Department of Veterans Affairs Electronic Health Record System
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1 Department of Veterans Affairs Electronic Health Record System Staff electronic immunization records & mass vaccination capabilities PRESENTATION TO: HHS National Vaccine Advisory Committee PRESENTING: Richard Martinello, MD September 11, 2012 Chief Consultant, Clinical Public Health Veterans Health Administration - Office of Public Health
2 Presentation Question to Answer What has VA developed to travel health care staff immunizations? Can the existing VA system help with vaccinations to non-va beneficiaries? What exists in the VA electronic health record system to support mass vaccination services?
3 Provision of medical counter measures during a national emergency or disaster VA is funded by Congress to provide care to beneficiaries defined by Federal law. Stafford Act: 1988 amended version of the Disaster Relief Act of 1974 Allows a means for Federal disaster assistance In general, unless VA is providing care and services pursuant to a mission assignment under the Stafford Act, VA must be reimbursed for care provided to non-va beneficiaries. Emergency Support Function #8 (ESF #8) of the National Response Framework (NRF) provides the mechanism for coordinated Federal assistance in response to a public health and medical disaster, potential or actual incidents requiring a coordinated Federal response, and/or during a developing potential health and medical emergency. VA is identified as a support agency for ESF #8 and can be called on to assist with distribution operations involving mass prophylaxis and vaccination.
4 VA Medical Facility Locations
5 VHA Directive Vaccination of Non-VA Federal Health Care and Emergency Support Staff Issued January 2010 Provides policy, responsibility for vaccination other Federal employees Policy: to provide vaccination services to non-va Federal employees who are hands-on health care providers, emergency support service providers, or handle potentially infectious clinical specimens containing the 2009 H1N1 influenza virus. Documentation is to be placed in the VHA Occupational Health Record-keeping System (OHRS).
6 Occupational Health Record-Keeping System (OHRS) Compliance with HIPAA and Privacy Act regulations Compliance with OSHA, EPA, OPM and Joint Commission Cost containment of work-related injuries National tracking and reporting Ability to accept demographic and emergency contact information on other Federal employees Reports on vaccination status can be generated for other agencies, as well as a vaccination record
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8 Current Features of OHRS Information Displayed Coversheet Respirator clearance Immunity Status Encounter distribution Cumulative vaccination record (printable) Encounters Listed by date, type, provider Sort and filter to easily find Notification list Notifications sent to employees Alerts Notifications to clinicians Patient Information Demographics Work Profile Risk profile Work Ability Resource links Other Federal Agencies - CDC, NIOSH References - Disability Guidelines Occupational Health Staff Directory
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10 Current Features - Data Entry General Patient Information Central PAID (upload weekly) Voluntary Service (upload biweekly) Other federal agency (able to accept) Other workers hand entry Risk Profile (surveillance profiles) Tuberculosis Hepatitis B Job Risk Pandemic influenza encounter Clinic visit Telephone consult Front door screening Adverse medication reaction Immunization administration Hepatitis A Hepatitis B Hepatitis AB MMR Varicella MMR Seasonal Influenza Novel H1N1 Influenza Pneumococcal TT Td Tdap Quickload (mass vaccination for influenza) Medical surveillance Medical clearance respirator Fit testing and training Work Ability
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14 Detailed and Summary Reports Facility / VISN/ National Detailed and Summary Vaccination Status Vaccination Rate Immunity Status Vaccine administration Infectious Disease Exposure Infectious Disease Surveillance Medical Surveillance Status Respirator Medical Clearance Respirator Fit Test Adverse Medication Reaction Work Ability Duty Status Other Federal Agency Vaccination Status Other Federal Agency Adverse Reaction OHRS user access tracking
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16 Future OHRS Releases Administrative Encounters Pre-placement, police, boiler plant operator etc. Medical Surveillance Encounters Asbestos, formaldehyde, ethylene oxide, etc Work-related injuries, illnesses and exposures Tuberculosis screening results Personal Health Wellness/Health Promotion Sick call, immunizations Scheduling Link to Safety and Worker s Compensation software Additional support reference tools
17 Mass Immunization Capabilities 2009 H1N1 monovalent influenza vaccine Seasonal influenza vaccines Ability to Report: Vaccination Status Vaccination Rate Number of Doses Administered Adverse Reactions Illness Staff fitness for duty Quickload feature
18 Adding Additional Features to OHRS New vaccines New report Length of time to implement is dependent on several factors Funding Complexity of what is needed Development time (depends on complexity) Testing (1 week) VA IT approval for release to the field Additional functionality added every 3 months Can expedite, if urgent need
19 Questions?
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