Damon A. Ferlazzo, MPA Clinical Use and Benefits of State Immunization Information Systems August 21, 2014
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1 Damon A. Ferlazzo, MPA Clinical Use and Benefits of State Immunization Information Systems August 21, 2014
2 What are Immunization Information Systems (IIS)? [ ]confidential, population-based, computerized databases that record all immunization doses administered by participating providers to persons residing within a given geopolitical area. 1 Sometimes called Immunization Registries Missouri s Statewide IIS is known as ShowMeVax All US states, territories and even some large cities (e.g. Chicago, NYC, LA, DC) have IIS
3 What are the Purposes of IIS? At the point of clinical care, an IIS can provide consolidated immunization histories for use by a vaccination provider in determining appropriate client vaccinations. 1 At the population level, an IIS provides aggregate data on vaccinations for use in surveillance and program operations, and in guiding public health action with the goals of improving vaccination rates and reducing vaccine-preventable disease. 1
4 Who Uses IIS? Clinics Hospitals Pharmacies Schools Child care Facilities Public Health Local public health agencies DHSS Division of Community and Public Health
5 Fast Stats. (as of May 2014) Total Clients: 3,826,725 Total Doses: 34,619, medical provider locations with 3,175 active users 481 schools and child care facilities with over 1,643 active users 200+ Connections with EMR/EHRs 10 bi-directional connections
6 What are the benefits to patients? Easily tracks immunizations over time and for multiple medical facilities Helps ensure patients are properly immunized On schedule Not over immunized Makes school immunization verification quick Records medical alerts and adverse reactions
7 What are the benefits to providers? Ensures patients are up-to-date Helps complete medical records Easier to work with patients who are referred or transferred to new medical home Coverage reports for quality care measures or grant applications Reminder recall reports If using EMR/EHR, The Centers for Medicare and Medicaid Services (CMS) Meaningful Use incentive eligibility Faster Vaccines for Children (VFC) vaccine order processing and delivery
8 How are IIS Related to CMS EMR/EHR Meaningful Use? CMS is authorized to make incentive payments to eligible professionals (EPs) and eligible hospitals (EHs) demonstrating meaningful use of certified Medicare and Medicaid Electronic Health Records (EHR) technology.
9 How are IIS and CMS EMR/EHR Meaningful Use Related? EPs For Stage 2 of Meaningful Use (MU) ongoing submission of electronic data for immunizations is in the core set for EP s and reporting for cancer and specialty registries is a menu selection. EHs The Stage 2 MU requirement for EHs ongoing submission of electronic data for immunizations, syndromic surveillance and electronic laboratory results.
10 What are the Data Sources for IIS? Manual Entry from Web Application Vital Records (hepatitis B birth doses) Electronic Medical Records / Electronic Health Records (EMR/EHR) via Health Level Seven (HL7) messages Direct interface or Health Information Networks (Missouri Health Connection) Medicaid Billing Batch files
11 Is reporting to an IIS subject to the HIPAA Privacy Rule? Per CDC, No. Reporting of immunizations to an IIS are exempt from the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule since it is considered a public health activity. 2
12 ShowMeVax EMR/EHR Interoperability Uses HL7 version Interfaces with existing EMR/EHR systems Bi-directional capability with EMR/EHR Submit & Query Web Application Internet Browser basedapplication Provides similar features to some EMR systems Provides several aggregate reports
13 Missouri s Statewide Immunization Information System SHOWMEVAX WEB APPLICATION (NON EMR/EHR ACCESS & USE)
14 ShowMeVax Web Application Requirements PC* High Speed Internet Internet Explorer* Paperwork Memorandum of Agreement, User Security Does not work with mobile devices (smart phones and non-windows based tablets) *limited support is supplied for Mac and other browsers
15 ShowMeVax Web Application Key Features Updated immunization schedule guidance Online vaccine ordering for Vaccines for Children Program Data reports available to providers Auto deducting immunization inventory management Patient immunization-related medical alerts
16 Home Page 16
17 17
18 Client Search 18
19 Client Search 19
20 Personal Information & Demographics 20
21 Adding/Deleting Contact Information 21
22 Provider Client Relationship Click the Edit VFC Information button to update client s VFC related information If a relationship already existed for the client, then the only option available is to close. After clicking the Close button, user can enter the Closed Date and Closed Reason. If a client s relationship is closed, the provider can re-open or open a new relationship by clicking the Add Providerclient Relation button. In the Add screens, the only required field is the effective date. 22
23 Medicaid Eligibility Information 23
24 VFC Eligibility Information 24
25 Family Unit With Responsible Persons 25
26 INVENTORY 26
27 Viewing and Printing Inventory Items 27
28 IMMUNIZATIONS 28
29 Immunization Record If alerts exist, you can view & navigate from here to Medical History Screen Print User may expand/ collapse the list to see all vaccines If other family members exist, you can switch between their immunization records from here. 29
30 Adding New Immunizations 30
31 Adding Historical Immunizations 31
32 CLINICAL APPLICATION 32
33 Immunization Schedule 33
34 Vaccine Schedule / Dose Validity
35 Age inappropriate vaccine (DTaP given to adult)
36 Too closely spaced (hep. B)
37 Medical Alerts
38 Next Dose Reminder Recall Reports
39 Vaccine Tally Sheet Additional Reports Doses Administered by Inventory Site, Vaccine Name, Trade Name and Age Group Doses Administered by Vaccine Name and Age Group (Historical) Doses Administered by Vaccine Name and Age Group (From HL7 Only) Client Listing Immunization Data by Vaccine Series Immunization Data by Vaccine Type and Summary of Vaccine Coverage By Age Group
40 Questions / Discussion
41 Clinical Use and Benefits of State Immunization Information Systems ETC.
42 Resources: Four self-paced learning modules: Missouri Public Health Meaningful Use Page: Centers for Disease Control & Prevention Meaningful Use Page: Centers for Disease Control & Prevention Immunization Information Systems Page:
43 References 1. About Immunization Information Systems, Centers for Disease Control and Prevention bout.html 2. IIS Frequently Asked Questions esources-refs/faq.html#q8
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Stage 2 Overview Tipsheet Last Updated: August, 2012
Stage 2 Overview Tipsheet Last Updated: August, 2012 Overview CMS recently published a final rule that specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical