1. RPMS Immunization Package Training – PATIENT MENU
Version 8.5*5
Amy Groom, MPH
IHS Immunization Program Manager

2. Some basic tips To go back to a previous screen, enter “^” (shift 6)
To save changes and exit, hit the F1 key and “E” in quick succession
To quit and go back to the previous screen WITHOUT saving changes, hit the F1 key and “Q” in quick succession

3. Patch 5 – Key Changes
Additional functionally required for Meaningful Use
Updated Smoking Health Factors used for determining High Risk Pneumo forecasting
Correction to HPV coverage calculation for Males
Addition of new vaccine codes, including all new influenza vaccine codes, to the Vaccine Table
Addition of new manufacturer code to the Manufacturer code table– Protein Sciences
Change in RPMS short names for influenza vaccines to reflect new CDC nomenclature
Change in Influenza report to capture vaccines given starting July 1st
Update to NDC code table to include new flu vaccine NDC codes
Updated influenza vaccine forecasting to include new influenza vaccine codes

4. Influenza Vaccines in RPMS Version 8.5*5
CVX Code
Full vaccine name (CDC abbreviation)
RPMS Short Name
Brand
Manufacturer
Trivalent Inactivated Vaccines (IIV3)
141
Influenza, seasonal, injectable, trivalent
FLU-IIV3
Afluria®, multi-dose vial
CSL Limited
FluLaval® , multi dose vial
ID Biomedical Corp.
Fluvirin® , multi dose vial
Novartis
Fluzone®, multi dose vial
Sanofi Pasteur
140
Influenza, seasonal, injectable, preservative free , trivalent
FLU-IIV3pf
Afluria®, single dose syringe
Fluarix® single dose syringe
GSK
Fluvirin® , single dose syringe
Fluzone®, single dose syringe, single dose vial
144
Seasonal influenza, intradermal, preservative free, trivalent
FLU-DERMAL
Fluzone® Intradermal
135
Influenza, high dose seasonal, preservative-free
FLU-HIGH
Fluzone® High Dose
155
Seasonal, trivalent, recombinant, injectable influenza vaccine,
preservative free (RIV)
FLU-RIV3
FluBlok®
Protein Sciences
153
Influenza, injectable, Madin Darby Canine Kidney, preservative
free (cell culture) (ccIIV3)
FLU-ccIIV3
Flucelvax®
Quadrivalent Inactivated Vaccines (IIV4)
150
Influenza, injectable, quadrivalent, preservative free
FLU-IIV4pf
Fluarix® Quadrivalent, single dose syringe
Fluzone® Quadrivalent,single dose syringe and single dose vial
158
Influenza, injectable, quadrivalent
FLU-IIV4
FluLaval® Quadrivalent, multi dose vial
Quadrivalent Live Attenuated Virus Vaccines (LAIV4)
149
Influenza, live, intranasal, quadrivalent (LAIV4)
FLU-LAIV4
FluMist®
MedImmune
Codes that should ONLY be used to record vaccines given elsewhere, if formulation is unknown 88
Influenza virus vaccine, unspecified formulation
FLU-NOS
None
Codes that should not be used this influenza season - Inactivate them in your vaccine table 15
Influenza virus vaccine, split virus (incl. purified surface
antigen)-retired CODE
FLU-TIVhx 16
influenza virus vaccine, whole virus
FLU-WHOLE
111
Influenza virus vaccine, live, attenuated, for intranasal use,
trivalent (LAIV3)
FLU-LAIV3
151
Influenza nasal, unspecified formulation
FLU-NasNOS
123
Influenza virus vaccine, H5N1, A/Vietnam/1203/2004
(national stockpile)
FLU-H5N1
Red denotes new RPMS Short Name

5. Flu Vaccines RPMS Immunization Package
New codes will be inactive in the Vaccine Table
Sites must activate them to use them
CVX code 111 – Flu-LAIV3 will be inactive
This is the trivalent LAIV (FluMist®) vaccine - will not be available this year
Forecasting
Same as last year – begins August 1st, ends March 31st
2 dose algorithm for children < 9 years included

6. Bug in Patch 5 – Temporary Fix
Issue: Disappearing vaccine histories for some adults in the EHR.
Solution: Because patch 5 contains critical information for patient care related to influenza, sites should install this patch.
To address the problem identified above, sites should either :
DISABLE the High Risk Factor Check in the Imm Managers' menu/ESP, parameter #18, or
Keep High Risk Factor Check ENABLED but remove SMOKERS.

7. Agenda PATIENT Menu SGL Patient Record Adding and Editing Data
Patient case data
vaccines you give today
historical vaccines
Forcing doses to be valid/invalid
ImmServe Profile
Lists and Letters
Generating Patient Lists

8. RPMS Immunization Package
MENU SYSTEM
PAT Patient Menu …
REP Report Menu …
MGR Manager Menu …

9. RPMS – Patient Menu PAT Patient Menu
SGL Single Patient Immunization Record
LET Print Individual Patient Letter
LLS Due Lists and Letters
The immunization record with forecasting you need when you walk into a patient’s room.
- also in the Health Summary
- also is what you see in EHR

10. PATIENT VIEW (IMM v8.5*4) Nov 21, 2012 10:54:14 Page: 1 of 5
Patient: PATIENT, DEMO DOB: 15-Apr-2011 (19 mths)
Chart#: at DEMO HOSPITAL Active Female M HBsAg: UNK
# Immunization History | Immunizations DUE on 11/21/2012
1 07/15/11 DTaP (KINRIX) Demo | HEP B PED past due
2 08/31/11 DTaP Demo | DTaP past due
| HIB,NOS past due
3 11/01/11 DTaP Demo | VARICELLA past due
| HEP A PED past due
4 07/15/11 IPV (KINRIX) Demo | PCV past due
5 08/31/11 IPV Demo |
6 11/01/11 IPV Demo | Last Letter: None
08/31/11 PEDVAXHIB Demo
8 11/01/11 PEDVAXHIB Demo | * CONTRAINDICATIONS/REFUSALS *
Scroll down to view more. Type ?? or Q to QUIT.
A Add Immunization D Delete Visit P Patient Edit
S Skin Test Add I ImmServe Profile C Contraindications
E Edit Visit H Health Summary L Letter Print
Select Action: Quit//
PATIENT VIEW (IMM v8.5*4) Nov 21, :54: Page: 1 of 5 Patient: PATIENT, DEMO DOB: 15-Apr-2011 (19 mths) Chart#: at DEMO HOSPITAL Active Female M HBsAg: UNK # Immunization History | Immunizations DUE on 11/21/ /15/11 DTaP (KINRIX) Demo | HEP B PED past due 2 08/31/11 DTaP Demo | DTaP past due | HIB,NOS past due 3 11/01/11 DTaP Demo | VARICELLA past due | HEP A PED past due 4 07/15/11 IPV (KINRIX) Demo | PCV past due 5 08/31/11 IPV Demo | 6 11/01/11 IPV Demo | Last Letter: None 08/31/11 PEDVAXHIB Demo /01/11 PEDVAXHIB Demo | * CONTRAINDICATIONS/REFUSALS * Scroll down to view more. Type ?? or Q to QUIT. A Add Immunization D Delete Visit P Patient Edit S Skin Test Add I ImmServe Profile C Contraindications E Edit Visit H Health Summary L Letter Print Select Action: Quit//

11. Active/Inactive in the Immunization Package – What does it mean?
Active/Inactive in the Immunization Package is independent of ‘Active” status in RPMS
Can be inactive in the immunization package, but still have an active chart
Active/Inactive ONLY impacts who is included in your childhood reports
3-27 month, Two year old
All children <36 months who reside in one of your GPRA communities are automatically activated into the immunization package
Can Inactivate children who meet the Moved or Going Elsewhere (MOGE) criteria
Active/Inactive status DOES NOT determine inclusion in Adolescent , Adult, or Influenza reports
Active/Inactive DOES NOT impact forecasting – software forecasts for all patients, regardless of status

12. Editing Patient Case Data
* * * EDIT PATIENT CASE DATA * * *
Patient Name: PATIENT, DEMO1 (19 mths) Chart#: 34000
Street: 1234 MAIN ST Patient Phone:
Cty/St/Zip: ALBUQUERQUE, NM 00087
_______________________________________________________________(The above data may be edited through Patient Registration.)
Case Manager: NURSE,DEMO1
Parent/Guardian:
Other Info: SHEEP CAMP IN SUMMER
Inactive Date: Inactive Reason:
Moved to/Tx Elsewhere: Ft. Defiance
Forecast Influ/Pneumo: Normal
Mother's HBsAG Status: Unknown State Registry Consent: YES

13. State Registry Consent Field
Use depends on rules around participation in state immunization registries
If an Opt -Out state (most states)
All patients are automatically entered into the registry unless they specifically say they don’t want to (Opt out)
Use consent field to record those who “Opt Out”
Leave registry consent field BLANK unless patient opts out of the registry – then enter “No”
Opt-In (MT)
Requires that patients specifically consent to have their data shared with the state registry (Opt in)
Use consent field to record those who “Opt in”
Leave BLANK unless patient Opts in – then enter “Yes”

14. Adding an Immunization
Imm v8.5* * * * ADD AN IMMUNIZATION VISIT * * *
Patient: PATIENT,DEMO DOB: 11-Nov-1985 (27 yrs)
Chart#: at DEMO HOSPITAL Inactive Female
_________________________________________________________________ Date: NOV 21, Category: Ambulatory
Vaccine: Tdap Lot#:
(Tdap)
NDC Code:
Inj Site: Vol: .5 ml
Location Type: IHS Location: DEMO HOSPITAL
Provider: USER,ASTUDENT
VIS Date: JAN 24,2012
Vac Elig:
_________________________________________________________________

15. NDC Codes NDC Codes are National Drug Classification codes
A unique code that identifies the Manufacturer, the vaccine type, and the presentation (e.g. syringe, vial)
NDC codes change frequently!
Currently can only enter NDC codes included in the drop down menu
Missing codes

16. Using Vaccine Eligibility Codes
Before using non – VFC vaccine eligibility codes, check with your state immunization program!
Add vaccine for a patient
In “Vaccine Eligibility” field
“??” to see all active codes
Type in code
can type in local label (uninsured adult) OR
standard code (e.g. CHA-01)

17. Imm v8.5*4 ADD AN IMMUNIZATIOIN VISIT
Imm v8.5* * * * ADD AN IMMUNIZATION VISIT * * *
Patient: PATIENT, DEMO DOB: 11-Nov-1985 (27 yrs)
Chart#: at DEMO HOSPITAL Inactive Female
________________________________________________________________
Date: NOV 21, Category: Ambulatory
Vaccine: Tdap Lot#:
(Tdap)
NDC Code:
Inj Site: Vol: .5 ml
Location Type: IHS Location: DEMO HOSPITAL
Provider: USER,ASTUDENT
VIS Date: JAN 24,2012
Vac Elig: ??
_________________________________________________________________
Choose from:
Unknown Unable to obtain
AKA ALASKA adultuninsured
ASA AMERICAN SAMOA uninsured adults
Imm v8.5*4 ADD AN IMMUNIZATIOIN VISIT

18. Invalid Doses
The forecasting software (ImmServe) will flag doses as invalid if:
Minimum age is not met
Minimum interval between doses is not met
Interval between 2 live virus vaccines is too short
Invalid doses are flagged with “*”, and the message “INVALID – SEE IMMSERVE”

19. Invalid Dose PATIENT VIEW (IMM v8.5*4) Mar 06, 2013 15:59:23
Patient: PATIENT, DEMO DOB: 15-Apr-2011 (22 mths)
Chart#: at DEMO HOSPITAL Active Female M HBsAg: UNK
Immunization History | Immunizations DUE on 03/06/2013
1 07/15/11 DTaP (KINRIX) Demo | HEP B PED past due
2 08/31/11 DTaP Demo | DTaP past due
| HIB,NOS past due
3 11/01/11 DTaP Demo | VARICELLA past due
| HEP A PED past due
4 07/15/11 IPV (KINRIX) Demo | PCV past due
5 08/31/11 IPV Demo | FLU-TIV past due
6 11/01/11 IPV Demo |
7 02/12/13 *IPV Demo | Last Letter: None
-INVALID--SEE IMMSERVE- | |
8 08/31/11 PEDVAXHIB Demo | * CONTRAINDICATIONS/REFUSALS
Scroll down to view more. Type ?? or Q to QUIT.
A Add Immunization D Delete Visit P Patient Edit
S Skin Test Add I ImmServe Profile C Contraindications
E Edit Visit H Health Summary L Letter Print
Select Action: Quit//

20. ImmServe Profile
ImmServe is the software that creates provider reminders/forecasts
ImmServe Profile gives you specific information re: what vaccines are due, will be due, and why doses are flagged as Invalid
To check the ImmServe Profile select “I” for ImmServe Profile.

21. Patient Immunization Profile Mar 06, 2013
PATIENT IMMUNIZATION PROFILE Mar 06, :21: Page: 3 of 6
Patient: PATIENT, DEMO DOB: 15-Apr-2011 (22 mths)
Chart#: at DEMO HOSPITAL Active Female
*** The Influenza dose on 11/7/2011 was given too soon after
11/4/2011.
Dose 2 of Influenza must be given at least 24 day(s) after
dose 1 of Influenza. This dose will therefore not count as part of the Influenza series.
*** The IPV dose on 2/12/2013 was given at too young an age.
Dose 4 of IPV must be given at or after 1457 day(s) of
age.
This dose will therefore not count as part of the OPV/IPV
series.
Enter ?? for more actions
Select Action: Quit//
Patient Immunization Profile Mar 06, 2013

22. Force a Dose to be Invalid
Select “E” to Edit the Immunization Visit
Select the visit with the vaccine that you want to make invalid
Enter “Invalid” in Dose Override Field; select reason for invalid
Imm v8.5* * * * EDIT AN IMMUNIZATION VISIT * * *
Patient: PATIENT,DEMO DOB: 28-Oct-1981 (31 yrs)
Chart#: at DEMO HOSPITAL Inactive Male _________________________________________________________________
Date: APR 28, Category: Ambulatory
Vaccine: TD (ADULT) Lot#:
(Td-ADULT)
NDC Code:
Inj Site: Vol: ml
Location Type: IHS Location: IHS HOSPITAL
Provider:
VIS Date: Reaction:
Vac Elig: V04 - Am Indian/AK Native Dose Override: INVALID
_________________________________________________________________
INVALID-BAD STORAGE
INVALID-DEFECTIVE
INVALID-EXPIRED
INVALID-ADMIN ERROR

23. Force a dose to be Valid Select “E” to Edit the Immunization Visit
Select the visit with the vaccine that you want to force to be valid
Enter “Force Valid” IN Dose Override Field
Imm v8.5* * * * EDIT AN IMMUNIZATION VISIT * * *
Patient: PATIENT, DEMO DOB: 15-Apr-2011 (22 mths)
Chart#: at DEMO HOSPITAL Active Female
__________________________________________________________________
Date: FEB 12, Category: Historical Event
Vaccine: IPV Lot#:
(IPV)
NDC Code:
Inj Site: Vol: ml
Location Type: IHS Location: DEMO HOSPITAL
Provider: GROOM,AMY
VIS Date: Reaction:
Vac Elig: V04 - Am Indian/AK Native Dose Override: FORCE VALID __________________________________________________________________
Exit Save Refresh

24. Add a Contraindication
CONTRAIND (IMM v8.5*4) Mar 06, :39: Page: 1 of 1
Patient: PATINET, DEMO DOB: 01-Feb-2009 (49 mths)
Chart#: 6666 at DEMO HOSPITAL Active Male
# Vaccine Reason Date Noted
Enter ?? for more actions.
A Add Contraindication D Delete Contraindication
E Edit Contraindication H Help
Select Action: Quit//A

25. Add a Contraindication
In Patient Record, select “C” for Contraindications
Select ‘Add” to add new contraindication
Imm v8.5* * * * ADD A CONTRAINDICATION * * *
Patient: PATIENT,DEMO DOB: 01-Feb-2009 (49 mths)
Chart#: 6666 at DEMO HOSPITAL Active Male
_______________________________________________________________
Vaccine: PERTUSSIS
(PERTUSSIS)
Reason: Anaphylaxis
Date Noted: MAR 6,2013
_________________________________________________________________
Enter the date on which this Contraindication was noted.

26. Skin Test PATIENT VIEW (IMM v8.5*4) Mar 06, 2013 15:41:19
Patient: PATIENT, DEMO DOB: 01-Feb-2009 (49 mths)
Chart#: 6666 at DEMO HOSPITAL Active Male M HBsAg: UNK
Immunization History | Immunizations DUE on 03/06/2013
1 08/24/10 FLU-TIVhx Demo | HEP B PED past due
2 10/07/10 FLU-TIVhx Demo | DTaP past due
| HIB,NOS past due
3 09/25/09 H1N1-pfree Demo | IPV past due
| MMR past due
4 02/01/10 PPD Demo | VARICELLA past due
(Negative 0mm) | HEP A PED past due
| PCV past due
| FLU-TIV due |
| Last Letter: None
Scroll down to view more. Type ?? or Q to QUIT.
A Add Immunization D Delete Visit P Patient Edit
S Skin Test Add I ImmServe Profile C Contraindications
E Edit Visit H Health Summary L Letter Print
Select Action: Quit// S

27. Imm v8.5*4 ADD/EDIT SKIN TEST VISIT
Patient: PATIENT, DEMO DOB: 01-Feb-2009 (49 mths)
Chart#: 6666 at DEMO HOSPITAL Active Male
_________________________________________________________________
Date: MAR 6, Category: Ambulatory
Skin Test: PPD Site: LEFT FOREARM Volume: .1 ml
Result: Reading: mm Date of Reading:
Location Type: IHS Location: DEMO HOSPITAL
Skin Test Provider: PROVIDER, DEMO
Skin Test Reader:
______________________________________________________________
Imm v8.5*4 ADD/EDIT SKIN TEST VISIT

28. Add Skin Test Result Imm v8.5*4 * * * ADD/EDIT SKIN TEST VISIT * * *
Patient: PATIENT, DEMO DOB: 01-Feb-2009 (49 mths)
Chart#: 6666 at DEMO HOSPITAL Active Male
________________________________________________________________
Date: MAR 6, Category: Ambulatory
Skin Test: PPD Site: LEFT FOREARM Volume: .1 ml
Result: POSITIVE Reading: 20 mm Date of Reading: MAR 6,2013
Location Type: IHS Location: DEMO HOSPITAL
Skin Test Provider: PROVIDER, DEMO1
Skin Test Reader: NURSE, DEMO1
______________________________________________________________________

29. Hands on Exercises SGL Patient Menu – Use Demo Patients!
Change patient status to Inactive in Immunization Registry
Add a MMR vaccine for today’s date
Add FluMist for yesterday’s date
Check the ImmServe profile to see why the MMR is invalid
Force the MMR vaccine to be Valid
Make the FluMist vaccine invalid because of poor storage
Add a contraindication for Varicella vaccine, Hx of Chickenpox

30. Immunizations in EHR

31. Electronic Health Record (EHR)
The EHR sits on top of RPMS Data entered into the RPMS roll and scroll will display in EHR
Data entered intoo the EHR will display in roll and scroll

32. EHR Immunizations What you can do Most SGL Patient Menu options
Enter/edit immunizations for a patient
Enter/edit contraindications
Enter/edit skin tests
Enter/edit VFC vaccine eligibility codes
Change active/inactive status
Change Case manager
What you can’t do
Access the Manager’s Menu
Change Forecasting options, VIS dates
Enter /Edit Lot numbers
Use Lists and Letters
Run Reports
Force dose to be valid/invalid
Add non-VFC vaccine eligibility codes

33. Immunization Tab in EHR

34. Add Immunization

35. Add Vaccine Eligibility Codes
Currently can only select VFC eligibility codes
EHR Patch 11 will have new state eligibility codes

36. Add Skin Test

37. Add Contraindication
Select Vaccine for, then add a contraindication

38. PatIEnt Lists and Letters

39. Patient Lists and Letters
Available in the PAT Menu
Roll and scroll only
Complement the canned immunization coverage reports
Allows you to run lists of patients based on different criteria
List of patients who received a certain lot#
Lists of patients who are due for certain vaccines
List of patients who received vaccines in a certain time period
Generate reminder letters for a listof patients

40. Immunization v8.5*4 Patient Menu
IMMUNIZATION v8.5* * PATIENT MENU * Site: DEMO HOSPITAL
================== User: GROOM,AMY
SGL Single Patient Record
LET Print Individual Patient Letter
LLS Patient Lists and Letters
You've got PRIORITY mail!
Select Patient Menu Option:
Immunization v8.5*4 Patient Menu

41. Immunization Lists & Letters
Immunization v8.5* Mar 06, :24: Page: 1 of 1
IMMUNIZATION LISTS & LETTERS
1 - Date of Forecast/Clinic..: 06-Mar-2013
2 - Age Range : 1-72 Months
3 - Patient Group (01) : Active
4 - Community : ALL
5 - Case Manager : ALL
6 - Designated Provider......: ALL
7 - Immunizations Received...: ALL
8 - Immunizations Due : ALL
9 - Health Care Facility.....: DEMO HOSPITAL
10 - Lot Number : ALL
11 - Additional Information...: None
12 - Order of Listing : by Patient Age
13 - Include Deceased : No
Select a left column number to change an item.
List of Patients Print Due Letters Help
Select Action: Quit//
Immunization Lists & Letters

42. Lists and Letters
To change a parameter, type in the number of the parameter
To change Age Range from Months to years
Type in Parameter # (2)
Type in “Y” to change to Years: “M” to change to Months
Patient Group
Can choose more then one, separated by a comma (e.g. 3,4 = Active, Inactive)
For lists that include adolescents or adults, ALWAYS include both “Active” and “Inactive” patient groups.

43. Hands on Exercises – Lists and Letters
Generate the following lists and include the total number:
Children 0 – 35 months who are Inactive ___________
Children 0 – 35 months inactivated between Jan 1, 2010-March 31st 2010 ______
Children 0 – 35 months automatically activated between Jan 1st 2011 – Dec. 31st 2011_____
Active and Inactive Adolescents yrs _____________
All Patients yrs who are Due for a Tdap ________
Patients due for a 2nd or 3rd dose of HPV _____
All children <5 who received a Varicella vaccine between Dec. 1st, – Dec. 31st 2010, ________
List of all AI/AN (e.g. beneficiary) patients < 5 years of age who refused a vaccine _________
List of all patients all ages who received seasonal flu vaccine Oct 31st, 2011.
List of children < 6 yrs who are due for a PCV, with parent/guardian name

44. Immunization Resources
RPMS Immunization Package User Manual
RPMS Application Documents
IHS vaccine preventable disease page
CDC vaccine resources
Immunization Action Coalition