MEDITECH Immunization Management Choosing the Correct Path for Meaningful Use Presented by Karl Frohlich Senior Consult, Santa Rosa Consulting
Session Overview Meaningful Use Requirements Query/Assessment-Based Model Centralized Immunization Management Tool NMI Interface Considerations for Meeting Meaningful Use 2
Meaningful Use Requirements Stage 1 Perform at least one test of the EHR to submit electronic data to Immunization Registries or Immunization Information Systems where required and accepted. Transmit data in accordance with CVX code set Menu Option Self Attestation No Report Required Stage 2 Bi-directional interface with ongoing submissions Core Requirement 3
Query/Assessment Based Model Historical Assessment Eligibility Screening Patient provided with VIS if eligible 4
Query/Assessment Based Model continued Physician or Pharmacy Entered Medication Order 5
emar & Assessment Display Medication Order Documentation Assessment 6
CDC Documentation Guidelines Type of Vaccine Dose # Dose Amount Manufacturer Lot # and Expiration Date Date the Vaccine was Administered Insertion Site Publication Date of VIS Assessment of Contraindications as Listed on VIS Name of Person Giving the Vaccine 7
Adverse Reactions Documented via emar Reassessment Pharmacist Adverse Immunizations Events (Both Models) 8
EMR - Both Models EMR Display - Patient Summary 9
Query/Assessment Based Model continued EMR Display - Medications Panel EMR Display - Administration Detail 10
Dictionaries & Parameters MIS Queries (PCS, EDM, PHA and EMR) Immunizations Expiration Date Manufacturer Lot Number Series Associated to emar assessments, MIS CVX Code Dictionary and MIS Toolbox Parameters Pharmacy Drug Dictionary emar assessment/reassessment CVX codes 11
MIS CVX Code Dictionary KB 40778 Load CVX Codes routine http://www2a.cdc.gov/nip/iis/iisstandards/vaccines.asp?rpt=cvx 12
Centralized Immunization Management Tool MEDITECH Standard Functionality/Dictionaries Enhanced Integration MRI, PCS, EDM, POM, PWM, PHA, MM and EMR Schedule and Conflict Checking Nurse or Pharmacist Administration Option Historical Documentation Routines 13
emar Documentation Screen Hard Coded Screen Replaces Assessment 14
Pharmacist Documentation Screen Enter Orders - Immunization Event Tab 15
Schedule and Conflict Checking Pharmacy Order Entry 16
Enhanced EMR Functionality Immunization Section 17
Enhanced EMR Functionality continued Immunization Section Detail 18
Historical Documentation Routines MRI Immunizations Menu 19
Dictionaries & Parameters Immunizations Menu Shared MIS Dictionaries (PHA) 20
MIS Component Dictionary Comment Tab Define Antigens Schedule Tab 21
MIS Vaccine Dictionary CVX code Vaccine entries associated to the PHA Drug Dictionary 22
Pharmacy Dictionaries & Parameters Order Type, Drug, Access and Customer Defined Parameters Adverse Drug Reaction Events Pharmacy Toolbox Parameters Ordering Screen PHA or POM order: Documentation by Nursing Record Event Pharmacist Order Entry and Documentation 23
Dictionaries and Parameters continued MIS Parameters MRI Parameters 24
NMI Interface Segment Information to Provide MEDITECH MSH 3 Sending Application MSH 5 Receiving Application MSH 6 Receiving Facility Messages Generated by Administration 25
NMI Interface continued MIS Mapping Tables Path: MIS -> Communications -> Maps -> Enter/Edit. Map Mnemonics added to NMI Toolbox 26
NMI Interface continued Mapping Table Example 27
Query/Assessment Based Model considerations Less Dictionary Build than Centralized Model Customize Queries/eMAR Assessments Standardization Challenges Dictionary Maintenance Difficult to Set-up Schedule or Conflict Checking No Option for Pharmacist Administration No Option for Historical Documentation 28
Centralized Immunization Management Tool - Considerations Intensive Dictionary Work (No Standard Content) Easier to Standardize Schedule and Conflict Checking Less System Maintenance Hard Coded Documentation Screen Option for Pharmacist Administration Enhanced EMR and Historical Documentation Routines Intensive Training for Nursing and/or Pharmacy 29
Thank You Contact Information 30