Georgia Registry of Immunization Transactions and Services GRITS

Georgia Registry of Immunization Transactions and Services (GRITS) Data Exchange 101 Immunize Georgia Conference / Nikki Griffin and Patrice Wade / September 14 th, 2018 GEORGIA DEPARTME NT OF PUBLIC HE ALTH

What is Data Exchange? Enters administered vaccine info into EMR HL 7 Message generated and sent Monitor Data entries in GRITS Locate and fix errors/ discrepancies Patient vaccination recorded created/ updated in GRITS Data exchange is the sharing of data between systems, organizations and individuals. • Movement of data from one system to the next • EMR/EHR to GRITS and/or GRITS to EMR/EHR • Content is not altered during transmission • Often referred to as “Interfacing” GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Who exchanges data? Immunization Information Systems (IIS) Fundamentals: Overview and Development GEORGIA DEPARTME NT OF PUBLIC HE ALTH

How is data exchanged with GRITS? Real Time (automated) Manual (batch) Real time HL 7 transactions can be exchanged with GRITS through two options… Batch flat file or HL 7 uploads are manual processes • PHINMS (Public Health Information Network Messaging System) • CDC-provided software • bi-directional and secure messaging platform It requires logging into GRITS and manually uploading each file on the ‘exchange data’ screen. • Web Service (WSDL) • an XML document • Data exchanged over a protocol (i. e. HTTPS) GEORGIA DEPARTME NT OF PUBLIC HE ALTH

When are EMR/EHR’s involved in Data exchange? Vendors are allowed to enroll into GRITS and send on behalf of clients. Involvement: Provides link from EMR/EHR to GRITS Provides means of Data Exchange for clients Provides means for meeting Meaningful Use Provides technical assistance in: • Setting up/monitoring/validating data exchange messages before “Go Live” • Monitoring data exchange after “Go Live” EMR/EHR GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Where does the data exchange process start? Testing: GRITS Data Exchange testing is done in the Staging/Testing environment www. gritstest. state. ga. us GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Why so technical? Staging Test Routine (Batch): 1. Login into GRITS Staging: https: //www. gritstest. state. ga. us 2. Select Exchange Data from the Data Exchange portion of the menu. 3. To upload a test: • Create a job name: • • • If uploading file formatted according to flat file specifications: • • • Enter your client file or use Browse to select your file and Enter your immunization file or Browse to select your file If uploading file formatted according to HL 7 specifications: • • GRITS recommends the following com: Org Code + today’s date + 1, Ex: CALHD 6/24 1. Should you need to resubmit the test data, increase the last number If job name is blank, today’s date will be used. Enter your HL 7 file or use Browse to select your file Submit job by clicking the Upload button. The Exchange Data screen will remain visible until the data files are loaded into GRITS. GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Who’s checking errors? 4. Check the Job Response File: To view the job click Check Status. On the Exchange Data Status screen, click on your job. The Job Summary page will be displayed. To view errors and warning messages, click on Response File (for flat file entries) or HL 7 Output (for HL 7 uploads). Common Errors: • Record rejected. This client has existing immunizations with vaccination date(s) prior to the client's birth date. • Record rejected. This immunization matches another immunization in incoming file. • Record rejected. Client does not have any valid immunizations. • Client and Immunization Record(s) Rejected. Eligibility code missing or invalid for a new immunization. • Given lot number (XXXXXXX) and funding (PRIVATE), no active vaccine lots were found for… • The vaccine is not associated with any active inventory for… GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Was this a success? Correcting Errors: • All mandatory and required fields within the file specifications must have an acceptable value, or the record will be rejected. • Error correction in the originating system may be needed in order to resolve data issues. • Some errors such as ‘Record rejected. This immunization matches another immunization in incoming file’ are acceptable. Resubmit Job: • If corrections were made, re-extract the data and repeat steps 2 -4 of the Testing Routine • Once all errors have been corrected, the testing can proceed to the Production environment. Resubmissions are continued until the Data Exchange processes successfully with no errors. Once your file has been uploaded with no errors, repeat the process with a different set of record values. After which, you are ready to ‘go live’ in production. GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Data Exchange 101 Who: Anyone administering a vaccine to a state of Georgia resident has the option of sending that data to the system electronically What: Data exchange is the sharing of data between systems, organizations and individuals. Movement of data from one system to the next. Where: GRITS both receives and distributes data through an interface. When: Providers/Facilities must be on the same page with their EMR/EHR as to when it is best to move forward with interface implementation. Why: Exchanging data through an interface eliminates the need of double entry and lowers the occurrence of human error GEORGIA DEPARTME NT OF PUBLIC HE ALTH

GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Georgia Registry of Immunization Transactions and Services (GRITS) Immunization Coverage Assessment Reports Immunize Georgia Conference/ La. Tonya Thomas-Smith, BS, MBA-HCM / September 14, 2018 GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Immunization Coverage Assessment Reports • The Georgia Registry of Immunization Transactions and Services (GRITS) has recently released easy-to-use immunization assessment reports to help monitor immunization rates for vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). • Development of the assessment reports are part of the Center for Disease Control’s efforts to transitions from Comprehensive Clinical Assessment Software Application (Co. CASA) to Registry based assessment reporting. • The assessment reports offer clinic-based and county-based immunization rates to assist in monitoring immunization coverage and quality improvement activities. The assessment reports can: Ø Generate baseline immunization rates Ø Identify areas for improvement Ø Provide data to assist with implementing practice change and/or outreach activities Ø Provides access to regular follow-ups to evaluate whether practices change and/or outreach is improving immunization rates GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Immunization Coverage Assessment Reports • Types of Reports Provided: The reports provided condenses various information into one summary report and/or other support documents. Reports are divided into three basic areas: Ø Childhood Ø Adolescent Ø Adult GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Immunization Coverage Assessment Reports – Childhood Immunization Summary: Childhood Immunization Summary Report identifies the percentage of 2 -year olds (children ages 24 through 35 months) who are up-to-date on each of the following vaccines by the time they are 24 months old: • • 4 or more doses of diphtheria, tetanus, and pertussis (DTa. P) 3 or more doses of polio 1 or more doses of measles, mumps, rubella (MMR) 3 Complete Haemophilus influenzae type b (Hib) 3 or more doses of hepatitis B 1 or more doses of varicella 4 Complete pneumococcal conjugate (PCV) All the above vaccines (the 4: 3: 1: 3: 3: 1: 4 series) In addition, the report also includes rates for: • Complete rotavirus series • 2 or more doses of hepatitis A vaccine GEORGIA DEPARTME NT OF PUBLIC HE ALTH

GEORGIA DEPARTME NT OF PUBLIC HE ALTH

GEORGIA DEPARTME NT OF PUBLIC HE ALTH

GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Immunization Coverage Assessment Reports – Adolescent Immunization Summary : Adolescent Immunization Summary Report identifies the percentage of 13 through 17 -year-olds who are up-to-date on the following vaccines: • • • 1 dose of tetanus, diphtheria, and acellular pertussis (Tdap) 1 st dose of meningococcal vaccine (MCV 4) Booster dose of MCV 4 1 st dose of human papillomavirus (HPV) Complete HPV series: percentage of clients who began the HPV series and received all recommended doses GEORGIA DEPARTME NT OF PUBLIC HE ALTH

GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Immunization Coverage Assessment Reports – Adult Immunization Summary: Adult Immunization Summary Report identifies the percentage of adults (18 -year old and older) who are up-todate on the following age-appropriate vaccines: • • 1 dose of tetanus, diphtheria, and acellular pertussis (Tdap) 1 dose of tetanus, diphtheria (Td) or Tdap 1 dose of pneumococcal conjugate (PCV 13) 1 dose of pneumococcal polysaccharide (PPSV 23) 1 st dose of human papillomavirus (HPV) 3 rd dose of HPV 1 dose of Zoster GEORGIA DEPARTME NT OF PUBLIC HE ALTH

GEORGIA DEPARTME NT OF PUBLIC HE ALTH

Immunization Coverage Assessment Reports – Using Assessment Reports for Quality Improvement Assessment reports can serve as the foundation of childhood, adolescent, or adult immunization rate improvement activities. Examples of some activities are: • Run Baseline Report: Run an assessment report to establish preintervention rates and identify the areas most in need of improvement. • Identify Opportunities: Implement or change clinic practices or begin outreach activities to address opportunities noted in the baseline report. • Evaluation: Measure both the steps taken to improve clinic process and the improvement in immunization rates by monitoring activity timelines and by periodically re-running assessment reports. Decide whether to continue current activities or change course. • Having solid quality improvement plans and activities in place can help health care providers demonstrate meaningful use of electronic health record immunization data and have better outcome data to report to public sources such as HEDIS. Most of all, monitoring and acting to improve immunization rates helps protect patients and the community from vaccine preventable disease. GEORGIA DEPARTME NT OF PUBLIC HE ALTH

GEORGIA DEPARTME NT OF PUBLIC HE ALTH