1. Assessment & Reminder Recall Becky Batchelor NC Immunization Branch

2. What is an Assessment? An assessment is a standardized routine collection, analysis and summary of immunization records

3. Why is it Important to Assess Immunization Rates? To increase immunization rates To ensure complete immunization records To identify pockets of need To help immunization providers to understand their true coverage rates

4. What’s my Goal?

5. NCIR Assessment Report

6. Numbers only report- helps you see your immunization rates right away. Keep track of your clients’ immunization status. Are they up to date? Do they need to come back in? Show the number of clients that could have been brought up to date with additional immunizations. Assessment of missed opportunities. How Will the Assessment Report Help Me?

7. 1. Evaluation Date: used to set the age range for the clients in the report. 2. Client Population: options are available based on what type of provider is requesting the assessment. What Information Do You Need to Run the Report?

8. To Run an Assessment Report Choose assessment report Select the Client Population

9. Choose assessment report Select your client population Select your evaluation date Click Generate when done Remember... only click Generate once!!!

10. If Status is Complete click on link under Job name Stage 1 Report Status!

11. Please be patient… You must wait 10 minutes before you can run another assessment report!

12. How to Understand the NCIR Assessment Summary Report

13. Verify the correct Client Population Note the Date Report Was Run Notice the Evaluation Date and How it corresponds to the Birth Date Range

14. Age Groups Include Clients Who Are: 36-72 months of age 24-35 months of age 12-23 months of age <12 months of age on the Evaluation Date, that was entered when the report was generated

15. Review the Number of Records Analyzed Verify the Birth Date Range corresponds with the age group(s) of interest. These birth date ranges will be used to generate the Request Reminder report to identify clients who are not up to date

16. Important Info! Records Analyzed shows how many active clients were in each Age Group as of the Date Report Was Run Data included in report is not updated in “real time” Changes made to a client’s information during a particular day will not be reflected until the next day

17. The “1-4” notation refers to the footnotes about benchmarks Immunization Status Table

18. Use months of age as your initial target group Benchmarks This is the % UTD For the 2 year olds

19. What I Need to Know… Age GroupBirth Date RangeRecords Analyzed 24 – 35 Months of Age01/01/2007 – 01/02/20068.8. Immunization Status Age (months)Up-to-Date (UTD) Late UTD @ Assessment 24 – 35 Months of Age 24 1 50.00%62.50% 12 2 75.00%87.50% 7373 62.50%87.50% 1) UTD by 24 months equals 4 DTaP, 3 HepB, 1 MMR, 3 HIB, 3 Polio 2) UTD by 12 months equals 3 DTaP, 2 HepB, 2 HIB, 2 Polio 3) UTD by 7 months equals 3 DTaP, 2 HepB, 2 HIB, 2 Polio

20. To Find a Count of the Number of Clients That are UTD: Immunization Status Age (months)Up-to-Date (UTD) Late UTD @ Assessment 24 – 35 Months of Age 2450.00%62.50% Records Analyzed 8.

21. A Look at Each Individual Vaccine at Different Ages (Benchmarks) A “benchmark” is used as a standard for measuring or assessing something

22. The Age Specific Immunization Benchmarks grid shows how many vaccines are needed to be considered UTD at specific age milestones.

23. Clients are Considered UTD at 24 Months if They Have Received: 4 DTaP, 3 HepB, 3 Hib, 1 MMR, 3 Polio, 3 Prevnar, and 1 Varicella

24. Age Specific Benchmarks

25. Clients who could have been UTD with ONE additional visit. There were 2 clients 24-36 months of age who could have been UTD with additional immunizations. This represents 25.0% of the total clients in this age group. 1 client needed only 1 vaccine to be brought UTD. That 1 client represents 50.0% of the 2 clients who could have been brought UTD.

26. Late Start or Dropped Off Schedule After a Good Start The upper portion of table shows Late Start Rates for 3 different age groups. The lower portion of table displays Drop Off Rates for 5 different age groups.

27. Studies have shown clients who start late are more likely to continue to be behind and therefore are not age appropriately immunized.

28. Calculating the Drop Off Rate Footnotes

29. No Birth Dose of Hep B and Have Not Completed the 3 Dose Series Note the footnotes here for further clarification of the clients being assessed.

30. Missed Opportunities NOTE: Missed opportunity on last visit may reflect incomplete documentation of immunization histories rather than true missed opportunities for simultaneous vaccination.

31. A Word About Alternative Schedules If your practice allows parents to vaccinate according to an alternate schedule this will affect your number of missed opportunities

32. Documenting Parental Refusals

34. Note the Client Comment and Applies to Date

36. RequestReminder Request Reminder Used to generate reports, letters, address labels, or a client listing for clients “active” in the organization. Unlike the Assessment report, the Request Reminder reports will show client specific information.

37. Determine which clients are not up to date with their immunizations. Provide a fast way to run a report with all the contact information for those clients that need to come back in. Improve immunization rates because you will be able to keep your clients up to date. The Reminder Recall Report will help to….

38. How Do I run the Request Reminder Report? How Do I run the Request Reminder Report? Click on the request reminder link under the Reports section Private Provider Health Department Which one are you?

39. Select vaccine group. The default is set to required vaccines. You can add or remove additional vaccines as necessary. Type in your birth date range Click Generate when done

40. Select the Client Population Select vaccine group.The default is set to required vaccines. You can add or remove additional vaccines as necessary. Type in your birth date range

41. Stage 1 – Click Refresh Stage 2 – Wait, It’s thinking!! Stage 3 –It’s Finished!!

42. What about Varicella?

43. Click on Omitted Clients Click Refresh When your report is ready click on the ‘Omitted Clients’ link

44. Take the omitted list and the client query list and “clean up” those records as much as possible How do I Fix the Omitted Clients?

45. Print the omitted client list Go back to Manage Client Add the responsible person information Notice! This client has a Chart Number Print the omitted client list Go back to Manage Client Add the responsible person information Omitted Clients

46. Go back to Manage Client Take the first client on your “Omitted Clients” list and enter the info into the Client search screen Click Find If you have chart numbers, you can search by that number

47. Click on the Responsible Person(s) Tab

48. Responsible Person Information Note that the √ has been removed from the “Notices?” box Note the last updated info. When you click the back button from the omitted clients, you will go back to the status page

49. Click the report link which is underlined in blue Type in the name of the report Click here

50. Click on the Report Link Report Link

51. Questions to Consider: Are there any active duplicate clients under my organization? Have all doses administered been keyed into NCIR? Have keyed doses been entered correctly? Are there clients that need to be made inactive?

52. Client Query Listing Look for not valid (NV) shots You can use the back button here

53. Client Query Listing Look for ‘blank’ records

54. Look for duplicate addresses Enter historical doses

55. Identify Duplicate Clients Don’t forget to report duplicates to the NCIR Help Desk!

56. Client Evaluation: –Responsible Persons: NC address and TX address –No doses entered since 2006 –Received confirmation from parent that patient now lives in Texas –Moved or Gone Elsewhere (MOGE) I’ve MOVED!

57. Last Updated by: WAKE COUNTY HUMAN SERVICES on 07/21/2009 Out of State

58. Unable to locate: 1.The client has not been seen by your office in the last 6 months 2.All available telephone numbers are no longer valid (disconnected or family no longer associated with number) 3.A postcard and/or letter has been returned as undeliverable and no other address information is known

59. to Run Request Reminder Again! Any time you edit client information (i.e. demographics, shot info.) the Request Reminder report must be run again in order to reflect the changes you have made

61. Report Status Report Link

64. Report Status Report is “ready” Click on link to view

65. What about HIPAA Compliance?

67. Report Status Click on link to view report

68. Mailing Labels correspond with reminder cards and letters generated Mailing Labels

69. Enter all children into the NCIR Enter historical immunizations (properly and completely) Check the ‘Notices’ box for at least one responsible person How to Get the Most From Reminder Recall

70. Required Series in NC: “431331” 4 DTaP, 3 Polio, 1 MMR, 3 Hib, 3 HepB, 1 Varicella

72. Strategies for Improving Immunization Rates Prioritize vaccinations in terms of staff responsibilities and communication among ALL staff members Placement and design of immunization flow sheet Check immunization status at every visit Give all needed vaccinations at each visit Educate parents

73. Strategies continued… Write legibly and clearly Document any adverse reactions or contraindications to vaccines Consolidate immunization records Document attempted communication Document transfers –MOGE Schedule or Use Reminder/Recall for next visit

74. Becky Houston Batchelor (252) 568-5529 Office (252) 568-5579 Cell becky.houston@dhhs.nc.gov Beth Meadows (252) 224-1282 Office (252) 224-1219 Cell Beth.meadow@dhhs.nc.gov Call the NCIR Helpdesk