An Overview of the Massachusetts Immunization Information System (MIIS) Presented by Tabitha Rohrer MIIS User Support Specialist Disclosure I, TABITHA ROHRER, HAVE BEEN ASKED TO DISCLOSE ANY SIGNIFICANT RELATIONSHIPS WITH COMMERCIAL ENTITIES THAT ARE EITHER PROVIDING FINANCIAL SUPPORT FOR THIS PROGRAM OR WHOSE PRODUCTS OR SERVICES ARE MENTIONED DURING THIS PRESENTATION. I HAVE NO RELATIONSHIPS TO DISCLOSE. I MAY DISCUSS THE USE OF VACCINES IN A MANNER NOT APPROVED BY THE U.S. FOOD AND DRUG ADMINISTRATION, BUT IN ACCORDANCE WITH ACIP RECOMMENDATIONS. Agenda Quick Overview of the MIIS Legislation & Regulations Data Sharing Registration MIIS Onboarding Process Launch Data Review Go-Live Meaningful Use Stage 3 Next Steps for Providers 2016 1
QUICK OVERVIEW OF THE MIIS Secure, confidential web-based system capable of electronic data exchange and direct data entry Consolidates immunization records over lifespan Assists providers with clinical decisions o o Helps identify due or overdue immunizations Prevents over/under immunization Includes practice management tools o o o Patient immunization and vaccine usage reports Assists schools with student immunization coverage Tracks over 3.2 million doses of vaccine distributed by MDPH annually Provides infrastructure for tracking essential information during public health emergencies One patient MIIS one record MIIS Immunization Registry (EHR or Web Interface) Vaccine Management (Web Interface only) Immunization Record Immunization Forecast Add/Edit Immunizations Certificate & Reports Annual Enrollment Vaccine Ordering Inventory Management Reports 2016 2
Agenda Quick Overview of the MIIS Legislation & Regulations Data Sharing Registration MIIS Onboarding Process Launch Data Review Go-Live Meaningful Use Stage 3 Next Steps for Providers Legislation (2010) Mandatoryreporting of all immunizations administered in MA Established provider s duty to inform patients about the MIIS and patient s right to object to data sharing State registry of vital statistics transmits immunization information regarding immunizations administered to a newborn Accessible by healthcare professionals that administer immunizations, as well as schools, LBOH, WIC, and other state agencies programs involved in immunizations Regulations (2015) Set out required information to be transmitted with historical vaccinations and current vaccinations System access and confidentiality, provider registration, research requests Patient access to records, requests to amend records Provider s duty to inform patients about the MIIS and patient s right to object to data sharing Compliance schedule ended in June 2016 all providers in MA should be reporting 2016 3
2013 Total Sites: 341 Total Patients: 1,539,629 Total Shots: 7,303,293 2015 Total Sites: 1,121 Total Patients: 4,427,623 Total Shots: 33,334,571 2011 Total Sites: 9 Total Patients: 3,902 Total Shots: 69,505 Total Sites 2017 Total Patients 2,200* 6,249,000* Total Shots 43,846,000* MIIS ROLLOUT BY TYPE OF PROVIDER Quick Overview of the MIIS Legislation & Regulations Data Sharing Agenda Registration MIIS Onboarding Process Launch Data Review Go-Live Meaningful Use Stage 3 Next Steps for Providers 2016 4
What is Data Sharing? Licensed health care providers administering vaccinations shall discuss the reporting procedures of the immunization registry with the persons receiving the vaccinations and their parents or guardians, when appropriate, and advise them of their right to object to the disclosure of such information as set forth in this section. - 105 CMR 222.000 Each patient has the right to limit who can see their immunization data in the MIIS Patient can choose to object or withdraw a previous objection any number of times Step by Step 1. Complete an Objection (or Withdrawal of Objection) Form 2. Update data sharing status in the MIIS 3. Fax completed form to MIIS Help Desk 4. File completed form with patient record Data sharing status = YES evitals birth information school nurse (read only) pharmacy community health center primary care provider Data sharing status = NO evitals birth information school nurse (read only) pharmacy community health center primary care provider 2016 5
Data sharing status = UNKNOWN evitals birth information school nurse (read only) pharmacy community health center primary care provider Data sharing status = YES evitals birth information school nurse (read only) pharmacy community health center primary care provider Quick Overview of the MIIS Legislation & Regulations Data Sharing Registration Agenda MIIS Onboarding Process Launch Data Review Go-Live Meaningful Use Stage 3 Next Steps for Providers 2016 6
MDPH Immunization Program - MIAP 2016 2016 7
Registration Each site registers on ContactMIIS.info and submits forms for MIIS and Virtual Gateway (VG) Required site forms: MIIS Provider Site Agreement VG Services Agreement Every site must have at least one Access Administrator (AA) Required AA forms: MIIS User Agreement VG Access Administrator Form The Access Administrator identifies users on ContactMIIS.info Required user forms: MIIS User Agreement Form A helpful metaphor MIIS VG VG USERNAME MIIS HELPDESK Agenda Quick Overview of the MIIS Legislation & Regulations Data Sharing Registration MIIS Onboarding Process Launch Data Review Go-Live Meaningful Use Stage 3 Next Steps for Providers 2016 8
Onboarding with the MIIS Launch Data Review Go-Live Launch Legal Requirements Review legislation and regulations Register for Meaningful Use (optional) HL7 Checklist Complete the HL7 Checklist & Mapping Table and submit it to the MIIS HelpDesk Onboarding Plan Identify the clinical champion who will oversee the onboarding process at your site View the onboarding webinar available on ContactMIIS.info Onboarding with the MIIS Launch Data Review Go-Live 2016 9
Technical Clinical Training Staff review: Technical teams connect site(s) to Certification Environment Clinical Workflow Vaccine Manager Training Training Videos Quick Reference Guides Message format & content is reviewed Stock clinics or offices with MIIS materials Clinical Workflow Technical Technical contacts at your site or with your electronic health record vendor oversee HL7 mapping and interface connection HL7 2.5.1 can be sent securely via SOAP web services or LAND device Messages are formatted to our local specifications Mapping CVX & MVX codes, Lot Numbers, VFC Eligibility status, and VIS dates Valid values must be mapped to applicable HL7 table values Real data is sent to the test environment Clinical Workflow 10/27/19 2016 10
Materials Each patient must be informed that their data is being reported to the MIIS. Recommended materials: MIIS Fact sheet (several languages) MIIS Posters (English and Spanish) Sample language For use in newsletters, websites, registration forms, etc. Objection (or Withdrawal of Objection) form Only to be given to patients who request it! Training All MIIS users need to access the web interface to perform core MIIS functions Search for a patient record De-duplicate patient records and shots Look up an immunization forecast Manage a patient s data sharing status Run usage, coverage, and reminder/recall reports Monitor data quality Vaccine ordering and inventory management Training Videos Please have your users view the required training videos (indicated in bold ) Italicized videos are beneficial, but are not required o Introduction, Login and Navigation (~14 minutes) o Data Sharing ( ~14 minutes) o Search and Add Patient Immunization Record (~15 minutes) o View, Edit, or Add Immunizations (~10 minutes) o Duplicate Records and Immunizations (~12 minutes) o Individual Patient Reports (~5 minutes) o Im munization Forecast Report (~7 minutes) o Clinical Comments (~10 minutes) o Reminder/Recall Report(~10 minutes) o Coverage Reports (~7 minutes) ContactMIIS Resource Training Center: www.contactmiis.info 2016 11
Onboarding with the MIIS Launch Data Review Go-Live Data Review Testing Connection established Patient data sharing set to unknown Message counts verified Legacy load obtained (when possible ensures complete patient records) Clinical Data Review Staff conducts data review in MIIS MIIS staff reviews data quality check and provides input Data Review Two Phases of Data Review Data Review in Test Environment Clinical staff looks up 10 patient records in their EHR MIIS staff compares records in test environment Clinical staff and MIIS staff go over data review results during a phone or internet meeting If data quality is good, provider is connected to production environment Data Review in Production Clinical staff looks up 10 patient records in their EHR to compare with information in the MIIS* If no issues are found during data review, MIIS staff work with the site to determine their date to go-live *Please complete within 2 weeks of your site s connection to MIIS production 2016 12
Onboarding with the MIIS Launch Data Review Go-Live Go-Live Implement Workflow Manage Data Sharing Ongoing Data Quality Provider informs patients about MIIS Provider processes Objection (and Withdrawal of Objection) Forms Designated staff to manage data sharing in MIIS as needed Patient data sharing status set to yes Quarterly data quality checks recommended Agenda Quick Overview of the MIIS Legislation & Regulations Data Sharing Registration MIIS Onboarding Process Launch Data Review Go-Live Meaningful Use Stage 3 Next Steps for Providers 2016 13
Meaningful Use and the MIIS Electronic data exchange with the MIIS meets the public health objective for meaningful use of EHRs o MA providers and hospitals are eligible for millions of dollars through federal reimbursements by CMS under the HITECH Act of 2009 o Will help the MIIS roll out by populating the system with a lot of data quickly o The MIIS has both the technical and administrative capacity to support immunizing providers in qualifying for Centers for Medicare and Medicaid s Electronic Health Record (EHR) Incentive Program to provide financial compensation for the Meaningful Use of certified EHR technology to achieve health and efficiency goals Meaningful Use Stage 3 https://www.cms.gov/regulations-a nd-guida nce/legislation/ehrincentiveprogra ms/downloads/ TableofContents_E P_Medicaid_Stage3.pdf Meaningful Use Stage 3 The MIIS has the technical and administrative capacity to support readiness for Meaningful Use Stage 3, which includes: o The ability to respond to bidirectional queries (QBP/RSP) o The capacity to receive NDC codes o Note: an IIS may also opt to require CVX codes in parallel with NDC codes until full adoption of NDC codes has been completed Declarations of readiness for Stage 3 MU, bidirectional queries, and NDC codes should be in addition to, rather than replace existing readiness declarations for Stage 2 MU (unidirectional reporting). Providers using a LAND device will NOT be eligible for Meaningful Use Stage 3. https://www.cdc.gov/ehrmea ningfuluse/docs/public-health--stage-3-mu-measures-in-2017_v1.pdf 2016 14
Agenda Quick Overview of the MIIS Legislation & Regulations Data Sharing Registration MIIS Onboarding Process Launch Data Review Go-Live Meaningful Use Stage 3 Next Steps for Providers What s next? Complete Registration Register for Meaningful Use Read through MIIS onboarding page Submit HL7 checklist Review MIIS legislation and regulations Attend kickoff call Contact the MIIS Help Desk to request to onboard ContactMIIS.info screenshot etc 2016 15
Registration Each provider site must complete registration for the MIIS and the Virtual Gateway (VG) Required forms: MIIS Provider Site Agreement VG Services Agreement Every site must have at least one Access Administrator (AA) identified Required forms: MIIS User Agreement VG Access Administrator Form Additional users are identified by an Access Administrator in the ContactMIIS Resource Center - www.contactmiis.info Required forms: MIIS User Agreement Form MIIS Help Desk Phone (617) 983-4335 Fax (617) 983-4301 Email miishelpdesk@state.ma.us Website www.contactmiis.info 2016 16