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this page:
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| General
Questions |
| Q:
Is CDC eliminating CASA and ACASA once CoCASA is completed?
We have providers that utilize both software programs for
evaluative purposes at this time. If they have to shift to
CoCASA, we need to gauge training needs.
A:
CASA
and ACASA will no longer be supported once CoCASA has been
made available. Obviously there will be a transition period
between the release of the new software and the lack of any
support for the existing software, but once CoCASA is made
available, all existing CASA and ACASA users are encouraged
to begin using the new software. (As for training needs, there
will be a training module within CoCASA that will help new
users learn the software.)
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| Q:
When we initially set up CoCASA we entered multiple user names
and they are all still listed in the log-on screen. We understand
what we did and why the names are there, but is there a way
to delete the names from the log-on screen?
A:
Unfortunately,
there is no way to delete names from the log-on screen once
they have been created.
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| Q:
If we didn't use your evaluation software for 2004 how will
we populate the 2005 version?
A:
We
are working on the ability to import information from a registry
or from VACMAN for the next release of CoCASA. For the time
being, you will need to manually enter the data into the 2005
software.
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| Q:
We have our own inventory system that we use as our PIN number,
and don’t readily have access to VACMAN numbers. Can
we use our inventory 11-digit PIN number?
A:
We
told people to use the VACMAN number as their PIN because
during one of the quarterly conference calls the majority
of people said the VACMAN number and the VFC PIN number are
the same. Also, in the next release, users will have the ability
to import provider information from VACMAN to populate the
database. If you don’t plan on importing from VACMAN,
then don’t worry. You can use whatever VFC numbering
system you currently have in place. Just remember, each provider
you enter into the database must have a unique VFC number.
So if you have several providers with the same PIN, you will
have to come up with a system for altering the PIN to make
it unique (e.g. adding a letter at the end of the number).
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| Q:
We like to sort our providers by specialty (Pediatrician,
Family Practice, etc). Should we just select ‘Other’
in the Provider Type variable and enter the specialty there?
A:
It
is important to first understand how the Provider Type variable
functions in the database before selecting ‘other’.
‘Provider type’ is an important
variable for the summary reports that you need to produce
for the annual VFC Management Survey. Currently, the report
reviews the ‘Provider Type’
field and classifies the provider as ‘Public’
or ‘Private’.
For example, the options ‘public
health dept clinic’
and ‘FQHC’
are classified as ‘Public’
in the report and the option ‘private
practice’
and ‘hospital
based - private’
are classified as ‘Private’
in the report. So, if you select ‘other’
for your pediatricians who are private physicians, these visits
cannot be incorporated into the report summary of your activities
as they cannot be included with either public or private visits.
We are considering adding a variable for ‘Provider Specialty’
to a future version of the software.
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| Q:
How is the variable ‘The number of children eligible
in the practice’, located on the Visit Information screen,
best determined? We find that most of our providers do not
know how many children they have in the 24- to 35-month-old
age group.
A:
The
‘number
of eligible children in practice’
variable is not a required field. To get this information,
most assessors ask the provider for an estimate, or take it
from a computerized list of age-eligible patients. If you
don't think the provider can give a good estimate (or a computerized
list is not available) then leave the field blank.
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| Q:
Is there a limit on how long a Custom Question can be?
A:
Yes.
The limit is currently set at 255 characters (for the multiple
choice question option this includes both the question and
the answers). However, if you exceed 150 characters, you will
not be able to see the entire text of the question.
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| Q:
Is it possible to create an open-ended question in the Custom
Question section?
A:
At
this time you cannot create an open-ended question. A solution
to work around this problem would be to create a multiple
choice question with broad categories. For example, if you
wanted learn the hours of service, you could create a multiple
choice question with the options of: normal business hours
(8-9 hours with appointments available between 8 a.m. and
6 p.m.), extended early business hours (appointments available
before 8 a.m.), extended late business hours (appointments
available after 6 p.m.), Saturday a.m. hours (morning), etc.
We are considering the possibility of including an open-ended
option in the Custom Questions setup for future software versions.
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| Installation,
Setup, and Compatibility |
| Q:
Can I install CoCASA on a network so that my staff can enter
data at their computer but the data is saved in one central
database?
A:
Yes.
There is a way to install CoCASA on your network (or a shared
drive) so that your staff can enter data in one, central database.
There are a few steps required to have this option set up.
We recommend that you contact us at nipCoCASA@cdc.gov
to assist with setting up your centralized database.
It
is important to note, however, that difficulties with using
CoCASA from a shared drive have been documented. In some cases
(particularly where users are accessing it remotely rather
than from one central site) the software has been very slow
to respond (slower than it is normally). Others have had the
application unexpectedly close. If these problems are experienced,
we recommend that you go back to using the database on your
individual hard drives and exporting data to one, central
database on a periodic basis.
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| Q:
Once the setup is imported, will it do any damage to import
it again (for a demonstration or by mistake)?
A:
You
will not do any damage by importing it again for demonstration
or by mistake. It will update your setup based on the latest
import, so just be sure you are importing the correct setup.
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| Q:
Is the software compatible with any type of hand-held computer
to use for direct on-site data entry during the actual site
visit?
A:
At
this time we have not yet tested the application on any hand-held
device, so we are not sure if the software is compatible.
There is a page
on the Microsoft website (exit site)
that lists the minimum system requirements and which machines
you should be able to deploy a .NET application.
|
| Q:
Is the software compatible with Windows 98?
A:
At
this time, we do not have a solution for running CoCASA under
Windows 98. The software programmers are looking into the
issue and will provide updates, when available.
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| Importing
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| Q:
If we retain all of the provider data and questionnaire data,
will duplicates be created when the import becomes functional?
Should the files be deleted before that? What do you suggest?
A:
There
should not be duplicate entries when you merge the data. The
software will be set to merge using the VFC PIN# for the providers.
As long as all users in a program use the same PIN for a provider,
then the visit data will all be merged into one record for
that provider. If different PIN numbers are used for the same
clinic, then you will have duplicate entries that will need
to be weeded out. This is why we are so adamant about unique
PIN numbers for each provider site and that everyone use them
consistently. If possible, populate all databases with the
provider names/address and PIN numbers from the start so that
differences are less likely to occur.
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| Q:
As we have several field staff that conduct VFC-AFIX visits
around the state, do you have any suggestion as to how we
can compile the information in CoCASA that we need to submit
with our Annual Report without having to do double entry?
Or are you expecting that the import function will be available
before the end of the year so we can import all the visits
and generate the reports we need for the Annual Report?
A:
The
import/export functions will be made available in the September
’05 patch release. You will be able to import data from
all end users in time to submit your annual reports to CDC
and elsewhere.
|
Q:
Can the field ‘Number of age-eligible children in provider
practice’ be imported along with the PINs prior to completing
visit information?
A:
Since
the number of age-eligible children is not a field in the
provider setup screen it cannot be imported.
|
Q:
How can our local import template be incorporated into CoCASA
so that it is available when the software is downloaded from
the web?
A:
Specific
instructions for this process have been added to the website
at the following location:
http://www.cdc.gov/nip/cocasa/cocasa_documentation.htm#importing
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|  Q:
How can I import my WinCASA sites to my providers that are
already in CoCASA?
A:
First
import your legacy WinCASA data into CoCASA. Then for each
assessment use the “Move” button on the Assessment
Setup tab to move each assessment from the provider that was
created from the import to the provider that was already in
CoCASA.
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| VFC/AFIX
Evaluation Module |
| Q:
If I conduct a follow-up site visit to see if a provider has
addressed issues of noncompliance from an earlier VFC Site
Visit, how do I document that visit? What type of visit would
this be?
A:
If
you do a follow-up visit, you should enter it as a new visit
and select ‘VFC
Follow-Up Visit’
as the purpose of visit. Although there is not currently anywhere
for you to enter notes summarizing the contents of that follow
up visit, the assumption is that you are following up on the
corrective actions you recommended at the previous VFC site
visit.
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| VFC
Site Visit Questionnaire |
| Q:
Regarding the storage section of the questionnaire, it has
fields for up to five different refrigerators. Our concern
is that our representatives won't remember which refrigerator
is which (when doing future site visits). This would be an
example where the person conducting the VFC site visit should
enter side notes for clarification.
A:
Since
there is not currently a separate notes field you may have
to keep track of information like this in a separate, electronic
file. If, however, one of the provider’s refrigerator
(or freezers) is outside the acceptable range, you can document
the exact location of this refrigerator in question #35 (where
you enter corrective actions). For example, “Refrigerator
#1 (next to sink in exam room #12) was out of the acceptable
temp. range. Vaccine needs to be moved to alternative unit
until temp can be controlled and monitored appropriately.”
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| Q:
If the provider's thermometer and our field representative's
thermometer have both been calibrated and certified, and if
there is a temperature difference (between thermometers, with
one outside the allowable range of proper storage), are there
any guidelines as to what is acceptable?
A:
If
the reviewer has brought their own thermometer to the practice,
then this is the temperature that should be entered into the
Site Visit Questionnaire. If this temperature is outside the
allowable range then the provider is not in compliance for
this aspect of vaccine storage.
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| Q:
Is there a way to lock the custom questions to ensure they
are always entered the same way?
A:
When
a questionnaire setup is exported or imported the custom questions
become locked and the end users cannot edit or deselect a
custom question. This way all exported/imported Custom Question
setups will be identical.
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| Q:
In the VFC Site Visit Questionnaire, why can’t I enter
data for question 22?
A:
Question
22 is auto-calculated by the computer. When you enter a temperature
in question 21, the computer will automatically determine
if the temperature was within the specified range and enter
the appropriate answer into question 22. After you enter data
into question 21 and then move your cursor to question 23,
the computer will fill in question 22.
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| Q:
When filling in information for the documentation section
of the survey, how should you answer question number 32 in
reference to VFC eligibility screening in the clinic/practice
if they are unable to provide you with records to review during
your site visit?
A:
Provider
offices should be contacted in advance of the VFC site visit
and informed of the purpose and expectations of the site visit;
including the specific number of records that should be made
available for review/inspection or available for the reviewer
to select from, depending on the protocol of the state VFC
Program.
If a reviewer finds that the provider records are not available
for inspection, the provider is noncompliant for this element
of the visit. Address the specific issue or reason with the
provider and schedule a follow-up visit within the next thirty
days. If records are located at an alternate location, schedule
a visit to that facility. If the records are not available
during the rescheduled visit, a letter should be sent from
the state program giving the provider a specific timeframe
to come into compliance. If compliance is not achieved, the
program should consider disciplinary actions such as suspension
from the program. Medical records maintenance is not only
a requirement for the VFC program, but a state requirement
and a Medicare and Medicaid requirement.
|
| Q:
How can I move the information listed in the box titled ‘Issues
Requiring Corrective Actions’
to the text box to the left (Question 35)?
A:
You
are not able to move information from the list on the right
to the text box on the left. The purpose of the list on the
right is to let you know in which high priority areas the
provider was noncompliant. The purpose of the text box on
the left is for you to document what actions you took with
the provider to correct the problems. For example, if the
list on the right said the provider was not recording temperatures
at least 2 times per day, you might enter “Reviewed
guidelines for recording temperatures with provider; instructed
provider to record temps at least 2x a day”
in the text box on the left.
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| Reports |
Q:
When I try to run the ‘VFC
Site Visit Questionnaire Results’
or ‘VFC
Site Visit Questionnaire Optional Questions’
reports, I get the following error message: “Index was
outside the boundaries of the array.” What does this
mean?
A:
This
error is due to a bug in that report. This problem has been
reported by a few users and is being fixed in the patch.
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Error
Messages |
Q:
I’m getting an error message that says “Failed
to load resources from resource file” when I start CoCASA.
What can I do to fix this?
A:
A.
Download and install Service Pack 1 for the .NET Framework
1.1 at http://www.microsoft.com/downloads/details.aspx?FamilyID=a8f5654f-088e-40b2-bbdb-a83353618b38&displaylang=en.
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Q:
I’m getting an error message that says “Foxpro
driver does not support this function” when I try to
import legacy WinCASA data. What can I do to fix this?
A:
If
you have Windows XP, download and install an updated Foxpro
driver at http://msdn.microsoft.com/vfoxpro/downloads/updates/odbc/default.aspx.
The
file you need to download and install is the VFPODBC.MSI file
(not the VFPODBC.MSM file). You should click on the link that
says “English” under the heading “VFPODBC.MSI”
towards the bottom of the web page.
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| Differences
between CASA and CoCASA |
| Q:
The missed opportunity* rate for most assessments is significantly
higher (twice as big in many cases) in CoCASA than in CASA…we
used the "at last visit" (vs "at any visit")
setting. Do you know anything that might help explain why
the missed opp rates are so different in CoCASA vs CASA even
when the assessments are seemly set up to run similarly?
A:
One
important difference between CASA and CoCASA is in the definition
of a “missed opportunity.” CoCASA considers the
patient’s entire immunization history, while CASA considers
only the doses that were given in the series specified by
the user.
For example, suppose a user runs the CASA Summary report for
the 43133 series and the child received a dose of DTaP, Polio,
MMR, HIB and HepB on his/her last visit to the office (the
last visit date for all vaccines is the same date), but the
child is still missing a DTaP4. The child also received an
influenza vaccine 9 months after this last visit. CASA would
consider the child as “not-up-to-date” but not
as a “Missed Opportunity” because it does not
consider the influenza dose…it’s not part of the
43133 series that the user specified. CoCASA on the other
hand, would classify the child in the “Missed Opportunity”
category because it does consider the entire history and the
child could have received a 4th dose of DTaP on the date that
he/she received the flu shot. Therefore, the Missed Opps would
be greater in CoCASA than in CASA.
It’s important to remember (as in CASA) that the Not
Up-to-Date categories in CoCASA are hierarchical and mutually
exclusive. Once a patient is identified as Not Up-to-Date,
the record is reviewed to determine if a missed opportunity
occurred. If not, then the record is reviewed to determine
if the child is eligible for any doses (meaning minimum ages
or intervals have been met on the day of the assessment).
If the child is eligible, then the record is reviewed to see
if the last visit was within the past 12 months or over 12
months ago.
*NOTE:
The answer above assumes that Missed Opportunities are defined
as “On the last Immunization visit”.
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Q:When
comparing single vaccine rates using the "ACIP Rec."
box vs not using ACIP recs., there are times when the single
vaccine rates actually are higher when the "ACIP rec."
box is checked (that was a very poorly written sentence).
I can't think of any reason why single vaccine rates would
be higher when the "ACIP Rec." box is checked but
that appears to be the case in some assessments.
A:
Most
likely you are looking at a report like the Diagnostic Report
which requires the user to select a series and then provides
the coverage for that series and each individual component
of that series. If this is the case, most likely HIB is the
issue. When the ACIP Recs are applied, the software is programmed
to accept 1 dose of HIB after 15 months as “up-to-date”
for HIB even if the series that was selected was the “43133”
(3 doses of HIB) series. If a user deselects “Apply
ACIP Recs”, then up-to-date for 3 doses of HIB would
count only situations where 3 dates were recorded for HIB.
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| Q:
What is the biggest difference between CASA and CoCASA?
A:
The
most important difference between reports results from CASA
and CoCASA is the option to Apply ACIP Recommendations. This
option is applied by default in CoCASA and means that only
valid doses are considered in the calculation of report results.
If a dose is determined as “invalid” by CoCASA,
then it is as if that dose never occurred. This can result
in a very different categorization of a patient included in
the Summary Report. For example, if a child received all doses
in the 43133 series before 24 months of age with the first
MMR after the first birthday, the child would be considered
“Up-to-Date” in CASA. However, if the 4th DTaP
was not given 6 months after the 3rd dose of DTaP, then this
child would be considered “Not Up-to-Date” in
CoCASA.
Deselecting the ACIP Recs.
The
“Apply ACIP Recs” option is only available in
CoCASA and is selected by default to apply all ACIP recommendations.
If it is deselected, all recommendations for minimum age and
minimum intervals between doses are not considered. The software
only counts the dates recorded for each vaccine type. In CASA,
the software does not consider minimum intervals for any report
that produces a coverage level, or rate. The CASA Summary
Report only verifies that the first dose of MMR and/or Varicella
was given after 12 months of age and that the specified series
was completed prior to 24 months of age
When
the “Apply ACIP Recs” option is deselected, the
results for CoCASA and CASA should be similar for the Up-to-Date,
Late Up-to-Date and Not Up-to-Date. They may not match exactly
because in this situation, CoCASA is not applying any ACIP
recommendations (minimum age, minimum interval, etc), but
CASA does look for a minimum age of 12 months for MMR and
Varicella. Therefore, the up-to-date rates in CoCASA may be
slightly higher. The biggest difference between CoCASA and
CASA when the “Apply ACIP Recs” is deselected
will be found in the 4 categories for “Not Up-to-Date”.
These four categories include: Missed Opportunities*, Not
Eligible for Vaccine, Last Visit <12 months and Last Visit
>= 12 months.
Without
applying the ACIP Recs, CoCASA will look for a missed opportunity
on the last visit date for any immunization regardless if
the minimum age or interval has been met (remember ACIP recs
are NOT applied). So, if a child received an immunization
but did not receive an immunization in all other vaccine groups
included in the series (i.e. 43133 series is selected in the
criteria and child did not get a MMR on the last immunization
date recorded), CoCASA will categorize that child as having
had a “Missed Opp” regardless if he/she has met
the minimum age of 12 months. CASA on the other hand, will
not consider this a Missed Opp, because the minimum age has
not been met. Therefore, the category results will drastically
differ.
*NOTE: The answer above assumes that Missed Opportunities
are defined as “On the last Immunization visit”.
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