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SE MN Beacon Immunization Initiative Lacey Hart Dr. Rajeev Chaudhry

SE MN Beacon Immunization Initiative Lacey Hart Dr. Rajeev Chaudhry. SE MN Beacon Immunization Goals. Assess current processes of vaccine administration and documentation Collect baseline vaccination rates and assess improvements Conduct gap analysis

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SE MN Beacon Immunization Initiative Lacey Hart Dr. Rajeev Chaudhry

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  1. SE MN Beacon Immunization InitiativeLacey HartDr. Rajeev Chaudhry

  2. SE MN Beacon Immunization Goals • Assess current processes of vaccine administration and documentation • Collect baseline vaccination rates and assess improvements • Conduct gap analysis • Provide recommendations for improvement for population health

  3. Phase I: Gap AnalysisDecember 22 , 2010 – March 14, 2011 • Identified baseline metrics using Health Information Technology (HIT) across SE MN practices • Mayo Clinic Rochester (MCR): • Used Point of care decision support system to identify patients with chronic conditions • Provided decision support for providers for adult patients who need vaccinations during any visit in practice • Used population management system to identify population of patients who are due for vaccinations for a primary care practice • Integrated the process with state registry comparison

  4. Beacon Diabetic/Asthma Population Unvaccinated Intervention Current Data Flow Provider Schools Provider Provider Daycare Data Repository MIIC SEMIC Public Health Long-term Care facilities Pharmacies Employers

  5. Gaps Identified OMC Diabetic Population OMC Asthma Population MC Diabetic Population MC Asthma Population MHS Diabetic Population MHS Asthma Population WHS Diabetic Population WHS Asthma Population Immunization Filter Immunization Filter Immunization Filter Immunization Filter Unvaccinated MC/MHS Schools MIIC (SEMIIC) Registry Daycare Long-term Care facilities Unvaccinated WHS Public Health Providers Pharmacies Providers Employers

  6. Gap Analysis Method • Winona Health and Mayo Clinic Rochester identified all asthma and diabetic patients (age 18+) who have not received influenza vaccine in 2010 (MCR = 18,700 and WHS = 1,881) • Local records compared to MIIC database and found: • 910 Winona Health System eligible for influenza vaccine (Letters sent on 2/4/2011) • 5996 Mayo Clinic (Baldwin Family Medicine, Baldwin Primary Care Internal Medicine, Kasson Clinic, Mayo Family Clinic NE, Mayo Family Clinic NW) • Letters sent from MCR starting 2/10/2011 in a staggered manner • Letters sent by Winona in Feb 2011 • Monitoring and tracking vaccine improvement will continue through March 16, 2011

  7. Script for Response to Mailings Response to questions related to SE MN Beacon Immunization Initiative Thank you for your call. How can I help answer your question? Our records show as of December 31, 2010, you may not received a flu shot. Have you had your flu shot elsewhere? E.g. At a pharmacy? At a flu clinic at work? It isn’t too late to get your flu shot. Getting immunized is one of the best ways we can help keep ourselves healthy and safe from communicable diseases. Would you like to schedule an appointment to get your flu shot? Who is your primary care provider?

  8. Results of Letter Intervention Provider 1 Provider 2

  9. Gap Analysis • Identified 120 pharmacies in SE MN, only 14 participate in MIIC • Pharmacists who administer vaccination are required to notify primary care MD but may not report to MIIC; fax information to MD • Some pharmacies do not participate in Mark of Excellence training programs and may not report to MIIC • Corporate pharmacy policies direct vaccinations to corporate office (difficult to separate the 11 county area)

  10. Gap Analysis • Unclear who reports to MIIC at open flu clinics; Need exploration of employer flu clinic processes • Unclear of processes in schools, day care, long term care etc • Reporting delays impact point of care • Explore duplicates in population aggregate

  11. Issues Identified • Need to reinforce MIIC/SEMIC database enhancement & utilization as central repository for vaccination data to manage SE MN Beacon population health • Develop plan to address duplicates in population aggregate • Need further study needed in direct entry into MIIC and impact at the point of care • Review tracking and real time management of immunizations using SEMIC

  12. Issues Identified • Conduct process mapping of process work flows in retail pharmacies, day care, employer flu clinics etc and determine needs for data exchange from other sites of vaccine delivery and reporting • Define proactive practice intervention workflows for high risk population in need of vaccine • Explore SEMIC repository data access via other modes of electronic access (i.e. iPhone, iPad, etc)

  13. SE MN Beacon Immunization Initiative A patient story …. A gentleman called WHS re the letter his wife had received. He informed that his wife had been in a long term care facility in Winona for over a year now. He was confused as to why she had not been given a flu vaccine when they both got them every year. I checked her records, and informed him that she had not in fact gotten her vaccine. The gentlemen couldn’t believe that she was under the watchful eye of a doctor, and yet she hadn’t received her yearly flu vaccine at long term care facility. Husband took the letter to LTC and requested that she be vaccinated ..

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