Improving Pneumococcal and Influenza Vaccination Rates

1. https://sites.google.com/a/u.northwestern.edu/med-inf-403-group3/https://sites.google.com/a/u.northwestern.edu/med-inf-403-group3/ ImprovingPneumococcal andInfluenza Vaccination Rates Team #3 – Med Inf 403 (Spring Term 2010) - Michael Aguilar - Wade Astin - Jacob Frimpong - Kevin Scharnhorst

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4. Assumptions • An EMR systems already exists in the in-patient landscape. • Funding and adequate staffing exist to support the project • Administrative leadership will be present and visible to promote adoption. • An adequate supply of vaccine exists. • The solution must adhere to security policies and architecture as imposed by the organizations. • End user training will occur. • Pre and post implementation measurements will performed. • Needed adjustments will be made post implementation to processes and data collection methods. • Immunization Information System (IIS) exists.

5. Conceptual Work Flow

6. Conceptual Data Flow

7. Process starts at Admission… Admission Order Sets can include NEW component called … “Immunization Sub Plan”

8. Process starts at Admission… The order is pre-checked…but, provider can “opt out” with a single click

9. Assume they “Opt In”

10. The Nurse will receive an order/task to… “Review Immunization Criteria”

11. Encounter questions ? This is filled out as part of a the routine part of the patient encounter.

12. Meet or Not Meet Criteria?

13. Physician Alerterd! ….An “Discern” alert will appear

14. Vaccination Administered Vaccination Data sent to Immunization Information System

15. Standardizations • TCP/IP • Health Level Seven (HL7) • Technical: Moving data from System A to System B • Semantic: Ensure that system A and System B understand the data in the same way • Process: Enabling business processes at organizations housing system A and system B to work together • Secure Sockets Layer (SSL) • Secure FPT (sFTP)

16. Standard Reports • Report 1 • Measure Summary Report with patient detail drill down capability • Report 2 • Measure Patient Detail Report with Filter Options • Report 3 • Measure Refusal Summary Report with Patient Detail Drill Down Capability • Report 4 • Measure Refusal Patient Detail Report with Filter Options • Other Reports

17. Questions and Answers

18. References • Centers For Medicare & Medicaid Services (cms) And The Joint Commission, . (2009). NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. [Electronic version]. Specifications Manual, Version 3.1, 147-155, 10-16. • Centers for Medicare & Medicaid Services (CMS) (2010).Reporting Hospital Quality Data for Annual Payment Update: http://www.cms.gov/hospitalqualityinits/08_hospitalrhqdapu.asp • Division of the State Chief Information Officer South Carolina (2004). Business Case Methodology Template • Garets, D., & Davis, M. (2006). Electronic Medical Records vs. Electronic Health Records: Yes, There Is a Difference. [Editorial]. HIMSS AnalyticsTM, 1, 2. Retrieved May 15, 2010 from the World Wide Web: http://www.himssanalytics.org/​docs/​wp_emr_ehr.pdf. • HL7 Messages. (2010). Retrieved May 17, 2010 from HL7 International: http://www.hl7.org/​implement/​standards/​v3messages.cfm.

19. References • Horwood, F., & Macfarlane, J. (2002). Pneumococcal and influenza vaccination: Current situation and future prospects. Thorax: 2002 Year in Review, 57, II24- II30.  Retrieved May 19, 2010, from Alumni - ProQuest Medical Library. (Document ID: 210938771). • ImmTrac Texas Immunization Registry. (2009). Retrieved May 19, 2010 from Texas Department of State Health Services, Immunization Branch: http://www.dshs.state.tx.us/​immunize/​immtrac/​default.shtm. • Intro to HL7. (2010). [Electronic version]. [Digital Versatile Disc]. Ann Arbor, MI: HL7 International. • Minnesota Immunization Information Connection. (2009). Retrieved May 19, 2010 from Minnesota Department of Health, MDH: http://www.health.state.mn.us/​divs/​idepc/​immunize/​registry/​ index.html.

20. References • New York State Immunization Information System. (2009). Retrieved May 19, 2010 from New York State Department of Health, NYSIIS: http://www.health.state.ny.us/​prevention/​immunization/​ information_system/. • Nichol, K. L., Baken, L., Wuorenma, J., & Nelson, A. (1999). The health and economic benefits associated with pneumococcal vaccination of elderly persons with chronic lung disease. Archives of Internal Medicine,159(20), 2437-42.  Retrieved May 19, 2010, from Alumni - Research Library. (Document ID: 46325804). • Nichol, K. L., Wuorenma, J., & von Sternberg, T. (1998). Benefits of influenza vaccination for low-intermediate-, and high-risk senior citizens. Archives of Internal Medicine, 158(16), 1769-76.  Retrieved May 19, 2010, from Alumni - Research Library. (Document ID: 34057099).

21. References • Oregon Immunization ALERT. (2010). Retrieved May 19, 2010 from Oregon Department of Human Services, Oregon Immunization ALERT: http://www.immalert.org/​new/. • Porter, S. (2009). Physician Participation Key to Role Immunization Registries Play in Vaccination Efforts. Retrieved May 19, 2010 from American Academy of Family Physicians, AAFP News Now: http://www.aafp.org/​online/​en/​home/​publications/​news/​news- now/​vaccine/​20090804vacc-registries.html. • Scientific Technologies Corporation. (2010, January). Leveraging Statewide Immunization Registry Data Assets. [Brochure]. [Electronic version]. Tucson, AZ: Author. • State/Local Immunization Information Systems . (2010). Retrieved May 15, 2010 from CDC, State / Local IIS Contact Information: http://www.cdc.gov/​vaccines/​programs/​iis/​downloads/​ state-contacts-iis-list.xls.

22. References • Vaccination Records: Finding, Interpreting, and Recording. (2009). Retrieved May 15, 2010 from Center for Disease Control and Prevention, CDC.gov: http://www.cdc.gov/​vaccines/​recs/​immuniz-records.htm.