The cost to providers of participating in an immunization registry

Background: The medical and public health communities advocate immunization registries as one tool to achieve national immunization goals. Although su bstantial resources have been expended to establish registries across the n ation, minimal research has been conducted to evaluate provider participati on costs. Methods: The objective of this study was to identify the direct costs to pa rticipate in an immunization registry. To estimate labor and equipment cost s, we conducted interviews and direct observation at four sites that were p articipating in one of two immunization registries. We calculated mean data -entry times from direct observation of clinic personnel. Results: The annual cost of participating in a registry varied extremely, r anging from $6083 to $24,246, with the annual cost per patient ranging from $0.65 to $7.74. Annual per-patient costs were lowest in the site that used an automated data-entry interface. Of the sites requiring a separate data- entry step, costs were lowest for the site participating in the registry th at provided more intensive training and had a higher proportion of the targ et population entered into the registry. Conclusions: Ease of registry interface, data-entry times, and target popul ation coverage affect provider participation costs. Designing the registry to accept electronic transfers of records and to avoid duplicative data-ent ry tasks may decrease provider costs.