Implementation of the Influenza Vaccine Schedule and the Next-Due Recommendation in the Contra Costa County's IIS

Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to understand CCAIR's implementation of the Influenza vaccine schedule in terms of the unique challenges of wanting to leverage existing code and the table-driven next-due algorithm logic to support the “seasonal nature” of Influenza vaccine.

Background:
Providers looked up the next-due recommendations on CCAIR (Contra Costa Automated Immunization Registry) during patient clinic visits. A lower than expected Influenza immunization rate in past seasons was perceived to be partly due to the lack of next-due recommendation.

Objectives:
Improve the Influenza immunization rate by implementing the Influenza vaccine schedule.

Methods:
(1) Software changes were made to support the “seasonal” nature of the Influenza immunization schedule while leveraging existing code and preserving the table-driven design. (2) All Influenza vaccines administered to patients of immunization age were entered into CCAIR. (3) Over 100 test cases were specifically created to ensure the integrity of the recommendation given the complexity of the new schedule. (4) A specially written program was used for regression testing. (5) Encounter records on a data warehouse were used to analyze the immunization rate before and after the implementation of the new schedule and to detect missed opportunities to administer the vaccine.

Results:
The implementation was successful that the software now supports the current next-due Influenza schedule for patients from six months to nine years old and from fifty and up. It also passed all tests in our test case library. Changes in Influenza vaccination rates were determined by comparing the numbers from one season to the next.

Conclusions:
Leveraging existing IIS to support new vaccines with different next-due requirements proved out the solidarity of our system design.