AFIX Online Tool User Guide Version 2.0 Effective January 2015
Introduction The AFIX Online Tool is for assessing immunization practices within a clinic, private practice, or any other environment where immunizations are provided. This software is designed to be used in conjunction with the AFIX strategy. The AFIX Online is a data collection tool. After AFIX site visit information data is entered into the AFIX Online Tool, data analysis capabilities can be utilized to pinpoint strengths and areas of improvement for an individual immunization provider/clinic. Coverage data for the AFIX Online Tool will need to come directly from your IIS or IIS and CoCASA. The user guide describes how to utilize this system for recording, managing, and aggregating AFIX site visit information. Any questions or comments about the AFIX Online Tool should be communicated to the following personnel: Akash Dongol Tel. 1-800-803-5212 E-mail: afixonline@cdc.gov Page 1
Table of Contents Getting Started 3 AFIX-Home 5 Provider Information. 6 General Site Visit Information... 7 Questionnaire... 10 Assessment Results. 11 Feedback.. 12 exchange.. 13 Summary... 15 Files... 16 Notes... 16 AFIX-Help. 17 AFIX-Reports... 17 Submitting the AFIX Annual Report... 19 AFIX Online Tool Required Fields... 20 Page 2
Getting Started Accessing the AFIX Online Tool will require you to have a Secure Access Management Service (SAMS) account and an access to the Program Annual Report and Progress Assessments (PAPA) application. 1) Log into SAMS website (https://sams.cdc.gov). For help with SAMS account assistance, please contact the SAMS Help Desk at the toll free number: 877-681-2901, Email: samshelp@cdc.gov. For assistance with the AFIX Online Tool, please contact the AFIX Online Tool Help Desk (Akash Dongol) at the toll free number: 800-803-5212, Email: afixonline@cdc.gov 2) From the PAPA Welcome Page, click the AFIX Online Tool hyperlink. 3) AFIX Online Tool Home Page Page 3
4) AFIX Online Tool Site Visit Navigation Tabs Navigation Tabs 5) Required Field Status included in each site visit information page. a. Complete: if you see a complete status displayed on the page, this implies that all required fields have been entered, validated, and page is considered complete. In order for the entire site visit to be complete and to show up in the aggregate reports, you must ensure that each page status is marked as COMPLETE. You must enter all required fields, and check acknowledge (refer to the check box displayed in the screen under point 6) that all responses are final and the page is complete, then click on SAVE AND CONTINE to mark required field status as COMPLETE. b. In-progress: if you see an in-progress status displayed on the page, this implies the page is either missing a required field or has not been validated for completeness. 6) Data SAVE Options at bottom of each site visit questionnaire page. a. SAVE: Clicking here will allow you to save the data for later and remain on the page. It doesn t check for page completeness or required fields. b. SAVE AND CONTINUE: Clicking here will save the data and move users to the next page. It only checks for page completeness if you select the acknowledgement box. If you acknowledge that the page is complete and all responses are final, clicking save and continue will check the completeness of a page so that if required fields are missing you will need to complete them or the data will not save using this button. c. SAVE AND QUIT: Clicking here will save your site visit data and exit the AFIX Online Tool. You will be logged out of the PAPA application. Page 4
AFIX-Home Use this page to search and locate the provider you are planning to visit or add a new provider. From the search results, you will be able to begin a new site visit, edit the provider information or add data to an existing site visit record. To Search for a Provider 1) Search Criteria: To search for a provider, use any of the search criteria available including (Provider PIN number, Name of the clinic or practice, City, and ZIP code). You can also perform the search using parts of those search criteria. The Search Results will list all providers that match your search criteria. 2) Search: Click here to submit the search. If you leave all 4 search fields blank and click here it will provide a list of all providers. 3) Reset: Click here to reset all search fields and the search results list. To Add or Edit a Provider Information 4) Add a New Provider: Click here to go to the provider Information page to add a new provider. You will not have the ability in the AFIX Online Tool to delete enrolled VFC providers. 5) PIN: Click on the provider PIN hyperlink to go to the provider page to edit the provider information. To Add or View Previous site visits 6) Previous Visits: Click on this hyperlink to generate a list of all previous site visits for the selected provider. 7) New Visit: Click here to add a new site visit. Page 5
Provider Information Your provider information is preloaded into the system with the exception of 3 required fields; VFC Provider Type, Public Provider Details, and provider phone number in the Provider Address section. Make sure to enter those fields or review and confirm them if they d already been entered through prior visits. Entering those required fields is only required once and the information will carry over to following visits. Use this page to add a new provider or edit existing provider information. Once the provider information is SAVED, you could click on Go to General Site Visit Information to enter the new site visit data. All required fields are marked with red asterisk (*). Page 6
General Site Visit Information The assessment specific fields in the header section of this page are auto populated as you start filling out the Site Visit Information. The provider specific information fields in this page are auto populated for you. All Fields marked with a red asterisk (*) are required fields. Please note the Not a full AFIX visit function has been added to the General Site Visit Information tab for recording partial AFIX visits. Page 7
General Site Visit Information Field Name Site reviewer Assessment date Assessment name Assessment questionnaire Assessment age cohort Antigens Answer Tips Click on Choose reviewer to select a reviewer from the existing list or enter a new one. Enter the date of your assessment. A calendar will pop-up for you to select the date. A default name will be provided for this. The name will include the Provider name and the assessment date. You will have the option to change the Assessment name in this free text box. Based on your assessment criteria, select the appropriate questionnaire for the age group selected for your assessment. If conducting a childhood assessment, you would select the Childhood Assessment Questionnaire, while if conducting an adolescent assessment, you would select the Adolescent Assessment Questionnaire, and if conducting a combined (childhood/adolescent) assessment, you would select Both Assessment Questionnaire. The questionnaire is the same for both age groups with the exception of question 6 (Do you have a system in place to schedule wellness visits for patients at 11-12 years of age?) which is only applicable to adolescent assessments. Choose your patient age cohort for the site visit. If conducting a childhood assessment, you would select the Assessment Age Cohort 0-3 years and if conducting an adolescent assessment, you would select the Assessment Age Cohort 13-18 years and if conducting a combined (childhood/adolescent) assessment, you would select both age cohorts. Antigens are auto populated based on the Assessment Age Cohort selected. Number of age eligible (children/adolescents) in practice Enter the total number of children within the assessment age group (0-3 years) and/or the number of adolescents within the assessment age group (13-18 years) that belong to the practice. Page 8
Ages assessed The previous AFIX visit 4:3:1:3:3:1:4 Percent The previous AFIX visit Percent Date of previous/most recent AFIX site visit AFIX visit Type of VFC visit conducted AFIX Assessment method used AFIX Assessment tool or combination of tools used If age assessed is different than the standard 0-3 years or 13-18 years as of assessment date, then specify the ages assessed. Example, childhood [0-3 years by age 3] or age 24 35 months (all 2 year olds). Enter the provider s coverage (%) for the last childhood site visit, or leave it blank if you don t know it. Enter the provider s coverage (%) for the last adolescent site visit, or leave it blank if you don t know it. Enter the most recent AFIX site visit date for the provider. If the site visit is completed in conjunction with VFC site visits then choose Combined, otherwise choose Separate. If the AFIX visit is combined with a VFC site visit, indicate if the VFC site visit is a VFC Compliance or Unannounced visit. IIS is the new AFIX standard method, however, if patient charts are reviewed to confirm the accuracy and completeness of IIS data then select the IIS and Chart data option. If you don t use the CoCASA application for running provider coverage rates then select IIS only. However, if you export IIS data into CoCASA to generate provider coverage rates then select IIS combined with CoCASA as your assessment tool. Page 9
Questionnaire The YES or NO answer to each question in this page is required. In addition, at least 2 or more quality improvement (QI) strategies are required to select if the provider answers no to any of the questions. If the provider answers Yes to all questions then the selection of 2 or more QI measures is not required. The questionnaire contains the same questions for childhood and adolescent assessments with the exception of question #6 which applies to adolescent visits only. Question #6 will not appear if you select to conduct a childhood only assessment. In the case where you select both ages for an assessment, you will only have the ability to answer it in the adolescent column. Frequently Asked Questions QUESTION: I m missing the Childhood or Adolescent column for a YES or NO radio button. ANSWER: The displayed questionnaire columns depend on the selected questionnaire in the General Site Visit Information page. QUESTION: What do I do if the Site Visit Questionnaire is not used? ANSWER: If you don t use the Site Visit Questionnaire for a visit, set the Assessment questionnaire answer in the General Site Visit Information page to Questionnaire not used for this site visit. The system will require you to provide the reason/s for not using the questionnaire. Page 10
Assessment Results The assessment outcome measure percentage results need to come from either your IIS, or CoCASA s Assessment Results tab. All fields marked with a red asterisk (*) are required based on the Site Visit Information you select. If you don t have a percentage result at the time of the site visit, click the SAVE button which will allow you to skip the required responses and return to them later when the rates are available. Your program may select to track all the antigens provided in the childhood coverage list and/or the adolescent list. The items required for reporting are marked with the red asterisk (*). Page 11
Feedback A response to the Type of Feedback Method Used and the Delivery Method of Assessment Results are required for completeness and continuation to the next page. The Feedback Checklist Questions serve as a reminder on what to address during the feedback session. All checklist responses default to Yes, however, you have the option to modify the responses where applicable. Any place you see the Upload/Attach files link, you may attach program documents and documents specific to the AFIX visit. All this data will be saved online for record keeping and review. Page 12
exchange The initial exchange or follow-up should take place with every provider that receives an AFIX visit no later than six months following the feedback session. Using your Immunization Information System or the reimport registry data functionality in CoCASA, re-assess the Assessment coverage rates for the same provider and same age group but NOT the same list of patients. As you enter the percentage for Assessment Outcome Measures, the Percent Point Increase in coverage and Percent Point Decrease in missed opportunities are automatically calculated. The Percentage Coverage Goal for following Year is an optional entry and may be used to define a provider s coverage goals for the following year. All fields marked with red asterisk (*) are required for completing this page and continuing with data entry. Page 13
A response to Progress toward implementing selected QI strategies is required for each Recommended Quality Improvement Activity selected for implementation. The QI measures to report progress toward implementing are based on the QI selection made in the Site Visit Questionnaire for each visit. Please note once QI measures are selected, initial and subsequent followup fields will appear in the exchange tab. If progress completion for the initial follow-up is marked at 100%, subsequent follow-up field will not appear. If no QI measures are selected, initial follow-up and subsequent follow-up fields will not appear. In the example above, the Selected QI measures for follow-up (X) are for questions 3 and 5 in the Site Visit Questionnaire. Entering a Subsequent exchange of Information Subsequent follow up is a follow up process that takes place when the initial follow up does not yield 100% completion on implementation of selected QI measures. You determine the subsequent strategy to use and the timing for it based on communication with the provider. You are to record and document all your subsequent follow-up site visits and telephone call dates. As part of this process, you are to update the implementation progress for the list of selected QI measures. You are not required to re-run the coverage rates as part of the subsequent follow-up process; the only requirement is to mark status toward implementation of selected QI strategies. Your program may however choose to re-run the rates a 3 rd time, this process is up to your program to decide. Page 14
To Add 1) Date of contact (follow up visit, educational visit, follow up telephone call): Pick a site visit date from the pop-up calendar. 2) Add: Clicking this button will add the selected date to the list of subsequent X selections. To Delete 3) Select a Date: Click on date to select. 4) Delete: Clicking this button will delete date from the list of visit dates. A QA Review function was added to the exchange of Information tab. This allows awardees to approve the quality of the conducted AFIX Site Visit. Summary The site visit summary provides a summary of all site visit information you documented. You have the option of printing this page and sharing it with the provider or with others in your program. Click on Expand to view the site visit information details in each page (tab). Page 15
Files Here you will find a list of all files you ve uploaded and attached as part of the site visit information. Click on the file name hyperlink to view the selected document, and click on Remove this file hyperlink to delete the selected file. Notes The site visit notes can be documented on this page for record keeping and review purposes. You can enter text into the free text box and once you click save notes, all notes will be archived in the table. These notes will not appear on any report, they are intended for your program use only. Page 16
AFIX-Help This tab contains the AFIX Online Tool s help desk information as well as a copy of the user guide and any other helpful resources relevant to the AFIX Online Tool. AFIX-Reports AFIX Site Visit Tool Printable Documents 1. AFIX Site Visit Full Document: A hardcopy of the complete AFIX Site Visit 2. AFIX Site Visit - General Site Visit Information: Hardcopy of the general site visit information portion of the AFIX Site Visit 3. AFIX Site Visit Questionnaire: Hardcopy of the questionnaire to be used during site visits 4. AFIX Site Visit Assessment Results: Hardcopy of the assessment results for childhood and adolescent visits to be recorded during site visits 5. AFIX Site Visit Feedback: Hardcopy of the feedback portion of an AFIX site visit. 6. AFIX Site Visit exchange of Information: Hardcopy of the Initial exchange and the Subsequent exchange portions of an AFIX Site Visit 7. AFIX Site Visit Notes: Hardcopy of the notes section. Page 17
Management Reports 1. AFIX Annual Report: An aggregate summary of all site visit data for the CY year. This report is annually required by CDC. 2. AFIX Site Visit Status Report: Status of Site Visit Completion by provider clinic/practice 3. AFIX Assessment Questionnaire Aggregate Report: An aggregate summary of all data items collected in the Questionnaire page. 4. AFIX Assessment Results Aggregate Report: An aggregate summary of all data items collected in the Results page. 5. AFIX Assessment Results and Follow-up Results Aggregate Report: An aggregate comparison between initial and follow-up assessment results. 6. AFIX Feedback Results Aggregate Report: An aggregate summary of all data items collected in the Feedback page. 7. AFIX exchange of Information Results Aggregate Report: An aggregate summary of all data items collected in the Exchange of Information page. 8. AFIX Provider Follow-up Report: A list of all providers due for follow-ups. AFIX Resources 1. AFIX Policies and Procedures: First edition manual for the AFIX Program. 2. Additional Resources: List of additional resources on the AFIX Program. 3. AFIX Logic Model: Example of intended inputs, activities, outputs and outcomes for the AFIX Program. 4. Suggestions to Improve Your Immunization Services: Checklist for providers for best approaches in decreasing missed opportunity and increasing vaccination rates. Training Resources 1. AFIX Online Tool User Guide: Comprehensive Guide for using AFIX Online Tool 2. AFIX Online Tool Required Fields: Complete list of required fields to be completed in the AFIX Online Tool 3. AFIX Site Visit Questionnaire Answer Guide: Complete list of answers to the 2015 AFIX Site Visit Questionnaire Page 18
Submitting the AFIX Annual Report AFIX Online Tool users can submit the Annual Report using the AFIX Online Tool. The AFIX Annual Report is located in the Management Reports section of the AFIX-Reports in the Online Reporting Tool. After entering the AFIX Annual Report (AFIXAR) tab, please fill out the first 3 questions. The rest of the questions will be read only. Please review this section, if you do not wish to add any additional Site Visits, please approve and submit your Annual Report to PAPA AFIX Annual Report. To print, please press Ctrl P or Right Click and then print. Note: In the AFIX Annual Report (AFIXAR) only the completed Site Visits are aggregated. To consider a Site Visit complete, please complete the first 4 tabs (General Site Visit Information, Questionnaire, Assessment Results, Feedback) mark Final and Submit the report. After submitting the Annual Report in the Online Tool, please enter the Annual Reports tab in PAPA and then access the AFIX Annual Report. The Site Visits entered in the AFIX Online Tool should automatically be transported into PAPA. Please fill out the identifying information section of the AFIX Annual Report in PAPA and save and submit the Annual Report. Page 19
AFIX Online Tool Required Fields Required Fields Site Visit Page Name 1 General Site Visit Information Required Field Name 1. Assessment date 2. Assessment name 3. Assessment questionnaire (childhood or adolescent or both) 4. Assessment age cohort 5. AFIX visit (separate or combined) 6. If combined: Type of VFC visit conducted (compliance or unannounced) 7. AFIX assessment method used 8. AFIX assessment tool or combination of tools used 2 Questionnaire 1. A response to each question is a required entry. There are 17 YES/NO questions for childhood and 18 YES/NO questions for adolescents. If both age groups, childhood and adolescent, are assessed then a response to all 35 YES/NO questions is required. 2. The selection of QI measures is a required entry. 3 Assessment Results 1. Childhood Vaccine Coverage Level Results 1.1. 4 DTaP 1.2. 3 IPV (Polio) 1.3. 1 MMR 1.4. 3 Hib 1.5. 3 HepB 1.6. 1 VAR 1.7. 4 PCV13 1.8. Coverage level results (series 4:3:1:3:3:1:4) 1.9. Missed opportunities results (series 4:3:1:3:3:1:4) 2. Adolescent Vaccine Coverage Level Results 1.1. 1 Tdap 1.2. 1 MCV4 1.3. 3 HPV 3. Adolescent Missed Opportunities Results 1.1. 1 Tdap 1.2. 1 MCV4 1.3. 3 HPV 4 Feedback 1. Type of Feedback Method Used 2. Delivery Method of Assessment Results Page 20
Required Fields Site Visit Page Name Required Field Name 5 Exchange of Information (follow-up) 1. Childhood Vaccine Coverage Level Results 1.1. 4 DTaP 1.2. 3 IPV (Polio) 1.3. 1 MMR 1.4. 3 Hib 1.5. 3 HepB 1.6. 1 VAR 1.7. 4 PCV13 1.8. Coverage level results (series 4:3:1:3:3:1:4) 1.9. Missed opportunities results (series 4:3:1:3:3:1:4) 2. Adolescent Vaccine Coverage Level Results 2.1. 1 Tdap 2.2. 1 MCV4 2.3. 3 HPV 3. Adolescent Missed Opportunities Results 3.1. 1 Tdap 3.2. 1 MCV4 3.3. 3 HPV 4. Progress toward implementing selected QI strategies: Initial exchange of Information (follow-up) 5. Was a follow-up letter sent to provider? 6. Subsequent exchange of Information (addition of a date and selection of implemented strategy) 7. Were the exchanges of information documented? 8. Progress toward implementing selected QI strategies: Subsequent exchange of Information (follow-up) Page 21