kansas immunization registry (kswebiz) current … protect the health and environment of all kansans...

To protect the health and environment of all Kansans by promoting responsible choices.

Kansas Immunization Program

2011 Annual Conference

Topeka, KS

Timothy Budge, Trainer

Donna Conley, Data Quality Coordinator

Brittany Ersery, User Support Coordinator

Sherrie Forrestt, User Support

Michael McPherson, Immunization Registry Systems Coordinator

Michael Parsons, Outreach Coordinator

Debra Warren, Project Manager

Kansas Department of Health & Environment

Kansas Immunization Registry (KSWebIZ)

Current Status and Future Goals

Vision & Mission Statements • Vision:

– Any authorized user anytime and anywhere in the state of Kansas can immediately obtain comprehensive immunization information on any Kansas resident.

• Mission:

– To protect children and adults in Kansas from vaccine preventable diseases by providing a fully functional, effective and accessible web-based immunization information system that:

1. Consolidates immunization information from all immunization providers in the state (both public and private).

2. Provides secure access to all authorized users at any time.

3. Ensures high levels of data quality (timeliness, completeness and accuracy).

4. Provides full range of reports to support immunization practices and overall delivery of health care services.

5. Maintains compliance with the twelve NVAC approved functional standards for immunization registries.


Overall Goal of Project

• KSWebIZ will maintain a high level of data

quality and compliance with the NVAC approved

functional standards for immunization registries

and will contain a record with two or more

immunizations for 95% of Kansas children less

than six years of age by December 31, 2011.


June 2007 - Map


126 providers live

47 Local Health Departments

79 Private Providers 628 Users


Live Provider Sites as of August 22, 2008

County live on KSWebIZ (direct entry)

County live thru HL7*

*HL7 is a standard CDC interface format that communicates directly with KSWebIZ

Private provider live on KSWebIZ

Counties currently testing interface

Counties entering test phase December 2009

KSWebIZ Providers as of August 2011

Direct Entry

KIPHS

Insight

Statistics:

283 Total Providers Live

•178 Private Providers (4 Interface, 31 Non-VFC)

•105 Local Health Departments

•53 Direct Entry, 52 Interface

Private Provider Live on KSWebIZ

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KSWebIZ Schools Live as of August 2011

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In Training

No Status

Source: KDHE Immunization Program: 8/29/2011

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KSWebIZ Schools Live as of August 2011

Source: KDHE Immunization Program: 8/29/2011

Statistics:

School Districts Live: 242

Total Number of Schools Live: 872

Total Number of School Personnel Live: 484

Provider Site Enrollment Status (as of 8/2011)

• 283 total provider sites

– 178 private sites

• 4 interface

• 31 non-VFC

– 105 public sites (100%)

• 53 enrolled as direct entry sites

• 52 enrolled through interface


Current Statistics (as of 8/2011)

• Total number of patients = 1,848,220

• Up 5.1% from 2010

• Total number of vaccinations = 15,665,857

• Up 9.8% from 2010

• # of historical vaccinations = 13,039,540

• Up 3.1% from 2010

• # of administered vaccinations = 2,626,317

• Up 61.4% from 2010


Data Sources: Created Patients

14%

29%

33%

7%

0% 2%

15%

DE HL VR MM SN RX FF


Data Sources: Updated Patients

42%

34%

8%

5%

1% 3%

7%

DE HL VR MM SN RX FF


KSWebIZ Interface Work

• Established

– KIPHS, Insight, Office Practicum

• 57 providers

• Working with KHIN, LACIE

– HIEs


What is Meaningful Use

• Financial incentive

• Through use of certified EHR

• End goal:

– Incentive ($$)

– Reduction medical errors

• Prominent theme

– EHR, incentive, payment

HITECH Policies

Phase 1 (Capture/share data)

Phase 2 (Advanced care processes with decision support)

Phase 3 (Improved Outcomes)

2009

2011

2013

2015

Achieving Meaningful Use

Why Submit to an Immunization

Information System? • Objective: health outcomes policy priority

• Specifically – Improving population and public health

• Care goal: patient’s health care team communicates with public health agencies

• Other public health criteria:

– Syndromic surveillance

– Reportable lab results

However….

• State of Kansas allowing EPs & EHs to attest ‘exclusion’

• Resources diverted to building interfaces with Kansas HIEs:

– KHIN

– LACIE

• Individual interface building will resume after HIE interfaces established

Kansas IIS

HIE Provider

CDA, ???

MU

Provider

Bidirectional

HL7

Provider

HIE Provider

HL7 2.3.1

VXQ/VXU

KDHE

Health

Information

Exchange A

???

HL7 2.3.1

VXQ/VXU

???

Bidirectional

HL7

Provider

HL7 2.3.1

VXQ/VXU

...

...

Health

Information

Exchange B

KSWebIZ Future Goals

• Maintain a high level of data quality

• Comply with NVAC approved standards

• Two or more immunizations for 95% of Kansas

children less than six years of age

• Work with state-wide HIE effort

• Meaningful Use


Remainder of 2011

• Finalize interface for pharmacy

immunization data

• Continue recruiting providers

– Also looking at non-VFC providers

• Develop interface with 1 school system

• Maintain KWIC interface

• Pre-recorded trainings via KS Train


2011 continued…

• Assess the growth and quality of KSWebIZ data

and improve adherence to 12 Functional

Standards.

– Measure registry participation by geographic area.

• Develop a GIS report for public access that displays by

county the percentage of children <6 years with 2 or more

immunizations.

– Maintain potential duplicate patient records to < 1% of

full database.

– Refine method to detect and resolve potential

duplicate vaccines (within 5-7 days of each other).


Goals for 2012


• Achieve 95% of children <6 years with 2 more

immunizations in IIS.

• Continue to enroll and retain provider sites

– Interface

– Direct Entry

• Continue to enroll school nurses

• Develop and implement interface with IHS

system

• Finalize opt-in/opt-out for Direct entry

2012 continued…


• Continue to assess the growth and quality of

KSWebIZ data and improve adherence to 12

Functional Standards.

• Implement mechanism for online vaccine

ordering within IIS (Vaccine Ordering Module)

• Investigate options for an interface between

KSWebIZ and CLARIS (the state childcare

database).

2012 continued…


• Develop interface with new CDC vaccine

ordering system (VTrackS)

• Develop Billing Module

• Continue to facilitate HEDIS reporting

Accomplishments 2011 • .NET conversion

• Data security

• Reminder/safeguards/error-trapping

• Zip code lookup

• Cannot have future dates

• Help Desk can put attachments on

announcements page so watch for

administrative messages

• CDC link in recommender

• History of varicella


Accomplishments 2011

• Duplicates at < 1%

• Over 2M administered vaccinations (up

by over 50%)

• Online training for school nurses

• KSWebIZ recognized and published for

applying recommended best practices

for data quality measures. Yeah Niki!

• NIC presentations


Issues Being Addressed

• Recommender issues

• Big reports causing system to slow down

• Production log entries


Tips and Tricks

• Printing Vaccine Information Statements

• Completing a Vaccine Adverse Event

Reporting System

• Not Otherwise Specified (NOS) is now

Unspecified Formulation (UF)


…Tips and Tricks • Inventory

• Transferring vaccine to providers who

are not direct entry

• Reconciliation: When in Doubt, Call

Us!

• Printer icon on reconciliation page

only refers to that reconciliation time

period

• Adjustment reason ‘reconciliation’

translates to unaccounted for vaccine

• Add inventory when received

• Expire your vaccines in timely manner


…Tips and Tricks • Inventory

• Backdating – don’t do it!

• Do your reconciliation from your

reconciliation report – not from the on-

hand screen.

• Ramifications:

• Recalled vaccine

• Paying for unaccounted for vaccine

• Falsifying medical records

• Validity of patient records


Questions?


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