LP 3114 functional specification v9
0 likes93 views
This document provides an overview and specifications for adding immunization tracking functionality to an electronic health record system. Key features include allowing users to add reported immunizations, decline immunizations for visits, and stop tracking immunizations. Immunization data will be stored and managed through the Master Immunization Schedule (MIS) component. Reports and the interface to public health agencies will be updated to reference the new immunization data location. Physicians and nurses will be the primary users of the new immunization tracking functionality.
LP 3114 functional specification v9
- 1. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 1 MP Immunizations Functional Specification LP: 3114 Software Version: 6.08pp6 Designer: Andrew Shipe Specification Version: 9 Last Update: December 29, 2014 Table of Contents 1 OVERVIEW .....................................................................................................................................................................3 2 USE CASES....................................................................................................................................................................4 3 DATAFLOW AND ARCHITECHTURAL DESIGN...........................................................................................................5 3.1 Immunization Interface Data ...................................................................................................................................6 3.1.1 CVX Codes..........................................................................................................................................................6 3.1.2 VIS Publication Dates..........................................................................................................................................7 4 CONSIDERATIONS........................................................................................................................................................8 5 MENUS ...........................................................................................................................................................................9 5.1 MIS Clinical Dictionaries (F-O)................................................................................................................................9 5.1.1 Immunizations .....................................................................................................................................................9 5.2 APR Reports ...........................................................................................................................................................9 5.2.1 Immunization Reports .........................................................................................................................................9 6 DICTIONARIES.............................................................................................................................................................11 6.1 MIS Component Dictionary ...................................................................................................................................11 6.1.1 Component........................................................................................................................................................11 6.1.2 Schedule ...........................................................................................................................................................11 6.2 MIS Vaccine Dictionary .........................................................................................................................................13 6.2.1 Vaccine..............................................................................................................................................................13 6.3 APR Condition Category.......................................................................................................................................14 6.3.1 Category............................................................................................................................................................14 6.4 APR Condition Management.................................................................................................................................15 6.4.1 Standard Items..................................................................................................................................................15 7 ROUTINES....................................................................................................................................................................16 7.1 Condition Management .........................................................................................................................................16 7.1.1 Standard Items..................................................................................................................................................16 7.2 Immunization Details.............................................................................................................................................18 7.2.1 Overlay ..............................................................................................................................................................18 7.3 Immunization Details Menu...................................................................................................................................19 7.3.1 Pop-Over ...........................................................................................................................................................19 7.4 Reset Sequence....................................................................................................................................................19 7.4.1 Overlay ..............................................................................................................................................................19 7.5 Immunization Options ...........................................................................................................................................20 7.5.1 Pop-Over ...........................................................................................................................................................20 7.6 Add Reported Immunization..................................................................................................................................20 7.6.1 Overlay ..............................................................................................................................................................20 7.7 Decline for Visit .....................................................................................................................................................21 7.7.1 Overlay ..............................................................................................................................................................21 7.8 Stop Tracking ........................................................................................................................................................22 7.8.1 Overlay ..............................................................................................................................................................22 7.9 Add Additional Immunizations...............................................................................................................................22 7.9.1 Overlay ..............................................................................................................................................................22 7.10 Office Procedure with Medications Details ...........................................................................................................23 7.10.1 Overlay ..........................................................................................................................................................23 8 REPORTS AND LETTERS...........................................................................................................................................25 8.1 Reports..................................................................................................................................................................25 8.1.1 Immunization Report and Audit Log..................................................................................................................25 8.1.2 Print Vaccine History by Lot ..............................................................................................................................25
- 2. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 2 9 AUDITS .........................................................................................................................................................................26 10 APPENDIX ....................................................................................................................................................................27
- 3. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 3 1 OVERVIEW This project adds immunization tracking to Condition Management. Users will be able to add reported instances of immunizations, decline immunizations for a visit, and stop tracking immunizations. Immunization setup was moved from APR to MIS. MRI immunization reports and the immunization interface were updated to reference the new immunization data location in MRI. Scope and Disclaimers: This project does not include the ability to administer ordered immunizations. Release Info and Dependencies: This project requires mobile practice and requires LP 3176 to migrate existing immunization data. The project also follows Condition Management functionality originally outlined in LP 2824. Applications Affected: APR, LSI, MIS, MRI, RXM, WPM Intended Users: Physicians, Nurses Glossary: CVX Code: A number defined by the Centers for Disease Control (CDC) that represents a specific immunization Vaccine: - Single - A vaccine that has only one component. In terms of the system this would be an entry in the MIS Vaccine Dictionary that only has one associated MIS Component. Flu or Hepatitis B shots are examples of single vaccines. (N.B. DTaP is considered a single vaccine even though it vaccinates against multiple diseases) - Combination - A vaccine that has multiple components. In terms of the system this would be an entry in the MIS Vaccine Dictionary that has multiple associated MIS Components. Pediarix or Twinrix are examples of combination vaccines VIS Publication Date: Federal law requires healthcare providers to give a CDC-published Vaccine Information Statement to each patient for each vaccine they receive during a visit. Recording when the provided VIS was published allows state registries to track the information patient's are receiving. Some combo vaccines have a VIS for the combo and some combo vaccines may provide multiple VISs for each component.
- 4. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 4 2 USE CASES
- 5. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 5 3 DATAFLOW AND ARCHITECHTURAL DESIGN The diagrams below indicate how the system chooses CVX Codes and VIS Publication Dates when generating messages for the immunization interface. Best practices for setting up CVX Codes and VIS Publication Dates: MIS Vaccine Dictionary CVX Code: Enter the most generic code for this vaccine (e.g., for flu shots: influenza, unspecified formulation (88)) VIS Publication Date: For combination vaccines, enter the VIS Publication Date if one exists MIS Component Dictionary CVX Code: Enter the code specific to the schedule defined for the component (e.g., for Hepatitis A: Hep A, ped/adol, 2 dose (83)) VIS Publication Date: Enter the date for the specific component RXM Drug Dictionary CVX Code: Enter the code specific to the drug (e.g., for flu shots: Influenza, injectable,quadrivalent, preservative free, pediatric (161)) VIS Publication Date: n/a
- 6. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 6 3.1 Immunization Interface Data 3.1.1 CVX Codes
- 7. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 7 3.1.2 VIS Publication Dates
- 8. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 8 4 CONSIDERATIONS Mobile Practice functionality follows documented design conventions, found here https://sites.google.com/a/meditech.com/lss-design/standards/mobile-design-standards (Design Google Site > Mobile Design Standards) All functionality in Mobile Practice should function like the FS clinical applications, unless otherwise noted. Technical: Existing data migration is not handled by this project. Refusal reasons are sent to the immunization interface in segment RXA 18 and evidence of immunity reasons are sent in segment OBX 5.1. Creates the MRI Background Job to file data from RXM to MRI. Quality Control: Items not documented in this specification should function identically to result items as defined in LP 2824.
- 9. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 9 5 MENUS 5.1 MIS Clinical Dictionaries (F-O) 5.1.1 Immunizations Overview MIS Immunizations Menu simplified to only list active and relevant dictionaries. 5.2 APR Reports 5.2.1 Immunization Reports Overview Immunization Report and Audit Log and Print Vaccine History by Lot reports added to the APR Reports Menu. See more information on the reports in the Reports and Letters section.
- 10. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 10
- 11. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 11 6 DICTIONARIES The View and List Dictionary routines for each dictionary in the following sections should also be updated with the changes outlined for each dictionary's Enter/Edit routine. 6.1 MIS Component Dictionary 6.1.1 Component Note Item Type Description Available Required Default Lookup 1 History of Disease Code Scalar Defines a History of Disease Code for messages to the immunization interface when users select "History of Disease" as a Stop Tracking reason in Condition Management Always No N/A Standard lookup to MIS Value Set (PHVS - Evidence of Immunity) 2 Lab-confirmed Immunity Code Scalar Defines a Lab-Confirmed Immunity Code for messages to the immunization interface when users select "Lab- confirmed immunity" as a Stop Tracking reason in Condition Management Always No N/A Standard lookup to MIS Value Set (PHVS - Evidence of Immunity) 3 Protocol Text MEditor Text Box Enter protocol text for the component Always No N/A N/A 6.1.2 Schedule Overview The MIS Component Schedule, with a few exceptions noted below, functions identically to the schedule in the APR Immunizations Dictionary.
- 12. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 12 Note Item Type Description Available Required Default Lookup 1 Sex Scalar Set the Sex for which a frequency-based schedule applies Always No N/A Choice lookup All, Female, Male, Unknown 2 Sex Scalar Set the Sex for which a sequence-based schedule applies Always No N/A Choice lookup All, Female, Male, Unknown 3 Default Stop Age Scalar Sets the age at which sequence-based immunizations stop appearing on a condition. Yes, for sequence-based immunizations No N/A N/A
- 13. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 13 6.2 MIS Vaccine Dictionary 6.2.1 Vaccine Note Item Type Description Available Required Default Lookup 1 VIS Publication Date Scalar VIS Publication Date for combo vaccines with available VISs. Always No N/A Standard Date 2 Procedures Multiple Link RXM Procedures to the vaccine. The system uses this to present the user with a list of orders when a component or components are queued from Condition Management Always No N/A Standard lookup to RXM Procedure Dictionary filtered to Office Procedure-type entries
- 14. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 14 6.3 APR Condition Category 6.3.1 Category Note Item Type Description Available Required Default Lookup 1 Type Scalar The Type of the Condition Category defines whether Result Items or Immunizations can be added to it. Always Yes N/A Choice lookup Results or Immunizations
- 15. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 15 6.4 APR Condition Management 6.4.1 Standard Items Note Item Type Description Available Required Default Lookup 1 Additional Immunizations Display Name Scalar Defines the name of the Additional Immunizations accordion in Condition Management Always Yes Additional Immunizations N/A 2 Category Type Scalar Displays the Type of the Condition Category No No N/A N/A 3 Item Scalar within the Item multiple MIS Component to be tracked on the condition Always No N/A Standard lookup to MIS Component Dictionary
- 16. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 16 7 ROUTINES 7.1 Condition Management 7.1.1 Standard Items
- 17. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 17 Note Item Convention On Click Display Rules Notes 1 Last Done Changed from Result Date 2 Immunization Name (sequence-based) Launches the Immunization Options Pop- Over Name of the MIS Component linked in the APR Condition Dictionary For sequence-based immunizations, only show the immunization if: - For the patient's sex-appropriate schedule - The patient's age falls after the schedule start age but before the default stop age - Even if there are eligible ages that occur after the default stop age). - The component is enabled for the patient's sex on the condition's dictionary entry 3 Sequence Progress Launches the Immunization Details Overlay Number of immunizations completed in the sequence defined in the MIS Component Dictionary 4 Immunization Name (frequency-based) For frequency-based immunizations, only show the immunization if: - For the patient's sex-appropriate schedule - The patient's age falls in the from- through range - The component is enabled for the patient's sex on the condition's dictionary entry 5 Frequency Info Icon Launches the Immunization Details Overlay Uses the Info icon 6 Frequency Frequency defined in the MIS Component Dictionary 7 Add Additional Items Secondary Button Changed from a primary button with label "+" 8 Add Additional Immunizations Secondary Button Launches the Add Additional Immunizations Overlay 9 Additional Immunizations Accordion Expands the Additional Immunizations Accordion
- 18. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 18 7.2 Immunization Details 7.2.1 Overlay Note Item Convention On Click Display Rules Notes 1 Menu Menu Launches the Immunization Details Menu Pop-Over 2 Dose Number Only displays for sequence-based immunizations Calculated based on the administered date. 3 Reported Only displays if the dose was reported (i.e., not administered through the system) 4 Administered Date Date and Time 5 Reported Dose Results - Immunizations Reported 6 Remove Reported Result Secondary Button Removes the reported result listed directly above the button. Only available for reported results 7 Sequence Reset Displays after the last ignored dose if a component's sequence has been reset from the Menu. 8 Administered Dose Results - Immunizations Administered 9 Projected Due Date Projects the next due date for the next dose/instance based on the most
- 19. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 19 Note Item Convention On Click Display Rules Notes recent administered immunization. 7.3 Immunization Details Menu 7.3.1 Pop-Over Note Item Convention On Click Display Rules 1 Reset Sequence Launches the Reset Sequence Overlay Only available for sequence-based immunizations. 2 View External Reference InfoButton 7.4 Reset Sequence 7.4.1 Overlay Overview Reset Sequence allows users to restart dose sequence calculations and tracking for patients. This functionality is helpful for sequence-based immunizations that can be completed multiple times or immunizations with strict schedules that patients may miss. Note Item Convention On Click 1 Sequence Reset Date Overlay - Date Overlay (with Clear) Selects the date to start calculating the immunization sequence from and closes the Date Overlay. All instances before the date will be ignored in calculations. 2 Clear Reset Date Overlay - Date Overlay (with Clear) Removes the reset sequence date and closes the Date Overlay
- 20. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 20 7.5 Immunization Options 7.5.1 Pop-Over Overview Clicking on the name of a component in Condition Management will launch this Pop-Over. It functions similarly to the Pop-Over launched by clicking on a result item. Note Item On Click Notes 1 Add Reported Launches the Add Reported Immunization Overlay 2 Decline for Visit Launches the Decline for Visit Overlay This option is not available if there is not a MIS Vaccine that contains only the selected component. 3 Stop Tracking Launches the Stop Tracking Overlay 7.6 Add Reported Immunization 7.6.1 Overlay Note Item Convention Display Rules Notes 1 Vaccine Given Data Entry - Drop-down List every MIS Vaccine that contains the selected component. The first vaccine found that contains only the component will default. Best practice is to have only one single MIS Vaccine per MIS Component. 2 Date Performed Data Entry - Drop-down 3 Comment Data Entry - Free
- 21. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 21 Note Item Convention Display Rules Notes Text 7.7 Decline for Visit 7.7.1 Overlay Note Item Convention Display Rules Notes 1 Decline for Visit Reason Data Entry - Drop-down List of reasons (and unique behaviors): - Parental decision - Sends code 00 on interface message - Patient decision - Sends code 03 on interface message - Religious exemption - Sends code 01 on interface message - Other refusal - Sends code 02 on interface message 2 Comment Data Entry - Free Text Always available
- 22. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 22 7.8 Stop Tracking 7.8.1 Overlay Note Item Convention Display Rules Notes 1 Stop Tracking Reason Data Entry - Drop- down List of reasons (and unique behaviors): - Complete - Marks item as complete - Does not generate an interface message - History of disease - Uses MIS Component's History of Disease Code in interface message - Lab-confirmed immunity - Uses MIS Component's Lab-confirmed immunity code in interface message - Parental decision - Sends code 00 on interface message - Patient decision - Sends code 03 on interface message - Religious exemption - Sends code 01 on interface message - Other - Sends code 02 on interface message 2 Comment Data Entry - Free-Text Always available 7.9 Add Additional Immunizations 7.9.1 Overlay Overview The Add Additional Immunizations Overlay looks up to the MIS Components Dictionary and follows the Multi-Select Results for Simple Lookups convention.
- 23. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 23 7.10 Office Procedure with Medications Details 7.10.1 Overlay Overview Office Procedures with medications were updated to use the same display format defined in the Immunization Details - Overlay section.
- 24. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 24
- 25. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 25 8 REPORTS AND LETTERS The two reports listed below were updated to display information from immunization data stored in MRI. The reports were also added to the APR Menu (APR -> Reports). 8.1 Reports 8.1.1 Immunization Report and Audit Log 8.1.2 Print Vaccine History by Lot
- 26. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 26 9 AUDITS The Immunization Report and Audit Log Report in (APR -> Reports -> Immunization Report and Audit Log) tracks all immunization instances for a patient and also serves as an audit log via an option on the report criteria screen. The audit information on the report continues to display all audit information previously available on the APR Supervisor List Edit Log.
- 27. _________________________________________________________________________________________________ LP: 3114 MP Immunizations 27 10 APPENDIX