New York State Immunization Information System Update for

New York State Immunization Information System Update for AAP Vaccine Summit May 2010

Provider Participation

Key Statistics As of May 1, 2010: 3. 1 million patients 36. 4 million immunizations 9, 200+ individual users 3, 100+ health care provider organizations 1, 500+ schools 78. 7% of NYS children (outside of NYC) less than 6 years of age have 2 or more shots in NYSIIS

Provider Participation in NYSIIS Percent of Known Providers Participating in NYSIIS By Month, January 2009 – May 2010

Percent of Children Less Than 6 Years of Age with Two or More Shots in NYSIIS* Percent Participating** New York State (Outside of New York City) *New York State Immunization Information System **Based on Claritas population estimates for 2008 (Jan 08 -Nov 08) and 2009 (Jan 09 -present). 05/03/2010

2009 NYSIIS Saturation Rates* by Region Children < 6 with 2+ Shots 86. 0% 90. 4% 87. 3 % Western Region 55. 7% Finger Lakes Region Central New York Region Capital District Region Total Upstate 78. 7% 52. 2% Lower Hudson Long Island *Based on 2009 Claritas population estimates. Updated 05/03/2010

Counties Reaching 95%+: Broome Cortland Genesee Hamilton Onondaga Saratoga Warren Washington Wayne

NYSIIS and H 1 N 1 Response

SUPPORTING H 1 N 1 RESPONSE Doses administered reporting (age groups and priority groups) Required for children less than 19 years of age Encouraged for adults (written consent needed, waived for public health clinics) Cross walked NYSIIS org id to H 1 N 1 PIN for vaccine accountability Successful use of inventory tracking module by 500+ practices Doses wasted, expired, recalled Successful use of reminder-recall feature especially with identifying children less than 10 years of age who required 2 nd dose

SUPPORTING H 1 N 1 RESPONSE Public clinic data load (PODs) All files have been transferred, rejected records are being corrected by local health departments Adverse event monitoring Exchanged info with 3 health plans (Aetna, Cigna, Humana) to compare immunization history to health care utilization data to monitor potential adverse events (miscarriages, GBS). Evaluation project Did different vaccination strategies in counties impact H 1 N 1 immunization coverage rates in children?

NYSIIS and H 1 N 1 As of May 11, 2010: 852, 944 H 1 N 1 doses administered have been reported to NYSIIS by 1, 831 practices. 51. 7% of the 1, 648, 857 total doses reported to all NYSDOH systems (IVR, online, CDMS, etc. ) A vast majority (82%) are children and young adults 6 months through 24 years of age. 45. 1% of children 6 months through 9 years of age with one H 1 N 1 dose reported to NYSIIS also have the recommended second dose also recorded in NYSIIS.

Technical Activities

Electronic Data Exchange Vendors and Providers (as of 5/1/10) • Data export files are being accepted from vendors/providers using electronic medical record (EMR) or billing systems. • LIVE: 50 vendors serving 350+practices (+46 practices using in house systems) • An additional 22 vendors are testing or in progress. • A complete list of vendors currently working with NYSIIS is available on the NYSDOH public web site at: https: //commerce. health. state. ny. us/hpn/bcdc/immunization /nysiis_data_transfer_specs. html • Early efforts underway to implement HL-7 version 2. 5.

Organizational Extracts New feature being tested Outbound files (NYSIIS to Provider) For providers who are manually using NYSIIS and are moving to an EMR, a file can be extracted from NYSIIS for possible loading into the new EMR software.

Bi-directional Interfacing Child Health Information Integration (CHI 2) Much bigger than NYSIIS! Bi-directional real-time exchange between providers and NYSDOH is ultimate goal ARRA funds (through Medicaid program) accelerating work on a universal public health node to connect internal and external systems together NYSIIS is a pilot program to connect to UPHN RHIOs will also connect to node EMR systems connected to RHIOs now linked to NYSDOH Will be an ADDITIONAL method for providers to connect to NYSIIS (current connections not touched)

Data Quality Patient address is critical For data entry users: Complete patient address should be recorded, including COUNTY For data exchangers: verify data is being sent and stored correctly. Problems should be reported to your vendor.

Data Quality Completeness: H 1 N 1 doses administered still being reviewed Expecting 100% compliance! Manufacturer and Lot number – important for vaccine recall, safety issues

Data Quality VFC Reporting VFC program is using NYSIIS in verifying shots administered. Data exchangers should verify that VFC eligibility is being sent and stored correctly AND practice is identified as owning the shots you administer (i. e. not being sent as historical). If VFC eligibility is not being sent, or is being stored incorrectly, your VFC reports are NOT VALID. Any problems should be reported to your vendor and NYSIIS staff.

System Modifications NYSIIS releases 1. 5. 0, 1. 5. 1, 1. 5. 2 and 1. 5. 3 were successfully completed in October, December, February and April. The releases included: Countermeasure and Response Administration (CRA) module to support H 1 N 1 response. Scheduler updates to accommodate new vaccines, age range changes, and prevent conflicts among live viruses. VFC eligibility tracking and reporting enhancements.

Upcoming Releases Release 1. 6 (Clinical) – May 2010 Add new vaccines and modify schedules as appropriate for Hiberix, Cervarix, and Prevnar 13. Update HPV schedule for age and adjacent dose rules Include HPV series for males (Gardasil only) Release 2. 0 Lead – July 2010 Lead user interface module, historical data upload from Lead. Web Phase 3 (reports and prompts) to follow later

Training, Communication and Outreach

De c-0 7 Ja n-0 8 Fe b-0 8 Ma r-0 8 Ap r-0 8 Ma y-0 8 Ju n-0 8 Ju l-0 8 Au g-0 8 Se p-0 8 Oc t-0 8 No v-0 8 De c-0 8 Ja n-0 9 Fe b-0 9 Ma r-0 9 Ap r-0 9 Ma y-0 9 Ju n-0 9 Ju l-0 9 Au g-0 9 Se p-0 9 Oc t-0 9 No v-0 9 De c-0 9 Ja n-1 0 Fe b-1 0 Number of Participants Trained NYSIIS Training by Modality December 2007 - Present 400 350 300 250 200 150 100 50 0 Classroom Live Webinar Recorded Webinar Online Tutorials Onsite

2010 TRAINING PLAN Outreach by HP (formerly EDS) staff Phone contact at the county level Contact Providers Increased onsite trainings (key strategy) Org-specific webinars Classroom sessions (heavy Downstate) Webinars (live and recorded) Online Self-Guided Tutorials Ask The Trainer Webinar Newly revised user manual released January 2010

2010 Webinar Schedule Register at: http: //nysdoh. webex. com Live instructor led sessions scheduled approximately once a week. Standard User Combined Standard/Administrator User Advanced Reports Previously recorded sessions available on demand. Beginning User (Standard & Combined) AFIX-Co. CASA School Access User Standard User for Pharmacy

ON-LINE SELF-GUIDED TUTORIALS 13 modules posted on NYSIIS Training Page in Health Commerce System: https: //commerce. health. state. ny. us/hpn/bcdc/immuniz ation/training_info. html NEWEST MODULES - Advanced Reports: Ad Hoc lists and counts Benchmark Assessment

ASK THE TRAINER This open forum webinar was designed to allow NYSIIS users to bring their questions to the NYSIIS trainers for one-on-one resolutions. Last Friday Each Month at 11: 30 -12: 30 http: //nysdoh. webex. com – click “Training Center” Select “Ask the Trainer: NYSIIS Noon Time Webinar” Enter Name and Email Enter Session Password: train 10

COMMUNICATIONS NYSIIS News –distributed electronically in March 2010 NYSIIS application announcements and blast email distributions Important vaccine specific and general immunization related information Maintenance/outage notices Training/user group reminders NYSIIS tips of the month

ADMINISTRATIVES ACTIVITIES Program Linkages and Future Priorities

Program Linkages WIR Consortium – continued code sharing with various projects, especially Oregon Enhanced immunization evaluator (scheduler) Data exchange file interacting with inventory module Health Insurance Plans – query only capability to support QUARR and HEDIS reporting Inter-state data sharing agreement Template under final revisions

Future Priorities - 2010 Commissioner’s Prevention Agenda http: //www. nyhealth. gov/prevention_agenda/ American Recovery and Reinvestment Act (ARRA) aka “Stimulus Funding” Disaster recovery server Integrated immunization support visits NYSIIS enhancements Bi-directional interfacing

Help Desks Commerce Accounts Management Unit (CAMU) Help Desk For HPN access or account issues (866) 529 -1890 or hinhpn@health. state. ny. us NYSIIS Technical Help Desk For NYSIIS user access or questions on how to use the system (866) 389 -0371 or nysiishelpdesk@hp. com NYSIIS staff For general program or policy questions (518) 473 -2839 or nysiis@health. state. ny. us Growing Up Healthy Hotline For parents/public 1 -800 -522 -5006

Q&A (518) 473 -2839 nysiis@health. state. ny. us