introduction & traning for the pa-siis web...

PA-SIIS Update

PA Department of HealthBureau of Health Statistics & Registries

Kathy Till, RHIA

PA SIIS Registry Specialist

DisclosureI have no relevant financial

relationship with any proprietary entity producing, marketing, re-

selling, or distributing health care goods or services, used on, or

consumed by, patients.

Agenda

Background information

PA SIIS Implementation Types

Data Entry Challenges (HL7)

Meaningful Use (HL7 sites)

Background Information

PA-SIIS

Pennsylvania Statewide Immunization Information System

Background Information

The PA-SIIS is a statewide immunization registry and tracking system that serves the public health goal of reducing or eliminating vaccine preventable diseases. The PA-SIIS was developed to achieve complete and timely immunizations of individuals. Source: PASIIS Confidentiality Policy

Background Information

Use of Immunization Registry Data

The purpose of the PA-SIIS is to assist in deterring vaccine preventable diseases by collecting and tracking immunization histories through a shared network. Source: PASIIS Confidentiality Policy

Background InformationPA-SIIS

Internet based tracking system for immunizations

Population based (all ages)

Began in May of 2000

Software vendor (Avanza) since 2003

Background Information

Populated w/ PA birth records

(1996-2000)

Vital Events Registry populates PA-SIIS weekly

PA’s annual birth rate

• 143, 000/year

PA SIIS Implementation

Implementation Types-PA/AC Active Web & HL7 sites (Updating

patient records)

PA- 6396

AC – 1602 25%

PA SIIS Implementation

Implementation Types-PA/ACWeb Application sites -

PA- 771

AC – 567%

HL7/EHR sites –

PA - 5625

AC – 154627%

PA SIIS Implementation

Implementation status-PA/ACVFC ordering only (Inventory only) -

PA – 475

AC – 327%

Schools/Districts (View Only) –

PA 586/484

AC – 6211%

PA SIIS Implementation

Implementation status-PA/ACH1N1 sites – (2009-10) Currently Inactive

unless site has fully implemented SIIS via web application or HL7 interface

PA - 4,489

PA SIIS Implementation-PA

PA SIIS ImplementationPA vs Allegheny County (2015)

PA SIIS ImplementationAllegheny County

Large Groups: UPMC, AHN, Pediatric Alliance, Genesis Medical Associates, Preferred Primary Care Physicians, Heritage Valley Health System, Premier Medical Associates, UPMC CA Centers

PA SIIS ImplementationAllegheny County

Pharmacy Chains: Walgreens, Rite Aid, Sams Club, Walmart

IP Acute Facilities: UPMC (all including CHP), AHN-Forbes Regional, St Clair Hospital

IP facilities onboarding soon:

AGH (Nov 7, 2015)

OVH

PA SIIS Implementation

Immunization volume/Total (PA-March 2014)

Immunizations - 56,835,952

Patient Records - 7,124,025

PA SIIS Implementation

Immunization volume/Total

(PA-September 2015)

Immunizations – 68,568,437Patient Records – 8,692,789

PA SIIS Implementation

Immunization volume/Increase

(From March 2014 to September 2015)

Immunizations - 11,732,485Patient Records - 1,568,764

Immunization volume/Total(2014 vs 2015)

Patient Record volume/Total(2014 vs 2015)

PA SIIS Implementation

PAIIS Maturity rate Allegheny County and Statewide

(Excluding Philadelphia County)

Effective September 2015

PA SIIS Implementation

PAIIS Maturity rate

Definitions: Numerator: Total Number of Active Patients

in Geography and Age Group with 2 or more vaccines

Denominator: Total Number of Active Patients in Geography and Age Group

PA SIIS Implementation

PAIIS Maturity rate Under 19 YO

PA - 65.1%

AC - 76.9%

19 Years Old and Over

PA - 56.8%

AC - 65.9%

PA SIIS Implementation

Maturity rate

PA SIIS Implementation

Immunization volume/HL7

HL7 = Health Level 7

EHR Vendors – @ 25 implemented

Not all support bidirectional

PA SIIS Implementation

Immunization volume/HL7

PA - HL7 Transmissions/week = @ 131393 (Average)

AC - HL7 Transmissions/week = @ 27651 (Average)

21% from AC

PA SIIS Implementation

Immunization volume/HL7 - PA

HL7 (VXU=vaccine updates) Transmissions/week = @ 62579 (Average) 48%

HL7 (Queries) Transmissions/week = @ 68814 (Average) 52%

PA SIIS Implementation

Immunization volume/HL7 - AC

HL7 (VXU=vaccine updates) Transmissions/week = @ 5965 (Average)22%

HL7 (Queries) Transmissions/week = @ 21686 (Average)78%

PA SIIS Implementation Immunization volume/HL7 – PA vs AC

(Patient Summary) Vaccine History

ENT Column

Refers to how vaccination was entered into the PASIIS

A = Add History

G = Give Vaccine (link to Inventory)

U = Uploaded

ENT =HowEntered

A=Add History

G =Give Vaccine

ENT =HowEntered

U =Uploaded (HL7)

Data Entry Issues/challenges

Types of vaccines

Enter as administered

DTaP vs DTP vs Tdap

IPV vs OPV

Adult vs Child dose

Data Entry Issues/challenges

Combination vaccines

Enter as combination/not individually

DTaP-IPV-Hep B

DTaP-IPV-Hib

Hep B-Hib

Meaningful Use (HL7 sites)

Where did the term MU originate?

“The American Reinvestment & Recovery Act (ARRA) was enacted on February 17, 2009. ARRA includes many measures to modernize our nation's infrastructure, one of which is the Health Information Technology for Economic and Clinical Health (HITECH) Act. The HITECH Act supports the concept of Electronic Health Records.”Source: http://www.cdc.gov/ehrmeaningfuluse/

Meaningful Use (HL7 sites)

Meaningful use is using certified electronic health record (EHR) technology to:

• Improve quality, safety, efficiency, and reduce health disparities.

• Engage patients and family.

Meaningful Use (HL7 sites)

• Improve care coordination, and population and public health.

• Maintain privacy and security of patient health information.

Source: http://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives public health

Meaningful Use (HL7 sites)

3 stage Plan for providers to phase-in/Implement EHR technology

Stage 1 (Effective in 2010)

Data capture and sharing

Stage 2 (Effective 2013 for EH/2014 for EP)

Advance clinical processesSource: http://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives public health/

Source: http://www.cdc.gov/ehrmeaningfuluse/

Meaningful Use (HL7 sites)Stage 3 (Effective 2018)

Bidirectional function will be required for Stage 3 beginning in 2018 (2017 for early adopters*)

Improved outcomesSource: http://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives public health

*Source: Medicare and Medicaid Programs: Electronic Health Record Incentive Program --Stage 3 and Modifications to Meaningful Use in 2015 through 2017 -https://federalregister.gov/a/2015-25595

Meaningful Use (HL7 sites)

CMS/MA AuditsAudit Letter/period

Practice is certified with the PASIIS (not individual provider)

Contact Information

(W PA)/ ktill@pa.gov/ 412-209-6263

Bureau of Health Statistics and Registries

555 Walnut Street, 6th Floor

Harrisburg, PA 17101-1900

717-783-2548 (Harrisburg)

877-774-4748 (Toll Free)