come to our clinic. More often than not, the parent does not bring the immunization record to that first appointment. The record has been misplaced at home or lost. This is especially true for children who are in foster care or living in a shelter. Many of these children have been vaccinated at different times in multiple clinics. The only hope for finding all of these children’s prior immunizations is by looking in the Texas immunization registry, ImmTrac. When these records cannot be found, we have no choice but to revaccinate these children. Obviously, this is painful to the child and is a waste of precious health care dollars and staff resources.

So, you may ask, why do we need to change the current consent process for ImmTrac? Unfortunately, the current consent process for inclusion in ImmTrac is time-consuming and burdensome. If my staff immunizes a child who is not currently in ImmTrac, we take that opportunity to offer them consent, but that opportunity comes with significant costs. Along with a health economist at The University of Texas, School of Public Health, my staff and I conducted analyses to delineate these costs. We learned that regardless of when or where a family is consented, significant nurse or staff time must be used to successfully complete the ImmTrac consent process at a cost of $1.4 million per year.  Moreover, moving to an opt-out system would save approximately $1 million a year.  We know that nine out of 10 families choose to participate in ImmTrac. Therefore, we are directing precious resources towards a consent process that focuses on the majority of parents who are likely to grant consent. Instead, we could focus on the small subset of parents who decline consent and redirect these resources towards other aspects of medical care. It’s important to understand that parents would still be able to choose if they would like their child to participate. The choices available to parents remain the same. 

In the end, we all pay for this system. Whether it’s through tax dollars or health care expenditure dollars, we pay for the administrative burden of the current opt-in consent system. Relieving this burden would allow health care providers to focus on patient care activities, improve immunization documentation, and improve the overall public health infrastructure in Texas. In light of crippling budget cuts and the cuts to Medicaid provider payment rates, we must streamline processes and find cost savings wherever we can.  Given the difficult financial decisions facing the legislature today, there are few measures that offer cost savings with no detrimental impact.

Thank you for the opportunity to share my testimony today. I would be happy to answer any questions that you may have.

82nd Texas Legislature Testimonies 


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