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

Overview Background Background GRITS Challenges GRITS Challenges GRITS Solutions GRITS Solutions Results Results Conclusions Conclusions

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

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

The Opt-out Challenge Pilot results reflected 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

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

Defining the Solution Design Definition Phase Design Definition Phase Development Phase Development Phase Testing Evolution Testing Evolution  Detailed Test Plans  User Test & Acceptance

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

Development Specifics Development Phase Development Phase  Vendor and state collaboration  Routine update & feedback sessions  Net-Meetings  Solution walk-thrus

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

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

Process Specifics Two-Part Process The state office 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 The provider office  Initiates opt-out form submission  Identifies opted-out patient  Makes determination to decrement vaccine inventory

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

Vaccine Reporting Vaccine Reports Affected by Opt-Out Solution Vaccine Reports Affected by Opt-Out Solution  Vaccine Usage Reports  Doses Administered Reports  Vaccine Accountability Reports

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

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

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

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

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

Thank You!