Using technology originally developed for mass
disasters, Boston disease trackers are embarking on a novel experiment
– one of the first in the country – aimed at eventually creating a
citywide registry of everyone who has had a flu vaccination.

resulting vaccination map would allow swift intervention in
neighborhoods left vulnerable to the fast-moving respiratory illness.

trial starts this afternoon, when several hundred people are expected
to queue up for immunizations at the headquarters of the Boston Public
Health Commission. Each of them will get a bracelet printed with a
unique identifier code. Information about the vaccines recipients, and
the shot, will be entered into handheld devices similar to those used
by delivery truck drivers.

Infectious disease specialists in
Boston and elsewhere predicted that the registry approach could prove
even more useful if something more sinister strikes: a bioterrorism
attack or the long-feared arrival of a global flu epidemic. In such
crises, the registry could be used to track who received a special
vaccine or antidote to a deadly germ.

"Anything you can do to
better pinpoint whos vaccinated and whos not, thats absolutely
vital," said Michael Osterholm, director of the Center for Infectious
Disease Research & Policy at the University of Minnesota. "I wish
more cities were doing this kind of thing."

Boston is believed to
be the first city to embrace this particular approach to tracking
vaccinations against the seasonal flu, estimated to kill 36,000 people
each year in the United States, principally the elderly.

But when
Boston bought the monitoring system from a Milwaukee company in 2006,
emergency authorities had a far different use in mind: tracking people
injured in big fires, plane crashes, or other disasters.

theres a large catastrophic event, people end up in a variety of
healthcare facilities," said Dr. Anita Barry, Bostons director of
communicable disease control. "Of course, their family members and
loved ones are trying to find out where they are and how they’re doing."

see how well the system would work, emergency crews tested it at the
Boston Marathon and the Fourth of July extravaganza on the Esplanade.
The trial proved successful.

"If we can make it work in the
Boston Marathon medical tent, then you have to think about making it so
that it can work in other environments as well – whether its a
community clinic or a doctors office or a flu shot clinic," said Rich
Serino, chief of Boston Emergency Medical Services. Thus, the idea to
use the registry as a flu vaccine tracker was born.

Every autumn
in medical offices across the country, flu vaccine floods in. The
perishable medical product must be delivered to millions in a matter of

Keeping track of that cache of vaccine – and which patients are getting it – is a daunting proposition.

some medical offices, the information is entered into electronic
medical records. At Bostons health department, nurses fill out paper

But theres never been any way to systematically monitor
whether, for example, Dorchester has lower vaccination rates than the
North End.

"When you’re working in one clinic, you don’t have a
good sense of that," said Dr. Alfred DeMaria, top disease doctor at the
Massachusetts Department of Public Health. "But if you’re tracking
multiple clinics in real time, you can see where the uptake is better
and where its less, and then focus on outreach."

Todays experiment, which does not require any additional direct spending, is a first step toward that.

people arrive for their shots, they will get an ID bracelet with a
barcode. Next, basic information – name, age, gender, address – will be
entered into the patient tracking database. There will be electronic
records, too, of who gave the vaccine and whether it was injected into
the right arm or the left, and time-stamped for that day.

resulting trove of data could be used to figure out why some patients
had to wait longer than others to be vaccinated. "When all is said and
done," said Jun Davantes, director of product management at EMSystems,
the company that makes the technology, "Boston will be able to identify
where there are certain bottlenecks in the process and hopefully
improve it the next time around."

Ultimately, city health
authorities said, they envision creating a network across the city that
would allow public and private providers of flu shots to add data to a

But acknowledging patientsprivacy concerns, officials
promised that if a citywide system were implemented, only a limited
amount of information would be gathered – all sitting behind an
encrypted firewall.

"I have had people say, ‘Oh, thats so big
brother," said Laura Williams, EMS deputy chief of staff. "But in
truth, the unique identifier is unique to the incident. Its not like
you will go to the hospital, and they’ll say, ‘You’re the one who got
the flu vaccine at 10 o’clock yesterday at the Boston Public Health

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