New York State Immunization Information System

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

2. Provider Participation

3. 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

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

5. *New York State Immunization Information System**Based on Claritas population estimates for 2008 (Jan08-Nov08) and 2009 (Jan09-present). 05/03/2010 Percent of Children Less Than 6 Years of Age with Two or More Shots in NYSIIS* New York State (Outside of New York City) Percent Participating**

6. 2009 NYSIIS Saturation Rates* by Region Children < 6 with 2+ Shots 86.0% 90.4% 87.3% 87.3 % Western Region 55.7% Finger Lakes Region Total Upstate 78.7% Central New York Region Capital District Region 52.2% Lower Hudson Long Island *Based on 2009 Claritas population estimates. Updated 05/03/2010

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

8. NYSIIS and H1N1 Response

9. SUPPORTING H1N1 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 H1N1 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 2nd dose

10. SUPPORTING H1N1 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 H1N1 immunization coverage rates in children?

11. NYSIIS and H1N1 As of May 11, 2010: 852,944 H1N1 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 H1N1 dose reported to NYSIIS also have the recommended second dose also recorded in NYSIIS.

12. Technical Activities

13. 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 workingwith NYSIIS is available on the NYSDOH public web site at: Early efforts underway to implement HL-7 version 2.5. Electronic Data Exchange Vendors and Providers (as of 5/1/10) https://commerce.health.state.ny.us/hpn/bcdc/immunization/nysiis_data_transfer_specs.html

14. 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.

15. Bi-directional Interfacing • Child Health Information Integration (CHI2) • 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)

16. 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.

17. Data Quality • Completeness: H1N1 doses administered still being reviewed • Expecting 100% compliance! • Manufacturer and Lot number – important for vaccine recall, safety issues

18. 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 correctlyANDpractice 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.

19. 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 H1N1 response. • Scheduler updates to accommodate new vaccines, age range changes, and prevent conflicts among live viruses. • VFC eligibility tracking and reporting enhancements.

20. Upcoming Releases • Release 1.6 (Clinical) – May 2010 • Add new vaccines and modify schedules as appropriate for Hiberix, Cervarix, and Prevnar13. • 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 LeadWeb • Phase 3 (reports and prompts) to follow later

21. Training, Communication and Outreach

23. 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

24. 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-CoCASA • School Access User • Standard User for Pharmacy

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

26. 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: train10

27. 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

28. ADMINISTRATIVES ACTIVITIES Program Linkages and Future Priorities

29. 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

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

31. 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

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