DESCRIPTION (provided by applicant): The objective of this proposed project is to evaluate the cost benefit to providers of using electronic connections (also known as electronic interfaces) to the Houston-Harris County Immunization Registry. The specific aims of this proposal include (1) determining and comparing the cost to providers of entering immunization information into the HHCIR by two methods: manual data entry and automatic data entry through an interface, and (2) determining and comparing the completeness of information entered into HHCIR by two methods: manual data entry and automatic data entry through an interface. Three types of practices will be used to determine the costs associated with using HHCIR: (1) manual data entry, practices with computers and internet access, and that manually enter patient immunization information into HHCIR, (2) dual data entry, practices with computers, internet access, patient data management systems, and no application interfaces with the Registry, and that manually enter patient immunization information into HHCIR, and (3) automated data entry, practices with computers, internet access, patient data management systems, and application interfaces with the Registry, and that automatically enter patient immunization information into HHCIR. We will compare costs of data entry in group 3 against group 1 and group 2 (separately and combined). Cost data will be collected through interviews and time logs completed by providers and staff using HHCIR. We will compare the completeness of entered immunization information for group 3 against group 1 and group 2 (separately and combined). Completeness of information entered in the registry will be assessed by comparing shots entered in the charts with shots reported in the registry for a period of 1 year in 10 practices that manually enter data in the registry. In 10 practices with the interface, we will obtain information from practice staff about the working of the registry. By evaluating the costs and completeness of immunization records using an immunization registry, we aim to achieve the goal of making immunization registries more available to private providers. This, in turn, will help increase childhood immunization coverage levels. Improving methods of reporting immunization data by individual providers through the Registry and interfaces ultimately enhances public health decision making at the local, county and state levels to protect the health of children. These goals and actions compliment the mission of the CDC and National Institutes of Health (NIH) is to improve health through science (curing, treating and preventing disease).