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Unit D: Immunization Information Technology Infrastructure

Immunization Program Operations Manual (IPOM)

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Assure that the immunization information technology infrastructure supports program goals and objectives.

 

Overview

Immunization information technology infrastructure is the framework upon which hardware, software, and standards are used to enable disparate systems to interconnect computers and users to support the flow and processing of information. An immunization information system (IIS) is a confidential, computerized, population-based information system that collects and consolidates vaccination data from vaccine providers and provides tools for designing and sustaining effective immunization strategies at the provider and program levels. IISs inform vaccinators of upcoming vaccination needs; generate vaccination coverage reports, patient reminders or recalls for past due vaccinations; order vaccines for providers; manage vaccine inventory; and interoperate with electronic health record systems and CDC’s vaccine tracking system (VTrckS).

A fully operational IIS should meet all IIS Functional Standards by 2017. A Healthy People 2020 objective is to increase to 95% the percentage of children aged <6 years whose immunization records are housed in a fully operational IIS. Many IIS are lifespan and, therefore, collect and consolidate data on children, adolescents, and adults. In 2010, the Task Force on Community Preventive Services reported that there was strong evidence of IIS effectiveness and recommended that IIS be used to increase vaccination coverage. IISs are increasingly being utilized

  1. beyond traditional healthcare providers to include complimentary vaccinators, such as pharmacists;
  2. in other settings, such as school-located vaccination clinics; and
  3. during a vaccine-preventable disease response.

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References

 

Awardees must identify activities that will describe HOW the following required objectives will be accomplished. Suggested activities are provided for each objective, but awardees are strongly encouraged to think strategically about the specific activities that will best help them achieve this goal.

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Required Awardee Objective: D-1

Assure EHR-IIS interoperability readiness using IIS Functional Standards and facilitate Meaningful Use of EHR-IIS data.

 

Suggested Activities:

  1. Assess IIS progress towards meeting IIS Functional Standards of operations.
  2. Develop HL7 2.5.1 capacity, and provide a local implementation guide.
  3. Develop capacity for and implement bi-directional data exchange.
  4. Educate EHR vendors on requirements in order to build functionality into the EHR systems.

Reporting Elements:

  • Immunization Information System Annual Report.
  • Quarterly online CDC meaningful use survey.

Suggested Performance Measures (target to be defined by awardee):

  • Percentage of functional standards attained.
  • Implementation date for HL7 2.5.1 capability.

Allowable Funding Sources:

317 FA Operations, 317 DA Operations, VFC Operations

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Required Awardee Objective: D-2

Promote provider site participation and assure immunization record completeness, timeliness, accuracy, efficiency, and data use to support immunization program goals and objectives.

 

Suggested Activities:

  1. Identify all providers who administer vaccine in awardee’s jurisdiction, including both pediatric and adult immunization providers.
  2. Collaborate with partners and develop a provider recruitment strategy to include complementary vaccinators, such as pharmacists and school-located vaccination clinics.
  3. Encourage IIS participation among VFC providers.
  4. Develop a written plan and timeline to implement MIROW guidelines.
  5. Develop and implement a data quality process for incoming data feeds.
  6. Perform vaccination coverage assessments for local areas (e.g., counties, Census tracts, zip codes, etc.) within awardee's jurisdiction by age group and vaccine/vaccine series, using IIS to identify areas of lagging coverage and/or pockets of need. (See Required Objective B-1 of this IPOM.)

Reporting Requirements:

  • Immunization Information System Annual Report

Suggested Performance Measures (target to be defined by awardee):

  • Percentage of public/private and complementary immunization provider sites that routinely submit immunization events to the IIS.
  • Percentage of records that are accurate (IIS data reflects what occurred during the encounter), complete, and submitted in a timely manner.
  • Number of vaccination coverage assessments conducted using IIS.

Allowable funding sources:

317 FA Operations, VFC Operations

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Required Awardee Objective: D-3

Incorporate dose-level accountability into IIS functionality so that information can be received and stored. (Dose-level accountability includes assigning a provider-determined program eligibility category for a patient to each administered dose of vaccine.)

 

Suggested Activities:

  1. Conduct education and monitoring of providers to improve eligibility tracking and reporting.
  2. Conduct compliance assessments of eligibility screening practices using IIS in the field.
  3. Modify IIS to be able to receive eligibility data more consistently at the vaccine level for the age groups and eligibility categories that exist in awardee’s program.
  4. Build reporting functions and data quality checks within IIS to monitor compliance with eligibility screening.
  5. Educate EHR system vendors on the eligibility screening requirements in order to build functionality into the EHR systems.
  6. Modify local implementation guides to support collection of eligibility data at the dose level.

Reporting Requirements:

  • Immunization Information System Annual Report.
  • Percent of assessed providers who were in compliance with eligibility screening requirements.

Suggested Performance Measures (target to be defined by awardee):

  • Implementation dates for activities #3 and #4.
  • Percentage of providers assessed who were in compliance with eligibility screening requirements.

Allowable funding sources:

317 FA Operations, 317 DA Operations, VFC Operations

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Required Awardee Objective: D-4

Assure provider participation in vaccine ordering and inventory management using either VTrckS Direct or an ExIS (which could be an IIS or other external system) that communicates with VTrckS using the CDC-compliant interface.

 

Required Activities:

  1. Educate providers regarding awardee vaccine ordering policies, including CDC’s inventory-on-hand requirement and other awardee-supporting documentation requirements for vaccine orders.
  2. Develop and implement a plan for transitioning providers to electronic submission of inventory and orders using VTrckS or awardee’s ExIS.
  3. Monitor progress of the implementation of this transition plan.
  4. If using VTrckS Direct, ensure providers that will be using VTrckS for order entry acquire SAMS credentials for access.
  5. Train providers to use VTrckS or awardee ExIS for inventory and order entry.
  6. Develop and implement a plan for ensuring that new providers have access to and training for entering orders and inventory using VTrckS or awardee’s ExIS.

Reporting Requirements:

  • None.

Required Performance Measures:

  • Percent of providers submitting inventory and orders electronically, using VTrckS or awardee’s ExIS.
    • Target = 85% by one year after awardee has transitioned onto VTrckS

Allowable Funding Sources:

317 FA Operations, 317 DA Operations, VFC Operations, VFC Ordering

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Required Awardee Objective: D-5

Assure that annual IIS planning documents are developed or updated.

 

Required Activities:

  1. Develop a written five-year strategic plan (2013 - 2017) to include a needs assessment, vision and goals, compliance with NVAC functional standards, and a monitoring and evaluation* plan by March 31, 2013.
  2. For the first and each subsequent year, propose activities, timeline, and a budget designed to meet the specific goals for that year. Include all non-317 resource requirements (e.g., Medicaid, in-kind, state). Include a monitoring and evaluation* plan with indicators, metrics, and assigned resources.

    *This evaluation plan is a distinct, separate plan from the evaluation requirement in Required Objective B5.

Reporting Requirements:

  • Immunization Information System Annual Report
  • Semi-annual monitoring and evaluation report on progress or corrective actions, if required.

Required Performance Measures:

  • Annual plan is developed and approved by CDC.

Allowable funding sources:

317 FA Operations, VFC Operations

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