Documentation, Registries and Performance Improvement Ruth Carrico PhD RN FSHEA CIC Associate Professor Division of Infectious Diseases University of Louisville

Objectives Review documentation requirements when vaccines are administered Describe current systems that are focused on meeting Meaningful Use guidelines Identify options that may assist the individual with maintaining their individual immunization records

Documentation Internal documentation – Patient (vaccine recipient) – System Needs External documentation – Billing – Reorder logs Documentation may be paper, electronic, or combination

Documentation Internal documentation – Patient (vaccine recipient) Consent forms VIS distribution ( date on the VIS and date given to patient) Vaccine, lot #, expiration date, site of administration, dose Patient tolerance Where dose administered (clinic location) and who administered Return visit(s) Adverse events

Vaccine Adverse Event Reporting System (VAERS) One component of the US vaccine safety monitoring system – About 30,000 reports submitted each year – Adverse event (happens after immunization) v. side effect (linked to the vaccine) VAERS repots monitored by CDC and FDA Anyone can submit a report to VAERS Reports used to determine the potential for a case-effect relationship that should be investigated

Documentation Internal documentation – System Needs Medication inventory/chain of custody Supply/equipment forms Monitoring of vaccine for return or credit Monitoring costs associated with the program Monitoring of vaccine that may be provided via a state or federal program

Documentation External documentation – Billing – Reorder logs

Kentucky Immunization Registry Partnership with the Kentucky Health Information Exchange (KHIE) Primarily focused on pediatric vaccines Can input adult vaccines Web-based connection (server-to-server input) or sharing data via VPN Step toward meeting Meaningful Use conditions

Meaningful Use One of the goals of the American Reinvestment & Recovery Act (ARRA) enacted Feb 2009 CMS established incentive program to encourage eligible providers and hospitals to adopt and use EHR systems Immunization registries/information systems are one of those EHR systems

Performance Improvement You measure what you treasure Performance improvement components – Personnel activities – Safe Injection Practices – Vaccine handling and management – Ordering procedures – Patient responses – Patient perceptions and values

Providing the Recipient with Documentation Goal is to engage the recipient in the immunization process that will go on throughout their lifetime Provide documentation in a manner that will be useful and meaningful to the individual Paper cards, forms, web link to EHR,

Objectives Review documentation requirements when vaccines are administered Describe current systems that are focused on meeting Meaningful Use guidelines Identify options that may assist the individual with maintaining their individual immunization records