What is TOTS?

TOTS, or Tracking Our Toddlers’ Shots, is an immunization record sharing system developed by the Illinois Department of Public Health (IDPH). The system allows public and private health care providers to share the immunization records of Illinois residents. Currently, the system contains more than 12 million shot records.

Besides keeping track of the shots a child has already received, TOTS forecasts immunization due dates based on the nationally recognized “Recommended Childhood Immunization Schedule.” These recommendations are approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics and the American Academy of Family Physicians.

What is TOTS for?

TOTS is designed to help health care providers record, track and report their patients’ immunizations. Participation is voluntary. The registry allows physicians to access patient records for information about immunizations administered outside their practices.

What is the goal of TOTS?

The primary goal of TOTS is to increase the immunization coverage level of Illinois’ 2-year-olds to 90 percent. In 1999, approximately 78 percent of Illinois’ 2-year-olds were properly immunized, according to a National Immunization Survey.

While this goal focuses on 2-year-olds, keep in mind that patients of all ages can be included in the TOTS system.

How does TOTS work?

TOTS users can exchange data with the statewide registry in one of three ways:

• Electronic data interchange (EDI)
• Voice response system
• TOTS computer program

EDI allows the sharing of electronic data in a structured format between computer systems. It lets health care facilities with their own immunization tracking systems to share information with TOTS.

By using the voice response system, non-computer users can access TOTS patient information and update the statewide registry. This system may also be the ideal choice for sites that administer a low volume of immunizations. Callers use the keypad of a touch-tone telephone to request information on a patient. The system can read the requested information over the phone or it can fax the patient’s immunization history or school physical form to the caller. The caller then can fax updated immunization history back to TOTS. By using character recognition and bar code technology, the system can automatically process the form and include the data in the statewide registry.

The TOTS computer program is the system’s most robust component, allowing health care providers to collect, store, analyze and report immunization data at individual sites. A modem allows a site to dial into the statewide registry to share immunization information.

Here are the main features of the computer program:

• Calculation of immunization due dates
• Print option for school physical form and patient immunization history report
• Remind/recall feature to track and notify patients of due dates
• Recording of patient contraindications, adverse reactions or immunities
• Assessment of immunization coverage levels for a practice

What about security and patient confidentiality?

TOTS is designed to protect patient confidentiality and to provide access to statewide registry information. This balance is maintained by several security controls.

Open access to the statewide registry is not allowed. Only registered TOTS users have access to the data and information is available only on a need-to-know basis. In other words, a TOTS user cannot browse through patient records. Specific name or ID search criteria must be used to access information in the statewide registry.

An audit log at the statewide registry tracks all updates to patient records and which TOTS user made each update. In addition, a site can only produce reports for its patients.

What kind of equipment is needed to operate TOTS?

A computer needs at least 200 MB of free space and 32 MB of RAM (memory) to install and run TOTS. Additional RAM will provide more optimum performance of the software. TOTS can operate in a Windows® (95 or 98) or NT environment. You also must have access to a CD ROM drive to install TOTS.

A modem (33.6Kbps) is necessary to connect to the statewide registry. You also will need dial- up networking capability to connect to the statewide registry via modem. Keep in mind that each patient you save is stored in your local TOTS system. Therefore, you do not need a continuous connection to the statewide registry during the workday. The modem connection is only necessary when you share information with the statewide registry or when you search the statewide registry for a patient.

What if a patient does not want to participate in TOTS?

A patient, or a child’s parent or guardian, must give consent to be included in the statewide registry. If consent is not given to participate in the statewide registry, the patient can still be included in your local TOTS system. However, this patient’s information will NOT be shared outside your local system.

Keep in mind that any patient, of any age, can be included in your local TOTS system, thereby allowing you to use the system’s tracking and reporting capabilities.

How do I register to use TOTS?

Contact the Illinois Department of Public Health if you would like to register for the voice response system or for the computer program. License agreements and other registration materials will be sent to you to complete and return. IDPH will then send you the ID and password necessary for your site to access TOTS. Computer program sites also will receive an installation CD-ROM and training video.

If you would like to register for TOTS or if you have questions, please call the Department’s help desk at 800-942-0024 (TTY for hearing impaired use, 800-547-0466). Staff are available 8 a.m. to 5 p.m., Monday through Friday.

Illinois Department of Public Health
535 West Jefferson Street
Springfield, Illinois 62761
Phone 217-782-4977
Fax 217-782-3987
TTY 800-547-0466
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