Information for Providers
Comprehensive Clinic Assessment Software Application
What is CoCASA?
The Centers for Disease Control and Prevention's (CDC) Comprehensive Clinic Assessment Software Application (CoCASA) is a tool for assessing immunization practices within any environment where immunizations are provided. This software is designed to be used in conjunction with the Assessment Feedback Incentives and eXchange (AFIX) strategy.
CoCASA has data entry and import capabilities. After immunization data is entered into CoCASA, data analysis capabilities are utilized to identify strengths and areas of improvement for an individual immunization provider.
Why Use CoCASA?
The use of CoCASA with immunization providers allows the Bureau of Immunization field staff an opportunity to provide technical assistance related to clinical practices and outcomes identified through the CoCASA reports. These practices can be inhibiting a clinic's ability to reach the state and national immunization coverage goal of 90% for 4 diphtheria-tetanus-pertussis (DTaP); 3 polio; 1 measles-mumps-rubella (MMR), 3 Haemophilus influenzae type b (Hib), 3 hepatitis B (HepB), and 1 varicella (chickenpox) vaccine (4-3-1-3-3-1) by 24 months of age or they can reflect a clinic's proactive work in achieving the 90% immunization coverage goal. These providers can illustrate the positive relationship between best practices and high coverage rates for other providers striving to reach the state and national goals.
The AFIX approach presents an educational opportunity, encourages partnerships, and increases awareness of cooperative efforts among immunization providers. The assessment and feedback portions of the process are data-driven. The data, whether assessed through the Florida State Health Online Tracking System (Florida SHOTS™) or CoCASA help determine provider performance and act as a catalyst to improve and maintain coverage levels.
CoCASA Diagnostic Reports
Generally, all reports in CoCASA are an analysis of the immunization history for a specified age cohort of children. Reports may be provided at the time of the visit if printing capabilities exist, or faxed to providers following an AFIX visit. Prior to conducting a data analysis for a particular practice, the field staff designates selected parameters such as clients' age (i.e., 12 through 23 months of age), vaccine (DTaP), vaccination series (4-3-1-3-3-1-4) and 'with or without ACIP recommendations.'
The following reports are available:
- Summary Report: This report provides a composite coverage rate for the records analyzed and the immunization antigen or series chosen for analysis. Calculated on the basis of the number of records analyzed, this reports depicts the number (and corresponding percentage) of children who are up-to-date by the assessment date (for a specified age cohort).
- Diagnostic Report: This report provides analytical information regarding factors that positively or negatively influence the provider's
coverage rate. This includes such elements as starting on time and drop out rates before an antigen series is completed.
- Duplicate Patient Names: This report identifies duplicate records included in the analysis. Including duplicate records for the same child improperly skews the analysis and provides inaccurate results.
- Invalid Doses: This report depicts which children received one or more invalid doses, the type of vaccine and the dose number inconsistent with the recommended starting age and/or interval between doses in a series.
- Last Visit Less than 12 Months Ago: This report identifies children who have not received all age appropriate immunizations but have visited the provider within the previous 12 month period. This information can be useful in creating a reminder/recall file of names and/or interpreting the impact of previous reminder/recall activities.
- Last Visit More than 12 Months Ago: This report identifies children who have not received all age appropriate immunizations and have not visited the provider within the previous 12 months. This information can be used to determine which children may have moved, gone elsewhere or perhaps changed to another provider and, with proper documentation, then eliminated from the provider's reminder/recall list of names.
- Missed Opportunities: This report depicts for all records analyzed, the number of visits by clients during which all age-appropriate immunizations should have been received and were not administered. Client information is provided detailing vaccine opportunities missed.
- Missing Immunizations: This report identifies children missing one or more immunizations and the doses necessary to be
up-to-date.
- No Immunization History:
This report identifies children who do not have any immunizations included in the CoCASA program. This report can identify children providers either failed to enter immunization information data from the health records or downloaded information from the Florida SHOTS™ that did not include any immunization information. This will affect immunization coverage levels as these children will not be complete for any of the assessed immunizations.
- Not Eligible for Vaccines: This report identifies children who have received all immunizations recommended by the immunization schedule. Children listed on this report are not age-appropriately immunized due to not meeting recommended intervals between doses.
Centers for Disease Control and Prevention
