To protect the health and environment of all Kansans by promoting responsible choices.

1. KSWebIZ: HL7 Users Group Meeting To protect the health and environment of all Kansans by promoting responsible choices. January 26, 2011

2. Agenda • Current Status • CVX Updates • Intro of UF vs. NOS • Retirement of CVX 15 • Meningococcal vaccines • Data Quality • Duplicate Patients • Upcoming reports To protect the health and environment of all Kansans by promoting responsible choices.

3. KSWebIZ Providers as of December 31, 2010 Private Provider live on KSWebIZ LHD live through direct entryLHD live through HL7 interface • Statistics: • 264 total providers live: • 159 Private providers (5 interface, 23 non-VFC) • 105 Local Health Departments (53 Direct entry, 52 interface)

4. KSWebIZ Statistics as of December 31, 2010 • Number of Providers = 264 • Private =159 (5 interface, 23 Non VFC) • Public =105 (53 direct entry, 52 interface) • Number of Patients = 1,792,399 • Number of Vaccinations = 14,778,855 

5. Patients by Updating User

6. Vaccinations by Updating User

7. CVX Updates • Keeping up to date • Unspecified Formulation vs. NOS • Retirement of CVX 15 • Meningococcal vaccines

9. CVX Numbers • Important to keep up to date • CPT to CVX guide • http://www2a.cdc.gov/nip/IIS/IISStandards/vaccines.asp?rpt=cpt

10. CVX: Unspecified Formulation • Term ‘Unspecified Formulation’ introduced to replaced ‘NOS’ aka Not Otherwise Specified • ‘NOS’ has other meanings in HIT • Effort to harmonize medical terms for Health Information Exchange (HIE) purposes • CVX number remains the same, just the description changes to ‘UF’ • Note, ‘UF’ entries do not have a CPT code

11. CVX: Retirement of CVX 15 • CVX 15 (Influenza) is being retired • Overused • CVX 140 (Influenza, seasonal, Pfree) • CPT 90654 • CPT 90655 – 6-35 months • CPT 90656 – greater than 36 months • CVX 141 (Influenza, seasonal) • CPT 90657 - 6-35 months • CPT 90658 – greater than 36 months

12. Meningococcal CVX numbers • New numbers have been added recently • Product names add to the confusion

13. Data Quality • Impact • Duplicate Patients • Upcoming reports • Duplicate Vaccines

15. Data Quality • Impact of poor data quality • Costly to diagnose and assess • Costly to repair • More KSWebIZ deduplication daze • Impacts quality of care & patient safety • Erodes trust in system (KSWebIZ)

16. Duplicate Patients • Matching criteria: • First & last name • DoB • SSN • If more than one match has been found: • Gender • Middle name • Alias name • Mother’s maiden name • Mother’s name To protect the health and environment of all Kansans by promoting responsible choices.

17. Cultural Surnames* • Naming conventions for non-western names • Chinese typically written family name first • Yao Ming => Last name ‘Yao’ • Multiple family names (e.g. Hispanic) • Ricardo Gonzalez + Carmen Ramirez = Rosa • Rosa Gonzalez Ramirez = ok • Rosa Gonzalez = ok • Rosa Ramirez = not okay * Privacy and Security Solutions for Interoperable Health Information Exchange

18. Bad SSNs • Impact of bad SSNs • Impact of not updating KSWebIZ with a new SSN • Queries won’t find their match • Remember to update KSWebIZ whenever any demographic information changes To protect the health and environment of all Kansans by promoting responsible choices.

19. Duplicate Patients: Illustrated Vital Records Bart Simpson DoB: 3/6/2003 SSN: 123-45-6789 HepB: 3/3/2003

20. Duplicate Patients: Illustrated CHD A Bart Simpson DoB: 3/6/2003 SSN: 234-56-7890 CHD B Bart Simpson DoB: 3/6/2003 SSN:

21. Duplicate Patients: Now What? • Call the helpdesk • Data entry tips • Make sure SSN is the patient’s • Correctly spelled names • Take into account special characters • E.g. Hyphen, tilde, apostrophe, …

22. KSWebIZ Dup Patients • Donna Conley (Data Quality Guru) • Always cleaning up duplicates • However, potential duplicate still at CHD • KSWebIZ fix needs to happen at CHD too • Duplicate report

23. Example: Duplicate Patient Report

24. Example: Closer Look

25. Example: Duplicate Patient Report

26. Steps: Dup Patient Report • KSWebIZ: Generate CHD report • KSWebIZ: Email password protected zip file • LHD: Refer to instructions for fixing • LHD: Call / email Donna for questions • Initially just Vital Record duplicates

27. Duplicate Vaccines • Making sure your procedures are accurate • E.g. Hibtiter vs. Hib PRP-T (aka ActHib) To protect the health and environment of all Kansans by promoting responsible choices.

28. Duplicate Vaccines: Illustrated KSWebIZ Provider A Bart Simpson, Historical Hibtiter (CVX=47), DoS=6/13/2005,

29. Duplicate Vaccines: Illustrated KSWebIZ LHD A Bart Simpson, Administered ActHib (CVX=48), Lot #=AA1234, DoS=6/13/2005 No duplicate created as the vaccine is from the same date and the same antigen family.

30. Duplicate Vaccines: Illustrated LHD A KSWebIZ Bart Simpson, Administered ActHib (CVX=48), Lot #=AA1234, DoS=6/13/2005 Bart Simpson, Historical Hibtiter (CVX=47), Lot #=AA1234, DoS=6/13/2005, Bart Simpson, Historical Hibtiter (CVX=47), Lot #=AA1234, DoS=6/13/2005, Duplicate created because CVX 47 not equal to CVX 48.

31. Duplicate Vaccines: Now What? • Immunization Hx Screen (SM-109) • If you are not the administering LHD: • Delete your history (ie. Accept the entry from KSWebIZ) • If you are the administering LHD: • Call KSWebIZ Helpdesk

32. Questions?

33. Contact Information Mike McPhersonKS IIS Interface Coordinator Kansas Department of Health & Environment 785-296-1319mmcpherson@kdheks.gov Donna Conley KSWebIZ Data Quality Coordinator Kansas Department of Health & Environment 785-296-2774 http://kdheks.gov/immunize/webiz.html To protect the health and environment of all Kansans by promoting responsible choices.