1. Kansas Data Collection Methods and Outcomes for the 2009-2010 H1N1 Doses Administered Event Nichole D. Lambrecht, MSc., Sue Bowden, RN, Mike Parsons, Mike McPherson, and Debbie Baker Kansas Immunization Program Kansas Department of Health and Environment To protect the health and environment of all Kansans by promoting responsible choices. 44 th National Immunization Conference - Atlanta April 19, 2010 Slide 1

2. Objectives Slide 2  Illustrate KS IIS-CRA background and provider requirements.  Discuss KS internal process flow.  Review doses administered comparison to doses available.  Identify gaps in reporting requirements.  Discuss benefits of using KS-CRA.  Take a future look at process changes. To protect the health and environment of all Kansans by promoting responsible choices.

3. KS IIS Background (KSWebIZ) Slide 3  September 2009:  Patients = 1.5 million  Vaccinations = 12.2 million  240 provider sites  138 private providers  102 public (Local Health Depts)  312 schools  76 school districts To protect the health and environment of all Kansans by promoting responsible choices.

4. KSWebIZ Status as of Sept 2009 Slide 4 To protect the health and environment of all Kansans by promoting responsible choices. County live on KSWebIZ direct entry County live through HL7 interface Counties that will go through HL7 interface Private Provider live on KSWebIZ

5. KS CRA Background Slide 5  Full inventory management for vaccine, antiviral medication, PPE, etc.  Basic reports available.  Fully operational but was not tested in exercise nor live event.  Needed slight modifications for expedited mass entry point and aggregate reporting. To protect the health and environment of all Kansans by promoting responsible choices.

6. Reporting Requirements - LHDs Slide 6  KS local health departments (LHDs) reported at the patient level using a modified Mass Vaccination Quick Add screen.  Deadline for reporting was end of day on Monday following the previous week that doses were administered. To protect the health and environment of all Kansans by promoting responsible choices.

7. Reporting Requirements - PPs Slide 7  Private providers (all non LHDs) reported aggregate totals in modified screen called Weekly Activity Report.  Due by noon on Mondays. To protect the health and environment of all Kansans by promoting responsible choices.

8. Provider Database & Registration Slide 8 To protect the health and environment of all Kansans by promoting responsible choices.  All providers required to pre-register electronically so that data could be captured for data migration to KS- CRA and tracking purposes.

9. Process Flow - Pre-vaccine event Slide 9  Providers pre-registered on KDHE website.  LHD approved providers in county and sent signed provider agreements to KDHE.  Set up KS-CRA and VACMAN accounts.  KDHE trained H1N1 providers how to report on KS-CRA system. To protect the health and environment of all Kansans by promoting responsible choices.

10. Provider Registration Results Slide 10  Results as of April 3, 2010.  Providers pre-registered = 1712  Total Providers approved = 1118 105 = LHD 105 = LHD 554 = Private practice 554 = Private practice  184 = Hospital  129 = Pharmacy  98 = Community Vaccinator  23 = University Student Health  15 = Correctional Facility  5 = Military Health Care  5 = Indian Health Center  Total number of users = 2,671 (New = 2,331/Previous = 340)  LHD users = 722 (518 / 204)  All other users (aggregate reporting) = 1,949 ( 1813 / 136) To protect the health and environment of all Kansans by promoting responsible choices.

11. Vaccine Distribution & Tracking Slide 11  KDHE sends weekly allocations.  LHD receives and approves vaccine orders.  Entered into VACMAN and filled.  Vaccine shipment entered by KDHE and transferred in system.  Provider receives and administers.  Provider completes weekly report. To protect the health and environment of all Kansans by promoting responsible choices.

12. Doses Administered Comparison Slide 12  Data as of April 3, 2010  Doses administered is 73.6% of doses distributed.  Doses distributed is 73% of doses allocated to KS. To protect the health and environment of all Kansans by promoting responsible choices.

13. Doses Administered Breakdown Slide 13  KS population = ~2.7 million  Doses Administered as of April 3 rd, 2010  Total 653,059  35,613 = 6-23 m  61,022 = 24-59 m  204,295 = 5-18 y  31,210 = 19-24 y  135,160 = 25-49 y  101,655 = 50-64 y  84,104 = 65+ y To protect the health and environment of all Kansans by promoting responsible choices.

14. Gaps in Reporting Slide 14  Transfers between providers were not timely for providers’ report to be completed.  Reports not closed on time.  Data was consistently changing making it hard to analyze final numbers (people entering at all times of day/week).  Big reports slowed down system so had to run off regular hours.  Non traditional immunization providers not used to reporting requirements.  Did not have patient level data to analyze from private providers for further analysis. To protect the health and environment of all Kansans by promoting responsible choices.

15. Gaps in Reporting (cont.) Slide 15  Due to quick turn around time between reports data quality suffered.  Improper Screening:  Doses administered in the 0-5 month range or age unknown.  Some 3 rd and even 4 th doses actually given.  Bad data entry:  DOB same day as vaccination date or vice versa.  Vaccination date with wrong year (09 vs. 10).  Incorrect Reports:  Some PP reports were closed without inventory added.  Doses expired, were at times, marked as doses administered. To protect the health and environment of all Kansans by promoting responsible choices.

16. Reporting Problems Slide 16 To protect the health and environment of all Kansans by promoting responsible choices.

17. Benefits of using KS-CRA Slide 17  Utilized current depository of patient demographics.  Utilized in house staff and one additional FTE.  Could easily facilitate vaccine recalls and identify providers with expiring vaccine.  Could track vaccine transfers in system.  Quick reporting capacity.  Identified new immunization providers in KS.  Increased KSWebIZ numbers - March 2010  Patients = 1.7 million (increased since Sept ~200,000)  Vaccinations = 13.5 million (increased ~1.3 million) To protect the health and environment of all Kansans by promoting responsible choices.

18. Future Look at Process Changes Slide 18  Automate ordering distribution process and have vaccine transferred automatically into system upon shipment.  Require patient level reporting for all providers for increased flexibility on data assessments.  More options for reporting.  Fax, scan, email…  Good use of LHDs as intermediary to private providers.  Pharmacies good providers for immunizations so could utilize them more in future. To protect the health and environment of all Kansans by promoting responsible choices.

19. Questions? Slide 19 Shawnee County Health Agency Vaccination Clinics at Kansas Expo Center To protect the health and environment of all Kansans by promoting responsible choices.