GRITS: Innovative Challenges and Solutions

1. GRITS: Innovative Challenges and Solutions 4th Annual Immunization Registry Conference Atlanta, GA October 27, 2003 Tracy Ingraham Business Analyst Georgia Registry of Immunizations Transactions and Services (GRITS)

2. Overview • Background • GRITS Challenges • GRITS Solutions • Results • Conclusions

3. Background • Registry Law OCGA 31–12-3.1 passed April 8, 1996 • Contract signed August 26, 2002 • GRITS Pilot May- August 2003 • 4 Health Districts • 43 counties • 150 provider participants • Available Statewide September 2003

4. Pilot Results • Pilot Results – August 2003 • Change Proposal • The Registry Law Impact • Registry Law 31-12-3.1, Section 1, paragraph (e) states: “All children shall be enrolled unless a specific exemption is requested by the child’s parent or guardian….”

5. The Opt-out Challenge • Pilot results reflected • Need to identify opted-out clients • Need to track inventory of clients who have opted out of the immunization registry • Need for reporting to reflect opt-out client vaccine usage

6. Solution Objectives • Flag client as opted out of the registry • Reject attempts to amend opted-out client records via user interface or batch up-loads • Allow mechanism to track vaccine inventory for opted out client • Allow mechanism for client to opt back into registry

7. Defining the Solution • Design Definition Phase • Development Phase • Testing Evolution • Detailed Test Plans • User Test & Acceptance

8. Design Specifics • Design Phase • Provider-side Q&A • State and Vendor brainstorm sessions • Detailed System Design Documentation • Design Approval Process

9. Development Specifics • Development Phase • Vendor and state collaboration • Routine update & feedback sessions • Net-Meetings • Solution walk-thrus

10. Testing Specifics • Testing Phase • Vendor Test • State Test (State-level users & SME’s) • Lead Site Test

11. Solution Implementation • State Process • Provider Process • Vaccine Inventory Impact • User Interface versus Batch Loads

12. Process Specifics Two-Part Process • The state office • Receives opt-out requests from client • Flags client record as opted out • Maintains original opt-out form for all clients • The provider office • Initiates opt-out form submission • Identifies opted-out patient • Makes determination to decrement vaccine inventory

13. Provider Process • The GRITS User • Identifies opted out client • System notification • Chooses to decrement inventory • System Inventory Option • Inventory Management • Ensures vaccine reports reflect usage

14. Vaccine Reporting • Vaccine Reports Affected by Opt-Out Solution • Vaccine Usage Reports • Doses Administered Reports • Vaccine Accountability Reports

15. Results • User input resulted in modification • Validation of vendor-state design process post pilot • Mechanism to track inventory of opted out clients • Opt-out change as part of fully functioning vaccine inventory management module

16. Lessons Learned • Bring users in early • Keep users informed of delays • Be mindful of public & private user perspective • Develop SME relationships • Expect Change • Change is good • Keep vendor informed of change

17. Lessons Learned • Utilize various informational resources • Subject Matter Experts (SME’s) • Public & Private Provider Sites • AAP/Other partners • Plan to train & retrain • GRITS State-level users • GRITS Statewide users • GRITS Trainers

18. Additional Notes • Where are we today? • Current number of registry users • Developing full functioning vaccine inventory management • Interim Solutions • Implementation Dates

19. Next Steps • What Now? • Additional GRITS Changes (Phased Approach) • Potential Legislation Modifications • More users = More feedback

20. Thank You!