Immunization Alerts in e-mds Ensure timely and appropriate immunization orders and administration Keeping track of patient vaccination requirements is an important aspect in the delivery of ongoing patient care. Alerts based on patient age, vaccination history, time since previous vaccination, and risk factors help streamline care and reduce the burden on providers to keep track of recommended vaccination requirements. This is especially helpful to ensure patients complete all doses in a vaccination series. In e-mds, these alerts are called Immunization Alerts. Benefits of Immunization Alerts Automated Immunization Alerts reduce the need to manually check records to assess patient vaccination needs, and help ensure that patients receive appropriate and timely vaccinations according to the Centers for Disease Control and Prevention (CDC) recommendations. Considerations: In e-mds, alerts for vaccines are not automatically created when a vaccine is added to the EHR immunization schedule, and they must be created for each new vaccine. A vaccine administered by another practice or in the pharmacy may not have been documented in the EHR; an alert could be triggered for a vaccine the patient has already received. Maintaining updated vaccine history for patients will minimize duplication User privileges to create alerts may be limited to select users with specific security privileges or subject to practice business policies If you have further technical questions, consult your internal or external EHR support resources. This Guide provides a highlevel overview of how to create an Immunization Alert within e-mds. This overview is designed to provide guidance for you, your practice electronic health record (EHR) champion, or IT staff. Please note that this Guide was created based upon e-mds version 8.. Features and their locations may change as new software versions are released. This Guide is meant to serve as overview information only, and should not replace detailed instructions provided to you by your internal or external EHR support resources. 1
Creating an alert for an immunization in e-mds e-mds enables the setup of Immunization Alerts based on criteria set in the Clinical Rule Manager. Available criteria include diagnosis, orders, current and prior medications and due or past-due vaccinations. The Immunization Alerts are displayed when the data in the patient chart meet the criteria. For example, an Immunization Alert may be created to alert prescribers of patients who have missed the second dose of a vaccination series. The following steps illustrate how to create Immunization Alerts to identify patients who may be due or overdue for a second dose of Product X. Creating a Clinical Rule for Immunization Alerts In situations where a second vaccination is recommended to be given within a certain amount of time after the first dose, it is necessary to create two separate Clinical Rules. 1. First Dose Rule Open the Rule Manager module and Select New e-mds Rule Manager Rule Tools Help Clinic Task New Copy Edit Delete Run Run All Search For: Reset Show Name Descri The Select Rule Module window displays a list of all available rule types Choose rule type Immunizations/Repetitive Testing Scenarios and click Select Select Rule Module Select Help Exit Description Disease Management Rules (eg. diabetes, CHF, etce Gestational Age Health Maintenance (based on CPT lookup) Immunizations/repetitive test scenarios Lab result (flowsheet) Lab Tracking rule for overdue cpt/hcpcs Medication rule by cpt Medication rule by cpt and icd Required Form (HIPAA or Advance Directive) Script Audit rule for overdue reports 2
The New Rule window displays In the New Rule window, add a which will display in patient charts. For example, Product X vaccine 1st dose Add a Result Description that clearly describes the focus of the rule and any actions that need to be taken. For example, Product X vaccine 1st dose all patients aged 18 and older Check the Rule Active checkbox Optional: If the rule will be displayed on the Patient Portal, check the Available on Portal checkbox in the Rule tab, and enter a patient friendly Portal Description. For example, You are due for a Product X vaccination Set Gender to All Patients Set the Minimum Age and the Maximum Age, as appropriate Set User Roles to determine who can see the Rules in the patent chart Set the Number of Times field to 1 to denote that this rule is only looking for one occurrence of the vaccine Save Specialty Help Exit Product X -1st dose Result Description Product X vaccine - 1st dose-all patients aged 18 and older Rule Drug Allergy Triggers Drug Allergy Triggers CPT Satisfiers Result Specialty Info Source Available to portal Portal Description You are due for Product X vaccination Gender All patients Male Female Minimum Age Weeks Months Years 18 Maximum Age 11 User Roles: Providers Clinical staff Non-clinical staff Rule Reminder Number of Times 6 1 (days before due) (cumulative number of times the patient needs to have this test done) Patient Only (Optional) Patient 3
Select CPT Satisfiers to set the CPT code that the rule will look for Select Add, search for and select the appropriate CPT code Select Save to activate the rule Result Description Product X -1st dose Product X vaccine - 1st dose-all patients aged 18 and older Rule Drug Allergy Triggers Drug Allergy Triggers CPT Satisfiers Result Specialty + X Add Delete Code Description 99999 Product X vaccine 2. Second Dose Rule To create a new rule for the second dose of Product X, open the Rules Manager module and select New Select Immunizations/Repetitive Testing Scenarios Add a for the 2nd dose. For example, Product X vaccine 2nd dose due 6 months after 1st dose Add a Result Description for the 2nd dose. For example, Product X vaccine 2nd dose all pts aged 18 and older due 6 months after 1st dose Check the Rule Active checkbox Optional: Select Available on portal and add Portal Description as appropriate. For example, You are due for a second dose of Product X vaccine 6 months after the first dose Set Gender to All Patients Set the Minimum Age and the Maximum Age the same as the 1st dose rule Set User Roles the same as 1st dose 4
Set the Number of Times field to 2 to denote that this rule is looking for 2 occurrences of the vaccine Save Specialty Help Exit Result Description Product X vaccine - 2nd dose due 6 months after 1st dose Product X vaccine - 2nd dose all pts aged 18 and older-due 6 months after 1st dose Rule Drug Allergy Triggers Drug Allergy Triggers CPT Satisfiers Result Specialty Info Source Available to portal Portal Description You are due for a second dose of Product X vaccine 6 months after the first dose Gender All patients Male Female Minimum Age Weeks Months Years 18 Maximum Age 11 User Roles: Providers Clinical staff Non-clinical staff Rule Reminder Number of Times 6 2 (days before due) (cumulative number of times the patient needs to have this test done) Patient Only (Optional) Patient Select CPT Satisfiers tab, and set the same CPT code as the 1st dose rule Result Description Product X vaccine - 2nd dose due 6 months after 1st dose Product X vaccine - 2nd dose all pts aged 18 and older-due 6 months a Select Add, search for and select the appropriate CPT code Rule Drug Allergy Triggers + X Add Delete Drug Allergy Triggers CPT Satisfiers Result Specialty Select Save to activate the rule Code Description 99999 Product X vaccine 5
View alerts in patient s chart If a patient is due for a vaccination, the alert will be displayed in the Rules/Reminders section of the chart Because there are two rules being created with the same age criteria, they will both initially display at the same time in the patient chart Order Override Run All Date Last Due Date Status Description N/A 9/18/217 Overdue Product X vaccine -1st dose N/A 1/18/218 Overdue Product X vaccine - 2nd dose due 6 months after 1st dose Add Rule Source Once the initial dose of Product X is documented, the alert for the 1st dose rule will be satisfied and will no longer display, and only the alert for the 2nd dose will be visible Order Override Date Last Due Date Status Description 9/28/217 1/28/218 Overdue Product X vaccine - 2nd dose due 6 months after 1st dose Run All Add Rule Source 217 GSK group of companies or its licensor. All rights reserved. Printed in USA. November 217 6