Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Doris G. Brown, RN, M Ed, MS, CNS Public Health Executive Director Louisiana Immunization Network for Kids StatewideScientific Technologies Corporation

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Presentation Objectives –Drill Overview –Drill Goals –Louisiana Challenges –General Systems Requirements –Solutions to Fit Drill Objectives –Real-Time Data Collected at the State EOC –Event Results –Looking Ahead – Prepare for All Event Scenarios

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Drill Overview Pandemic Flu Grant drill requirement: –2 mass vaccination clinics using influenza vaccine in each CRI city (4 total), 2 community sites. –Set up site as a point of dispensing clinic –Measure throughput

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Drill Overview, cont. LA has extensive experience with mass vaccination Challenge: 9 simultaneous sites, one in each Public Health Region All off-site, no public health buildings used 2 hours to set up, 6 hours of vaccination Opened the State EOC

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Drill Goals Open 9 simultaneous Community Point of Dispensing Sites Limited set-up time Use POD principals to set-up, operate, and evaluate site Offer free flu vaccine to the public for participating 200 vaccinations/hour at each site Open the State EOC to evaluate the drill real-time

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Core POD Team

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness POD Communications

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Louisiana Challenges Collecting patient & immunization data with paper forms has been problematic –Time consuming – data is handled at least twice –Inaccurate – illegibility, difficulties transcribing –Inefficient communications required to manage multiple sites, inventories, patient flows, etc. –Data not available for real-time inspection

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Louisiana Challenges, cont. Some skepticism and resistance to paperless data collection during an MI event Potential patient flow high due to a large mass media campaign –Each of the nine facilities expected average of 200 patients/hour –Unclear what actual flow would be

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Louisiana Challenges, cont. The Louisiana Immunization Network for Kids Statewide (LINKS) system is feature rich with steps and workflow to meet IIS standards Success of paperless reporting required –Streamlining the data entry steps –Reduce application training requirements –Reduce time of data entry per patient to less than that required to fill out a paper form

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness General Systems Requirements for Paperless Reporting Three system “levels” make up the LA solution –The SIIS (LINKS) –Mass Immunizations Module –Mass Immunizations Standalone Together, these systems can eliminate the problems of paper data collection and provide real-time or delayed electronic information for EOC activities.

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness General System Requirements for Paperless Reporting The SIIS (LINKS) –Fully featured statewide immunization information system. Provides extensive reporting on patients, vaccinations, vaccine inventory levels by facility –The EOC typically uses the system at this level during an event to determine patient flows and vaccine inventory levels –Accessible via the OPH network or via the Internet (includes wireless, wi-fi, cellular air-card, etc.)

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness General System Requirements for Paperless Reporting, cont. Mass Immunizations Module –Accesses the same database as LINKS –Can search against patients existing in the LINKS database –User interface designed specifically for mass immunization event requirements –Accessible via the OPH network or via the Internet (includes wireless, wi-fi, cellular air- card, etc.)

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness General System Requirements for Paperless Reporting, cont. Mass Immunizations Standalone –No network or Internet data access No real-time information for the EOC –No software to install on the PC or notebook –Self contained on USB memory stick (87 MB for small Java application) –Exports data to text files (three files: patients, vaccinations and contraindications) for upload to the SIIS

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Solution to fit the drill objectives Mass Immunizations Module – a Web-based module to LINKS –For the “front-line” user Three data entry screens –Search –Add patient –Select vaccination and optionally, contraindications –Save and search for next in line Fewer than 20 total possible data elements to complete Date and SSN field auto-masking Auto-fill city & state with entry of Zip code –Less than one minute to search, add, select and save data while patient is in line

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Solution, cont. Patient search

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Solution, cont. Patient add

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Solution, cont. Complete and save record Next patient in line…

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Data Entry Stations

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Full Mass Vaccination Clinic

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Solutions to fit the drill objectives, cont. For the manager/user… –The Mass Immunizations module provides Ease of use On-Site reporting –Patient names & counts by facility/date –Patient detail (demographic and vaccination) by facility/date For the EOC users –Using the same database, LINKS provides other management tools: Full power and tools of the SIIS application

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Real-Time data Collected at State Emergency Operations Center Real-time patient flow by site Real-time patient demographics by site Vaccine inventory by site Vaccine inventory by local providers near the site

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Event Results Activity at each facility much higher than projected –Expected 10,800 patients total –Expected 200 patients/hour for the six hour event at each of the nine facilities –Actual count for the six hours was approximately 27,000 patients/vaccinations –500 patients/hour average at each site

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Event Results, cont. Data entry –92% of the data entry completed in real-time –Backup plan (paper forms) used when Internet connectivity was lost at one facility –All data entry completed within 24 hours –Accuracy of data entry highly satisfactory –Users convinced of paperless reporting benefits

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Event Results, cont. Vaccine inventory supplies –Due to real-time data entry in Mass Immunizations, use of LINKS allowed managers at the EOC to project that all sites would run out of vaccine during the six hour period –Local stockpiles were assessed and vaccine was transferred. No sites ran out.

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Looking Ahead – Prepare for All Event Scenarios Be prepared! –System reliability and IT staff readiness –Consider standalone electronic applications for events with no network availability –Mass Immunizations, “USB Thumb Drive” version provides this capability to LA –Prepare to revert to paper forms as a backup option

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Drive-through Clinic

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Drive-through Clinic

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Conclusions Using LINKS Mass Immunization Module was a huge success Allowed for real-time data analysis Users report it was no more time consuming or complicated than paper Public/Media very supportive

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Contact Frank J. Welch, MD Medical Director, LA Immunization Program Ruben Tapia, MPH Program Manager, LA Immunization Program Mike Garcia Scientific Technologies Corporation