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CoCASA Questions and Answers on AFIX

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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.

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.

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.

Q: When I set up the questionnaire for AFIX visits, where can I access the selected custom and optional questions?

A: In CoCASA Version 8.2 and 8.3 custom and optional questions were added to the AFIX questionnaire set-up. To set-up the AFIX questionnaire go to the utilities tab and from the drop down menu select Set up 2013 AFIX Questionnaire/Review pre-2013 VFC-AFIX setups. The custom and optional questions will be accessible on this setup screen. If you select optional questions and/or include custom questions for the AFIX Questionnaire set-up, these selections will be available for AFIX visit data entry in the 2013 AFIX/Pre-2013 VFC-AFIX Evaluation tab.

Q: Will I need to set up my 2013 AFIX questionnaire again when I download CoCASA Version 8.2 or 8.3?

A: If you would like to add custom questions and/or optional questions to your AFIX site visit data entry within the 2013 AFIX and Pre 2013 VFC/AFIX Evaluation tab, then you will need to set up the questionnaire again. The optional and custom questions will only be available for AFIX visits conducted after the revised AFIX questionnaire has been set up.

Q: Where do I need to go to run the custom and optional question reports selected for AFIX visits?

A: To run the AFIX custom questions report for 2013, go to VFC-AFIX Reports and select VFC/AFIX Site Visit Questionnaire Custom Questions.

To run the AFIX optional questions report for 2013, go to VFC-AFIX Reports and select VFC/AFIX Site Visit Questionnaire Optional Questions.

Q: Does the VFC/AFIX Activities Core Report not work in CoCASA Version 8.2 (meaning the numbers that are generated are not correct)?

A: The Core Activities report is available in CoCASA Version 8.2 and 8.3, however, this report will exclude any 2013 VFC Site Visits. The numbers generated for 2013 AFIX-only visits and pre-2013 VFC/AFIX visits are accurate. All AFIX visits, whether conducted separately or jointly with VFC Visits, will be counted as AFIX-only visits.  The updated Core Activities Report will be available to run in an upcoming version of CoCASA.

Q: Where should I enter AFIX site visit information in 2013?

A: In CoCASA Version 8.2 and 8.3, the VFC-AFIX Evaluation screen used in previous versions has been replaced with the new 2013 AFIX/Pre-2013 VFC-AFIX Evaluation screen. This new screen must be used to enter all AFIX information collected from site visits or other AFIX contact made to enrolled VFC providers.

Q: How do I set up the questionnaire for AFIX visits?

A: Go to the utilities tab and from the drop down menu select Set up 2013 AFIX Questionnaire/Review pre-2013 VFC-AFIX setups. A window will pop up requesting a password. The password for setting up the AFIX questionnaire will remain the same for 2013. If needed, contact your AFIX coordinator for access to the password. The questionnaire will open and you can set up the 2013 AFIX Questionnaire in that window.

Q: Why does CoCASA consider a 4th dose of DTaP given at 4 months after dose 3 invalid?

A: CoCASA is a tool for implementing the AFIX process. The AFIX process is a continuous quality improvement strategy implemented to improve providers' immunization practices, including adhering to the ACIP Recommendations for childhood immunizations. Administering the 4th dose of DTaP between 4 and 6 months after DTaP3 is not the recommended standard of practice and should not be promoted as such.

ACIP does not refer to a DTaP4 dose given between 4 and 6 months after DTaP3 as "valid" or "invalid." ACIP simply states that these doses need not be repeated. Since they do not define them as "valid" or "invalid", the Missing Immunizations List and the Invalid Doses report include a note at the top of the reports to address this issue. This note at the top of the reports emphasizes that a provider should always use his/her clinical judgment before administering a vaccine. Since administering the 4th DTaP less than 6 months from the date of the 3rd dose is not the recommended standard of practice, the software is designed to adhere to the recommended interval. And since it is not the recommended standard of practice, administering the 4th DTaP outside the minimum intervals should not be a routine practice in providers' offices.

If after reviewing the CoCASA reports, you discover a provider is consistently administering the 4th DTaP less than 6 months from the 3rd dose, then this issue is of greater concern and would need to be addressed as a primary topic in the feedback session


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