To protect the health and environment of all Kansans by promoting responsible choices. KSWebIZ: HL7 Users Group Meeting January 26, 2011

To protect the health and environment of all Kansans by promoting responsible choices.Agenda ► Current Status ► CVX Updates  Intro of UF vs. NOS  Retirement of CVX 15  Meningococcal vaccines ► Data Quality  Duplicate Patients ► Upcoming reports To protect the health and environment of all Kansans by promoting responsible choices.

Private Provider live on KSWebIZ LHD live through direct entry LHD live through HL7 interface KSWebIZ Providers as of December 31, 2010 Statistics: 264 total providers live: 159 Private providers (5 interface, 23 non-VFC) 105 Local Health Departments (53 Direct entry, 52 interface)

To protect the health and environment of all Kansans by promoting responsible choices. KSWebIZ Statistics as of December 31, 2010 ► Number of Providers = 264  Private =159 (5 interface, 23 Non VFC)  Public =105 (53 direct entry, 52 interface) ► Number of Patients = 1,792,399 ► Number of Vaccinations = 14,778,855 ► Number of Vaccinations = 14,778,855

To protect the health and environment of all Kansans by promoting responsible choices. Patients by Updating User

To protect the health and environment of all Kansans by promoting responsible choices. Vaccinations by Updating User

To protect the health and environment of all Kansans by promoting responsible choices. CVX Updates ► Keeping up to date ► Unspecified Formulation vs. NOS ► Retirement of CVX 15 ► Meningococcal vaccines

To protect the health and environment of all Kansans by promoting responsible choices.

CVX Numbers ► Important to keep up to date ► CPT to CVX guide ►

To protect the health and environment of all Kansans by promoting responsible choices. CVX: Unspecified Formulation ► Term ‘Unspecified Formulation’ introduced to replaced ‘NOS’ aka Not Otherwise Specified ► ‘NOS’ has other meanings in HIT  Effort to harmonize medical terms for Health Information Exchange (HIE) purposes ► CVX number remains the same, just the description changes to ‘UF’  Note, ‘UF’ entries do not have a CPT code

To protect the health and environment of all Kansans by promoting responsible choices. CVX: Retirement of CVX 15 ► CVX 15 (Influenza) is being retired  Overused ► CVX 140 (Influenza, seasonal, Pfree)  CPT  CPT – 6-35 months  CPT – greater than 36 months ► CVX 141 (Influenza, seasonal)  CPT months  CPT – greater than 36 months

To protect the health and environment of all Kansans by promoting responsible choices. Meningococcal CVX numbers ► New numbers have been added recently ► Product names add to the confusion DescriptionCVXCPTProduct Name MCV4O Menveo MCV4P Menactra MPSV Menomune C conjugate103n/a Unspecified Formulation 108n/a

To protect the health and environment of all Kansans by promoting responsible choices. Data Quality ► Impact ► Duplicate Patients  Upcoming reports ► Duplicate Vaccines

To protect the health and environment of all Kansans by promoting responsible choices.

Data Quality ► Impact of poor data quality  Costly to diagnose and assess  Costly to repair ► More KSWebIZ deduplication daze  Impacts quality of care & patient safety  Erodes trust in system (KSWebIZ)

To protect the health and environment of all Kansans by promoting responsible choices. Duplicate Patients ► Matching criteria:  First & last name  DoB  SSN ► If more than one match has been found:  Gender  Middle name  Alias name  Mother’s maiden name  Mother’s name To protect the health and environment of all Kansans by promoting responsible choices.

Cultural Surnames* ► Naming conventions for non-western names ► Chinese typically written family name first  Yao Ming => Last name ‘Yao’ ► Multiple family names (e.g. Hispanic)  Ricardo Gonzalez + Carmen Ramirez = Rosa  Rosa Gonzalez Ramirez = ok  Rosa Gonzalez = ok  Rosa Ramirez = not okay * Privacy and Security Solutions for Interoperable Health Information Exchange

To protect the health and environment of all Kansans by promoting responsible choices. Bad SSNs ► Impact of bad SSNs ► Impact of not updating KSWebIZ with a new SSN  Queries won’t find their match  Remember to update KSWebIZ whenever any demographic information changes To protect the health and environment of all Kansans by promoting responsible choices.

Duplicate Patients: Illustrated Vital Records Bart Simpson DoB: 3/6/2003 SSN: HepB: 3/3/2003

Duplicate Patients: Illustrated CHD B Bart Simpson DoB: 3/6/2003 SSN: CHD A Bart Simpson DoB: 3/6/2003 SSN:

To protect the health and environment of all Kansans by promoting responsible choices. Duplicate Patients: Now What? ► Call the helpdesk ► Data entry tips  Make sure SSN is the patient’s  Correctly spelled names ► Take into account special characters  E.g. Hyphen, tilde, apostrophe, …

To protect the health and environment of all Kansans by promoting responsible choices. KSWebIZ Dup Patients ► Donna Conley (Data Quality Guru)  Always cleaning up duplicates ► However, potential duplicate still at CHD ► KSWebIZ fix needs to happen at CHD too ► Duplicate report

To protect the health and environment of all Kansans by promoting responsible choices. Example: Duplicate Patient Report

To protect the health and environment of all Kansans by promoting responsible choices. Example: Closer Look

To protect the health and environment of all Kansans by promoting responsible choices. Example: Duplicate Patient Report

To protect the health and environment of all Kansans by promoting responsible choices. Steps: Dup Patient Report 1. KSWebIZ: Generate CHD report 2. KSWebIZ: password protected zip file 3. LHD: Refer to instructions for fixing 4. LHD: Call / Donna for questions ► Initially just Vital Record duplicates

To protect the health and environment of all Kansans by promoting responsible choices. Duplicate Vaccines ► Making sure your procedures are accurate  E.g. Hibtiter vs. Hib PRP-T (aka ActHib) To protect the health and environment of all Kansans by promoting responsible choices.

Duplicate Vaccines: Illustrated Provider A KSWebIZ Bart Simpson, Historical Hibtiter (CVX=47), DoS=6/13/2005,

Duplicate Vaccines: Illustrated LHD A KSWebIZ Bart Simpson, Administered ActHib (CVX=48), Lot #=AA1234, DoS=6/13/2005 No duplicate created as the vaccine is from the same date and the same antigen family.

Duplicate Vaccines: Illustrated LHD A KSWebIZ Bart Simpson, Administered ActHib (CVX=48), Lot #=AA1234, DoS=6/13/2005 Bart Simpson, Historical Hibtiter (CVX=47), Lot #=AA1234, DoS=6/13/2005, Bart Simpson, Historical Hibtiter (CVX=47), Lot #=AA1234, DoS=6/13/2005, Duplicate created because CVX 47 not equal to CVX 48.

To protect the health and environment of all Kansans by promoting responsible choices. Duplicate Vaccines: Now What? ► Immunization Hx Screen (SM-109) ► If you are not the administering LHD:  Delete your history (ie. Accept the entry from KSWebIZ) ► If you are the administering LHD:  Call KSWebIZ Helpdesk

To protect the health and environment of all Kansans by promoting responsible choices. Questions?

Contact Information Mike McPherson KS IIS Interface Coordinator Kansas Department of Health & Environment Donna Conley KSWebIZ Data Quality Coordinator Kansas Department of Health & Environment http://kdheks.gov/immunize/webiz.html To protect the health and environment of all Kansans by promoting responsible choices.