LP 3114 functional specification v9

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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

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9 AUDITS .........................................................................................................................................................................26
10 APPENDIX ....................................................................................................................................................................27

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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.

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2 USE CASES

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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

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3.1 Immunization Interface Data
3.1.1 CVX Codes

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3.1.2 VIS Publication Dates

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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.

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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.

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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.

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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

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6.2 MIS Vaccine Dictionary
6.2.1 Vaccine
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
Always No N/A Standard lookup to RXM
Procedure Dictionary filtered
to Office Procedure-type
entries

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6.3 APR Condition Category
6.3.1 Category
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

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6.4 APR Condition Management
6.4.1 Standard Items
1 Additional
Immunizations
Display Name
Scalar Defines the name of the Additional
Immunizations accordion in
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

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7 ROUTINES
7.1 Condition Management
7.1.1 Standard Items

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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
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

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7.2 Immunization Details
7.2.1 Overlay
1 Menu Menu Launches the
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

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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

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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

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Text
7.7 Decline for Visit
7.7.1 Overlay
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
- Religious exemption
- Other refusal
2 Comment Data Entry - Free Text Always available

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7.8 Stop Tracking
7.8.1 Overlay
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
- Patient decision
- Religious exemption
- Other
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.

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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.

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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

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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.

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10 APPENDIX

LP 3114 functional specification v9

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