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Disclaimer This webinar may be recorded. This webinar presents a sampling of best practices and overviews, generalities, and some state laws. This should not be used as legal advice. Itentive recognizes that there is not a “one size fits all” solution for the ideas expressed in this webinar; we invite you to follow up directly with us for more personalized information as it pertains to your specific practice and issues. Thank you, and enjoy the webinar.

I TENTIVE WEBINAR SERIES Navigating Immunizations in 5.8 and 8.3

Immunizations in 5.8 and 8.3 In this Session we will cover; • From Template to Module; Why? • Immunizations set up in File Maintenance • VFC and Private • Inventory maintenance in EHR; Workflow; Ordering and Administering Immunizations. • Immunization Reports; VIS Documents; Tips and Tricks

Why the move to Module? To meet MU Stage 2 guidelines and reporting, it was necessary to move the Immunizations to a Module. • Must be able to generate CCD-A documents in proper format. • Immunization Registry submission requires an interface and successful submission for the entire reporting period. Many states require registration prior to reporting period. Start planning and coordinating now.

Version and Hot Fix is Important For Immunizations to function properly you need to upgrade to either: • 5.8 HF108 • 5.8 UD1 HF69.

File Maintenance Set Up • Vaccine Orders/Inventory • Vaccine Billing • Vaccine Relationships • Practice Preferences> Orders>Immunizations • VFC Reasons • VIS Set Up

File Maintenance Set Up – Order List or Inventory List • Note in 5.8 this is called Vaccine Orders and in 5.8 UD1 this is called Vaccine Inventory. • Each Vaccine Lot number has it’s own orders/inventory list. • Clean Up and Hide all Inactive vaccines. • Each Vaccine Lot is assigned a location. • Complete the Options tab on each vaccine order.

File Maintenance Set Up - Orders • All Vaccines Must have the following fields, which are pre-populated and cannot be changed: Status (active), CPT Code, CPT Description, CVX Code and CVX Vaccine Name. • Enter Vaccine Name • Strength, Route, Exp. Date, Brand Name (opt), Manuf (opt), Lot Number, NDC ID, Starting Units, Total Components • Select ICD Code. • Link to a Practice Location In Orders List – After Vaccine Name Add VFC or Private to easily confirm when choosing this lot.

CVX Codes The CVX Code is very important. Make sure all CVX codes are entered correctly and every vaccine has a CVX Code listed. CVX Codes are used to uniquely identify vaccines. Earlier versions of KBM and custom templates were often missing the CVX code which causes the “unknown” vaccines. If unsure what the correct CVX code is to use, refer to the CDC’s website: http://ww2a.cdc.gov/vaccines/llS/llSStandards/vaccines.as p?rpt=cvx

File Maintenance Set Up – Orders/Inventory • Do not enter additional Lot Numbers under Options • Do not enter a Vaccine Admin CPT code, UNLESS you want this specific code to overwrite the default Admin code.

File Maintenance Set Up Vaccine Billing • Every Vaccine MUST be linked to a SIM code(s) as well as marking one as the Default. • You can create custom SIM codes for VFC if you desire.

File Maintenance Set Up - Relationships Vaccine Relationships – This links all the vaccine CVX to the same vaccines. Review these, but no issues were discovered in this set up.

VIS Set Up and 8.3 • All VIS Documents can be loaded in the VIS Set Up. • Remember to load both English and Spanish.

Practice Preferences Orders Module Immunization Tab • Enter Default Registry (Must Request this through NG) • Default VIS print mode • Set up favorite categories and add immunizations to each category • Default vaccine schedule is loaded and can be changed within Practice Preferences.

VFC Reasons • Must have your Registry loaded first. Contact NG, if you have not set up your state Registry. • Master Files > System > VFC Reasons

Immunization Set Up - EHR • Map Vaccines in Unmapped Immunizations Panel • Inventory Management will continue to be maintained in EHR, after the initial FM set up- Ngkbm Immunizations • All set up in FM carries over to EHR. • You will only need to add any Brand New vaccines in FM, prior to adding them to your inventory.

Map Vaccines • Some records do not have an exact match during the upgrade and require manual mapping. • System\Practice Template  NgUtility Map Vaccines  NextGen KBM NgUtility Map Vaccines System Template

New Inventory Open an existing inventory and just update Lot Number, Expiration Date and Starting Units. Instead of clicking Update – Click Add to enter a new lot w/o having to enter all the data required.

Workflow Order and Administer • Orders Module>Immunization • Allergies • Complete Order>Task, Save and Send • Administering Vaccine • VIS Document • VFC versus Private • Wasted Vaccine • Exclusions

Workflow-Immunizations Order • Access directly through the Orders Module. Consider adding Immunization as a sub- navigation bar. • Review new immunizations required and Click New Order. • Diagnosis Codes are set up with the vaccines, so no diagnosis is required when ordering the immunization.

Workflow-Immunizations Order • Choose the vaccines you want to display. Utilize the Pediatrics, Adult or your Practice Favorites. You can always Search All. • The vaccine(s) you choose will display at the bottom of the order. The diagnosis will default to each vaccine.

Allergies • The review allergies will launch every time an Immunization is ordered. • This can be disabled if the practice desires within Practice Preferences.

Complete Order-Task, Save and Send • Save and Print – Prints the VIS. • Save and Send – Sends Immunization information to the Registry (if set up to auto send through the interface). • Save and Task – Create Task for workgroup. This task list does not list all staff members and must be specific work groups. • Save – Only saves the order.

Workflow-Administering Vaccine • Within the orders module, Click on Orders to view any ordered immunization. • Click to open the order. • Print VIS or Click on Document As Given.

Workflow-VFC or Private • Choosing a VFC Reason will allow you to only see VFC Lot Numbers. • For Private Insurance – Leave VFC Reason blank. • Enter Funding Source.

Workflow-VFC or Private • Choosing a VFC Reason will allow you to only see VFC Lot Numbers. • For Private Insurance – Leave VFC Reason blank. • Enter Funding Source.

Workflow-Administration • Drop Down and choose Lot Number. Free texting a lot number will throw off your inventory. If Lot Number is not available, check your inventory and lot numbers in FM. • All data will pre-populate based on your FM Set up. • Enter “Site”. This list can be altered by a SQL script. • Check Completed; You have options to mark partially administered, excluded, refused or not administered. • Order will change from Ordered to Completed

Workflow-Waste Vaccine and Vaccine Record Editing • If you are unable to administer the vaccine, complete the waste portion of the update immunization order. Remember to highlight the vaccine name you are documenting the waste. • Documenting a wasted vaccine, will keep your inventory up to date. • You now have the ability to edit a vaccine record, security rights are required. • Click on individual vaccine you wish to edit • Click Historical button and Vaccine Edit tab.

Exclusions-Series Complete • If an immunization is stating “Past Due”, but you have determined the patient does not require the vaccine, you will need to complete the series, utilizing the Exclusions tab. The series will then show as complete.

Immunization Documents Report • Do not use the KBM document, use the Crystal Report provided after 5.8 HF 87. • Review the VaccineSummary.Rpt. It is no longer in a matrix grid format. • Review all documents that you may have set up to pull immunization information; ie: School Forms. These will need to be reconfigured.

VIS Documents • The VIS (vaccine information sheets) are included in the 5.8/5.8UD1 and do not need to be downloaded but do need to be moved from the ../DistributedReports/VIS folder to the ../EMR/Reports folder. Move all VIS folders from the upgrade folder to the reports folder identified in Universal Preferences. Remember you can get Spanish and English • Make sure each vaccine is linked to the correct VIS. • Adjust your practice preferences to either print/prompt or do nothing with VIS documents when a vaccine is ordered.

Issues Resolved/Unresolved • Many Issues with Immunizations have been resolved with Hot Fixes in 5.8 HF108 or in 5.8 UD1HF69.  My Vaccines are not lining up!  I can’t administer immunizations on a locked encounter!  I can’t edit a vaccine because there is no loction_id!  I can’t edit a vaccine because it does not have an encounter_id! Upgrade to 5.8 HF108 or 5.8 UD1HF69. If you are still having an issue, open an ticket with NextGen.