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RPMS Immunization Package Training – PATIENT MENU

RPMS Immunization Package Training – PATIENT MENU. Version 8.5*4. Amy Groom, MPH IHS Immunization Program Manager Amy.Groom@ihs.gov. Some basic tips. To go back to a previous screen, enter “^” (shift 6) To save changes and exit, hit the F1 key and “E” in quick succession

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RPMS Immunization Package Training – PATIENT MENU

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  1. RPMS Immunization Package Training – PATIENT MENU Version 8.5*4 Amy Groom, MPH IHS Immunization Program Manager Amy.Groom@ihs.gov

  2. Some basic tips • To go back to a previous screen, enter “^” (shift 6) • To save changes and exit, hit the F1 key and “E” in quick succession • To quit and go back to the previous screen WITHOUT saving changes, hit the F1 key and “Q” in quick succession

  3. Agenda PATIENT Menu • SGL Patient Record • Adding and Editing Data • Patient case data • vaccines you give today • historical vaccines • Forcing doses to be valid/invalid • ImmServeProfile • Lists and Letters • Generating Patient Lists

  4. RPMS Immunization Package • MENU SYSTEM • PAT Patient Menu … • REP Report Menu … • MGR Manager Menu …

  5. RPMS – Patient Menu • PAT Patient Menu • SGL Single Patient Immunization Record • LET Print Individual Patient Letter • LLS Due Lists and Letters The immunization record with forecasting you need when you walk into a patient’s room. - also in the Health Summary - also is what you see in EHR

  6. PATIENT VIEW (IMM v8.5*4) Nov 21, 2012 10:54:14 Page: 1 of 5 Patient: PATIENT, DEMO1 DOB: 15-Apr-2011 (19 mths) Chart#: 34000 at DEMO HOSPITAL Active Female M HBsAg: UNK # Immunization History | Immunizations DUE on 11/21/2012 1 07/15/11 DTaP (KINRIX) Demo | HEP B PED past due 2 08/31/11 DTaP Demo | DTaP past due | HIB,NOS past due 3 11/01/11 DTaP Demo | VARICELLA past due | HEP A PED past due 4 07/15/11 IPV (KINRIX) Demo | PCV-13 past due 5 08/31/11 IPV Demo | 6 11/01/11 IPV Demo | Last Letter: None 08/31/11 PEDVAXHIB Demo 8 11/01/11 PEDVAXHIB Demo | * CONTRAINDICATIONS/REFUSALS * + Scroll down to view more. Type ?? or Q to QUIT. A Add Immunization D Delete Visit P Patient Edit S Skin Test Add I ImmServe Profile C Contraindications E Edit Visit H Health Summary L Letter Print Select Action: Quit//

  7. Active/Inactive in the Immunization Package – What does it mean? Active/Inactive in the Immunization Package is independent of ‘Active” status in RPMS Can be inactive in the immunization package, but still have an active chart Active/Inactive ONLY impacts who is included in your childhood reports 3-27 month, Two year old All children <36 months who reside in one of your GPRA communities are automatically activated into the immunization package Can Inactivate children who meet the Moved or Going Elsewhere (MOGE) criteria Active/Inactive status DOES NOT determine inclusion in Adolescent , Adult, or Influenza reports Active/Inactive DOES NOT impact forecasting – software forecasts for all patients, regardless of status

  8. Editing Patient Case Data * * * EDIT PATIENT CASE DATA * * * Patient Name: PATIENT, DEMO1 (19 mths) Chart#: 34000 Street: 1234 MAIN ST. Patient Phone: 505-777-8888 Cty/St/Zip: ALBUQUERQUE, NM 00087 _______________________________________________________________(The above data may be edited through Patient Registration.) Case Manager: NURSE,DEMO1 Parent/Guardian: Other Info: SHEEP CAMP IN SUMMER Inactive Date: Inactive Reason: Moved to/Tx Elsewhere: Ft. Defiance Forecast Influ/Pneumo: Normal Mother's HBsAG Status: Unknown State Registry Consent: YES

  9. State Registry Consent Field • Use depends on rules around participation in state immunization registries • If an Opt -Out state (most states) • All patients are automatically entered into the registry unless they specifically say they don’t want to (Opt out) • Use consent field to record those who “Opt Out” • Leave registry consent field BLANK unless patient opts out of the registry – then enter “No” • Opt-In (MT) • Requires that patients specifically consent to have their data shared with the state registry (Opt in) • Use consent field to record those who “Opt in” • Leave BLANK unless patient Opts in – then enter “Yes”

  10. Adding an Immunization Imm v8.5* 4 * * * ADD AN IMMUNIZATION VISIT * * * Patient: PATIENT,DEMO2 DOB: 11-Nov-1985 (27 yrs) Chart#: 136175 at DEMO HOSPITAL Inactive Female _________________________________________________________________ Date: NOV 21,2012 Category: Ambulatory Vaccine: TdapLot#: (Tdap) NDC Code: Inj Site: Vol: .5 ml Location Type: IHS Location: DEMO HOSPITAL Provider: USER,ASTUDENT VIS Date: JAN 24,2012 VacElig: _________________________________________________________________

  11. NDC Codes • NDC Codes are National Drug Classification codes • A unique code that identifies the Manufacturer, the vaccine type, and the presentation (e.g. syringe, vial) • NDC codes change frequently! • Currently can only enter NDC codes included in the drop down menu • Missing codes

  12. Using Vaccine Eligibility Codes • Before using non – VFC vaccine eligibility codes, check with your state immunization program! • Add vaccine for a patient • In “Vaccine Eligibility” field • “??” to see all active codes • Type in code • can type in local label (uninsured adult) OR • standard code (e.g. CHA-01)

  13. Imm v8.5*4 * * * ADD AN IMMUNIZATION VISIT * * * Patient: PATIENT, DEMO1 DOB: 11-Nov-1985 (27 yrs) Chart#: 136175 at DEMO HOSPITAL Inactive Female ________________________________________________________________ Date: NOV 21,2012 Category: Ambulatory Vaccine: Tdap Lot#: (Tdap) NDC Code: Inj Site: Vol: .5 ml Location Type: IHS Location: DEMO HOSPITAL Provider: USER,ASTUDENT VIS Date: JAN 24,2012 VacElig: ?? _________________________________________________________________ Choose from: 999 Unknown Unable to obtain AKA-01 ALASKA-01 adultuninsured ASA-05 AMERICAN SAMOA-05 uninsured adults

  14. Invalid Doses • The forecasting software (ImmServe) will flag doses as invalid if: • Minimum age is not met • Minimum interval between doses is not met • Interval between 2 live virus vaccines is too short • Invalid doses are flagged with “*”, and the message “INVALID – SEE IMMSERVE”

  15. Invalid Dose PATIENT VIEW (IMM v8.5*4) Mar 06, 2013 15:59:23 Patient: PATIENT, DEMO1 DOB: 15-Apr-2011 (22 mths) Chart#: 34000 at DEMO HOSPITAL Active Female M HBsAg: UNK Immunization History | Immunizations DUE on 03/06/2013 1 07/15/11 DTaP (KINRIX) Demo | HEP B PED past due 2 08/31/11 DTaP Demo | DTaP past due | HIB,NOS past due 3 11/01/11 DTaP Demo | VARICELLA past due | HEP A PED past due 4 07/15/11 IPV (KINRIX) Demo | PCV-13 past due 5 08/31/11 IPV Demo | FLU-TIV past due 6 11/01/11 IPV Demo | 7 02/12/13 *IPV Demo | Last Letter: None -INVALID--SEE IMMSERVE- | |----------------------------- 8 08/31/11 PEDVAXHIB Demo | * CONTRAINDICATIONS/REFUSALS + Scroll down to view more. Type ?? or Q to QUIT. A Add Immunization D Delete Visit P Patient Edit S Skin Test Add I ImmServe Profile C Contraindications E Edit Visit H Health Summary L Letter Print Select Action: Quit//

  16. ImmServe Profile • ImmServe is the software that creates provider reminders/forecasts • ImmServe Profile gives you specific information re: what vaccines are due, will be due, and why doses are flagged as Invalid • To check the ImmServe Profile select “I” for ImmServe Profile.

  17. PATIENT IMMUNIZATION PROFILE Mar 06, 2013 16:21:23 Page: 3 of 6 Patient: PATIENT, DEMO1 DOB: 15-Apr-2011 (22 mths) Chart#: 34000 at DEMO HOSPITAL Active Female *** The Influenza dose on 11/7/2011 was given too soon after 11/4/2011. Dose 2 of Influenza must be given at least 24 day(s) after dose 1 of Influenza. This dose will therefore not count as part of the Influenza series. *** The IPV dose on 2/12/2013 was given at too young an age. Dose 4 of IPV must be given at or after 1457 day(s) of age. This dose will therefore not count as part of the OPV/IPV series. + Enter ?? for more actions Select Action: Quit//

  18. Force a Dose to be Invalid • Select “E” to Edit the Immunization Visit • Select the visit with the vaccine that you want to make invalid • Enter “Invalid” in Dose Override Field; select reason for invalid Immv8.5*4 * * * EDIT AN IMMUNIZATION VISIT * * * Patient: PATIENT,DEMO2 DOB: 28-Oct-1981 (31 yrs) Chart#: 555555 at DEMO HOSPITAL Inactive Male _________________________________________________________________ Date: APR 28,1995 Category: Ambulatory Vaccine: TD (ADULT) Lot#: (Td-ADULT) NDC Code: Inj Site: Vol: ml Location Type: IHS Location: IHS HOSPITAL Provider: VIS Date: Reaction: VacElig: V04 - Am Indian/AK Native Dose Override: INVALID _________________________________________________________________ 1 INVALID-BAD STORAGE 2 INVALID-DEFECTIVE 3 INVALID-EXPIRED 4 INVALID-ADMIN ERROR

  19. Force a dose to be Valid • Select “E” to Edit the Immunization Visit • Select the visit with the vaccine that you want to force to be valid • Enter “Force Valid” IN Dose Override Field Imm v8.5*4 * * * EDIT AN IMMUNIZATION VISIT * * * Patient: PATIENT, DEMO2 DOB: 15-Apr-2011 (22 mths) Chart#: 34000 at DEMO HOSPITAL Active Female __________________________________________________________________ Date: FEB 12,2013 Category: Historical Event Vaccine: IPV Lot#: (IPV) NDC Code: Inj Site: Vol: ml Location Type: IHS Location: DEMO HOSPITAL Provider: GROOM,AMY VIS Date: Reaction: VacElig: V04 - Am Indian/AK Native Dose Override: FORCE VALID __________________________________________________________________ Exit Save Refresh

  20. Add a Contraindication CONTRAIND (IMM v8.5*4) Mar 06, 2013 15:39:23 Page: 1 of 1 Patient: PATINET, DEMO1 DOB: 01-Feb-2009 (49 mths) Chart#: 6666 at DEMO HOSPITAL Active Male # Vaccine Reason Date Noted Enter ?? for more actions. A Add Contraindication D Delete Contraindication E Edit Contraindication H Help Select Action: Quit//A

  21. Add a Contraindication • In Patient Record, select “C” for Contraindications • Select ‘Add” to add new contraindication Imm v8.5*4 * * * ADD A CONTRAINDICATION * * * Patient: PATIENT,DEMO1 DOB: 01-Feb-2009 (49 mths) Chart#: 6666 at DEMO HOSPITAL Active Male _______________________________________________________________ Vaccine: PERTUSSIS (PERTUSSIS) Reason: Anaphylaxis Date Noted: MAR 6,2013 _________________________________________________________________ Enter the date on which this Contraindication was noted.

  22. Skin Test PATIENT VIEW (IMM v8.5*4) Mar 06, 2013 15:41:19 Patient: PATIENT, DEMO1 DOB: 01-Feb-2009 (49 mths) Chart#: 6666 at DEMO HOSPITAL Active Male M HBsAg: UNK Immunization History | Immunizations DUE on 03/06/2013 1 08/24/10 FLU-TIVhxDemo | HEP B PED past due 2 10/07/10 FLU-TIVhxDemo | DTaP past due | HIB,NOS past due 3 09/25/09 H1N1-pfree Demo | IPV past due | MMR past due 4 02/01/10 PPD Demo | VARICELLA past due (Negative 0mm) | HEP A PED past due | PCV-13 past due | FLU-TIV due | | Last Letter: None + Scroll down to view more. Type ?? or Q to QUIT. A Add Immunization D Delete Visit P Patient Edit S Skin Test Add I ImmServe Profile C Contraindications E Edit Visit H Health Summary L Letter Print Select Action: Quit// S

  23. Imm v8.5*4 * * * ADD/EDIT SKIN TEST VISIT * * * Patient: PATIENT, DEMO1 DOB: 01-Feb-2009 (49 mths) Chart#: 6666 at DEMO HOSPITAL Active Male _________________________________________________________________ Date: MAR 6,2013 Category: Ambulatory Skin Test: PPD Site: LEFT FOREARM Volume: .1 ml Result: Reading: mm Date of Reading: Location Type: IHS Location: DEMO HOSPITAL Skin Test Provider: PROVIDER, DEMO Skin Test Reader: ______________________________________________________________

  24. Add Skin Test Result Immv8.5*4 * * * ADD/EDIT SKIN TEST VISIT * * * Patient: PATIENT, DEMO DOB: 01-Feb-2009 (49 mths) Chart#: 6666 at DEMO HOSPITAL Active Male ________________________________________________________________ Date: MAR 6,2013 Category: Ambulatory Skin Test: PPD Site: LEFT FOREARM Volume: .1 ml Result: POSITIVE Reading: 20 mm Date of Reading: MAR 6,2013 Location Type: IHS Location: DEMO HOSPITAL Skin Test Provider: PROVIDER, DEMO1 Skin Test Reader: NURSE, DEMO1 ______________________________________________________________________

  25. Hands on Exercises SGL Patient Menu – Use Demo Patients! • Change patient status to Inactive in Immunization Registry • Add a MMR vaccine for today’s date • Add FluMist for yesterday’s date • Check the ImmServe profile to see why the MMR is invalid • Force the MMR vaccine to be Valid • Make the FluMist vaccine invalid because of poor storage • Add a contraindication for Varicella vaccine, Hx of Chickenpox

  26. Immunizations in EHR

  27. Electronic Health Record (EHR) • The EHR sits on top of RPMS Data entered into the RPMS roll and scroll will display in EHR • Data entered intoo the EHR will display in roll and scroll

  28. EHR Immunizations What you can do • Most SGL Patient Menu options • Enter/edit immunizations for a patient • Enter/edit contraindications • Enter/edit skin tests • Enter/edit VFC vaccine eligibility codes • Change active/inactive status • Change Case manager What you can’t do • Access the Manager’s Menu • Change Forecasting options, VIS dates • Enter /Edit Lot numbers • Use Lists and Letters • Run Reports • Force dose to be valid/invalid • Add non-VFC vaccine eligibility codes

  29. Immunization Tab in EHR

  30. Add Immunization

  31. Add Vaccine Eligibility Codes • Currently can only select VFC eligibility codes • EHR Patch 11 will have new state eligibility codes

  32. Add Skin Test

  33. Add Contraindication • Select Vaccine for, then add a contraindication

  34. PatIEnt Lists and Letters

  35. Patient Lists and Letters • Available in the PAT Menu • Roll and scroll only • Complement the canned immunization coverage reports • Allows you to run lists of patients based on different criteria • List of patients who received a certain lot# • Lists of patients who are due for certain vaccines • List of patients who received vaccines in a certain time period • Generate reminder letters for a listof patients

  36. IMMUNIZATION v8.5*4 * PATIENT MENU * Site: DEMO HOSPITAL ================== User: GROOM,AMY SGL Single Patient Record LET Print Individual Patient Letter LLS Patient Lists and Letters You've got PRIORITY mail! Select Patient Menu Option:

  37. Immunization v8.5*4 Mar 06, 2013 16:24:28 Page: 1 of 1 IMMUNIZATION LISTS & LETTERS 1 - Date of Forecast/Clinic..: 06-Mar-2013 2 - Age Range................: 1-72 Months 3 - Patient Group (01).......: Active 4 - Community................: ALL 5 - Case Manager.............: ALL 6 - Designated Provider......: ALL 7 - Immunizations Received...: ALL 8 - Immunizations Due........: ALL 9 - Health Care Facility.....: DEMO HOSPITAL 10 - Lot Number...............: ALL 11 - Additional Information...: None 12 - Order of Listing.........: by Patient Age 13 - Include Deceased.........: No Select a left column number to change an item. List of Patients Print Due Letters Help Select Action: Quit//

  38. Lists and Letters • To change a parameter, type in the number of the parameter • To change Age Range from Months to years • Type in Parameter # (2) • Type in “Y” to change to Years: “M” to change to Months • Patient Group • Can choose more then one, separated by a comma (e.g. 3,4 = Active, Inactive) • For lists that include adolescents or adults, ALWAYS include both “Active” and “Inactive” patient groups.

  39. Hands on Exercises – Lists and Letters Generate the following lists and include the total number: • Children 0 – 35 months who are Inactive ___________ • Children 0 – 35 months inactivated between Jan 1, 2010-March 31st2010 ______ • Children 0 – 35 months automatically activated between Jan 1st 2011 – Dec. 31st 2011_____ • Active and Inactive Adolescents 11-18 yrs _____________ • All Patients 11-12 yrs who are Due for a Tdap ________ • Patients due for a 2nd or 3rd dose of HPV _____ • All children <5 who received a Varicella vaccine between Dec. 1st, 2010 – Dec. 31st 2010, ________ • List of all AI/AN (e.g. beneficiary) patients < 5 years of age who refused a vaccine _________ • List of all patients all ages who received seasonal flu vaccine Oct 31st, 2011. • List of children < 6 yrs who are due for a PCV, with parent/guardian name

  40. Immunization Resources • RPMS Immunization Package User Manual • RPMS Application Documents • http://www.ihs.gov/RPMS/index.cfm?module=home&option=documents • IHS vaccine preventable disease page • www.ihs.gov/epi • CDC vaccine resources • www.cdc.gov/vaccines • Immunization Action Coalition • www.immunize.org

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