Overview
OP sat for certification with the Immunization Integration Program (IIP) from HIMSS adopting the most up-to-date immunization specification standards. Immunization workflow enhancements are one result of this certification work including:
- A more comprehensive Complete List
- Streamlined processes to document vaccine deferrals, refusals, and documented immunity
- Ease of correcting documentation of incorrect administered vaccine details (ie. body site or vaccinator)
- Streamlined process to correct vaccine inventory errors based on location mistakes
- Ability to “restart” vaccine forecasting (ie. for patients who had a bone marrow transplant)
- More comprehensive DAR Vaccine Recall Reports
Delivered Features
- New fields in Complete List: Dose Size, Dose Units, Doses Given, NDCID, Comments, Source, Administered at Facility (Location) - name and address, Vaccine Status and Status Detail; CVX Code, DNF (Do Not Forecast), *Transmission Status, Entering Facility Name, External information: Provider, Administered Provider, Ordering Provider, Entering Provider
- Vaccine Statuses: Complete, Partially Administered, Deferred, Refused
- Enter Immunization button renamed Administer Vaccine
- Edit/Delete tab removed
- Current field newly visible in Complete List: Counseling Provider
- Vaccine records with Adverse Reaction are highlighted yellow
- New Action buttons for Complete List:
- New: enter a single historical vaccine record
- Edit: edit available fields for selected vaccine record
- Delete: delete selected vaccine record
- Refuse/Defer: enter a new vaccine refusal or deferral
- * Retry Failed: Retries transmissions that are currently marked as warning/errors in the next transmission.
- New/Edit Vaccine form with access to most of the Complete List fields
- Indicators displayed on Complete List: Refused; Documented Immunity, has protective titers; Documented Disease
- Defer/Refuse documentation form
- Do Not Forecast (DNF) feature
- Problem List subsection Documented Immunity
- All Vaccine documentation, edits, deletes are recorded in the Audit Trail
- Historical Status Indicators tab under Indicators
- New fields in DAR:
- Patient Demographics: Time of Birth, Middle Name included in Patient field
- Vaccine Status Recall: Birth Time, Vaccine Group, Doses Given, Due Date, Overdue Date
- Updated VIS sheets - associated with barcodes added to Clinical > Reference Data > More > Immunization Codes > Vaccine Information Sheets
- Demographics > Basic Information - Middle Name field
- Patient Chart > History> Perinatal History > Birth Info tab
- Check the box for part of a Multiple Birth
- Birth Order with a numeric dropdown up to 9
Note: Transmission Status column and Retry Failed button will only be functional after user’s state Immunization Registry retests to support OP’s robust bi-directional, real-time transmissions. |
Workflow
- More comprehensive Complete List
- Above mentioned columns are visible
- NDCID, CVX populates with documentation of vaccine administration and editing a vaccine record
- Doses Given represents the number of vaccine doses recorded/administered
- Print button on Complete List tab will print the displayed Complete List
- Streamlined processes to document:
- Administered vaccines default to a status of Complete
- Alert when choosing a Vaccine with an Expired Lot
- Alert when ordering a Vaccine with prior Adverse Reaction
- Alert when ordering a Vaccine with active indicator: Deferred, Documented Immunity, Refused
- Alert when selecting improper administration route
- Current standards to exchange information about vaccines now include coded reasons for deferral/refusal of vaccines. User will be guided to select:
- Reason: Parent, Patient or Medical Decision
- Details: Other, Philosophical Objection, Religious, Vaccine efficacy concern, Vaccine safety concern, Medical precaution, Out of Stock
- Vaccine deferrals
- Document from Order Worksheet or Complete List
- Defer will be documented and vaccine will continue to be forecasted
- Assign Defer Until Date
- Due dates for Tasks and Orders reflect defer until date or chosen date
- Check box to order consent for refusal/deferral
- Tasks created: Schedule f/u visit, vaccine, consent
- Able to convert a vaccine record to Defer/Refuse
- Status: Deferred
- Vaccine refusals
- Document from Order Worksheet or Complete List
- Refuse will be permanent and vaccine will no longer be forecasted
- Check box to order consent for refusal/deferral
- Able to convert a vaccine record to Defer/Refuse
- Status: Refused
- Documented immunity
- Problem List > New > subsection: Documented Immunity; can not enter directly into the Complete List
- Problem drop down offers only approved CDC SNOMED codes
- Edits/Deletes to the Problem Documented Immunity will be reflected in the Complete List
- Quick Entry vaccines have status of Historical information - source unspecified
- Vaccine Status Indicators will display on Complete List and the Indicators Tab (read only)
- Only valid indicators that will stop vaccine forecasting are: Refused, Documented Disease, Documented Immunity, serology
- Ease of correcting/editing documentation of administered vaccine details
- Function no longer available in Enter Immunization (Administer Vaccine) button
- Adjust incorrect details in form such as body site, lot number or vaccinator
- Change the vaccine's expiration date to be prior to the date given, the Do Not Forecast checkbox is checked and read-only. Vaccine considered invalid and not forecasted.
- Change vaccine status to partially administered, the Do Not Forecast checkbox is immediately set to checked and read-only. Vaccine considered invalid and not forecasted.
- Able to convert a vaccine record to Defer/Refuse, vaccine will be returned to inventory
- Status changes available: Complete, Partially Administered, Deferred, Refused
- Streamlined process to correct vaccine inventory errors based on location mistakes
- Administration records tied to inventory will only display information associated with that lot number
- Change lot number on an administered vaccine - inventory will be reconciled (decreased/increased) and location details will be updated
- Ability to “restart” vaccine forecasting (ie. for patients who had a bone marrow transplant)
- Manually check Do Not Forecast (DNF) box in the Edit Vaccine Form - this will mark vaccine as no longer valid for forecasting
- Forecast will reflect updated status with DNF vaccines removed
- Historical Status Indicators tab under Indicators
- Reference list of historical vaccine indicators - may no longer stop forecasting based on best practice
- Able to delete historical vaccine indicators
- Newly added indicators will be read only
- No manual entry permitted
- Current Indicators will be mapped:
- Documented Disease (DD) - Documented Disease, Other
- Documented Immunity (DI) - Documented Immunity, Other
- Refused (R ) - Refused, Parent Decision (permanent, will no longer be forecasted)
- Adverse Reaction (AR) - Deferred, Medical Precaution
- Deferred: vaccine not available (DNA) - Deferred, Other, Out of Stock
- All other statuses (AS, SC, NR, NRL, DMC, DVH) are not valid reasons to adjust vaccine forecasting and will only remain as historical references
- More comprehensive DAR Vaccine Recall Reports
- Doses Given represents number of vaccine doses recorded/administered
- Vaccine Groups represents the Antigen group of the vaccine recorded
- Due Date: the date the vaccine is due
- Overdue Date: the date the vaccine is behind and past the recommended dosing range
Note: New Immunization Registry transmission functionality will be rolled out on a state-by-state basis. |