Roll ‘Em… Statewide Rollout of Online Vaccine Ordering: Lessons Learned and Best Practices Featuring: Alaska, Arizona, Idaho, Louisiana, Mississippi Executive Producer and Narrator: Danielle Reader-Jolley

Where Our Story Begins… VMBIP announced in ~2007 with concept for VODS IWeb Consortium established requirements for IIS ordering system 2008 – VOMS (Vaccine Ordering and Management System) was born – interface with VACMAN was established 2008/2009 – Washington and West Virginia go live 2010 – Alaska, Arizona, Idaho, Louisiana and Mississippi go live Late 2010 VTrckS was born Late 2010 VOMS meets VTrckS during pilot with WA General feature functionality of VOMS

VOMS - A New Era Dawns Place orders, approve orders and receive orders Custom configurations Vaccine choice Standard and Depot Local approver levels Full accountability features Inventory transactions Lot Number Summary Cold chain Economic order quantity Allocation management Interface with either VACMAN or VTrckS Provider profile management Management reports General feature functionality of VOMS

VOMS: Provider Places Order

VOMS: State Fills Order

VOMS: Provider Receives Order

VOMS + VTrckS = TLA New export format – VACMAN vs. VTrckS Tracking and reporting of physical inventory New focus on the NDC Number – has turned out to have many benefits New support for typical dose volume tracking Reporting of line level order ID including line level urgency And some other stuff coming soon…

Now for the heroes of our story… (every story needs a hero!)

An Overview of Implementation * At the current time, all orders are entered into VOMS by AK state employees. State Average Orders per Week % Orders Processed through VOMS % Providers Directly Entering Own Orders via VOMS AK 40 100% 0* LA 150 42% 37.46% MS 80 AZ 180 40% 45% ID 85 98%

Alaska Rollout Process Flow: Rollout Strategy: Training Strategy: Two state employees enter, approve, and accept all orders entered into VacTrAK. All vaccine managed through a depot model Rollout Strategy: In 2011, Alaska will launch a pilot to train and allow providers to enter and accept their own orders. Eventually plan to have all providers entering and accepting all orders into VacTrAK. Training Strategy: Online training for all providers.

Arizona Rollout Process Flow: Rollout Strategy: Training Strategy: Provider enters order, state reviews/approves, sends to VACMAN, provider receives order and vaccinates.  Not using the inventory management tool at this time. Rollout Strategy: Piloted with County Health Departments first, then moved to hospitals, then to everyone else. Rolled out as part of the annual re-enrollment process  Training Strategy: AZ held in person training sessions and took it very slow for the original pilot sites – County Health Departments.  Hospitals and others were given access to a training video and a user manual. 

Idaho Rollout Process Flow: Rollout Strategy: Training Strategy: Provider enters order, state reviews/approves, send to VACMAN, McKesson file imported, provider receives order in VOMS after shipment arrives, the provider vaccinates child and attaches lot # to each administered vaccine Rollout Strategy: Legislative statute during 2010 legislative session Established Idaho Vaccine Assessment Fund Board Mandated online accountability reporting by all providers Prep for CDC’s rollout of VTrckS  Training Strategy: On site/in-person and WebEx.  Prior to the rollout, conducted a mass WebEx training campaign for providers.

Louisiana Rollout Process Flow: Rollout Strategy: Training Strategy: Provider enters order through VOMS, submits to state for approval, state approves, file is created from LINKS and uploaded to VACMAN, order is sent to McKesson and the provider receives the order into their inventory in LINKS. Rollout Strategy: Rollout is still ongoing. Pilot sites were public clinics. Secondary rollouts were high-volume providers. Medium and low volume providers are in process. Louisiana expects completion of the rollout by end of year 2011. Training Strategy: Louisiana trained providers via on-site personal training and regional trainings.

Mississippi Rollout Process Flow: Rollout Strategy: Training Strategy: Provider enrollments/profiles Provider enters order, local approver reviews order and makes sure clinic is updated, order approved by state approver, imported into VACMAN, provider receives order Rollout Strategy: Public health departments first, then private providers. Training Strategy: Training was provided on-site.

What have we learned from our heroes?

Lessons Learned Self taught personnel have learned and followed instructions better than those that were given personal trainings.  (AZ) The younger the office staff, the easier it is to train them. (AZ) Messages about the ordering process are key.  Get it down early and then stick with the same process and messages.  We have inconsistencies in the video and will need to re-do it because of process changes.  (AZ) Follow-up to make sure users are ordering correctly.  (LA) Make reconciliation of inventory mandatory each time a provider places an order. (LA)

Lessons Learned Training Best Practices (ID): Train only for 1.5 to 2 hours max.  Have a definite plan to move forward at the end and schedule additional trainings.  Make sure everyone who is a part of the ordering process will be there for the training.  Have many handouts.  Nursing staff like to have paper handouts they can keep handy.  Have providers count and enter all existing inventory prior to going live. If inventory is not maintained properly if will cause major problems for both clinics and the Immunization Program.  (MS) State users and support staff need to be well trained in VOMS. (MS)

Roll the Credits… Alaska Arizona Idaho Louisiana Mississippi STC Gerri Yett (gerri.yett@alaska.gov) Arizona Lisa Rasmussen (rasmusl@azdhs.gov) Idaho Jennifer Baker (bakerj1@dhw.idaho.gov) Louisiana Quan Le (quan.le@la.gov) Mississippi Christie Levy (christie.levy@msdh.state.ms.us) STC Danielle Reader-Jolley (Danielle_Reader-Jolley@stchome.com)