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
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
- Electronic data
- 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 patients 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
The TOTS computer program is the systems 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
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 childs 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 patients information will NOT be shared outside your
Keep in mind that any patient, of any age, can be included in your local
TOTS system, thereby allowing you to use the systems tracking and reporting
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 Departments 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