1. State of imMTrax 2016 Immunization Regional Workshop Lisa Rasmussen, IIS Manager Michelle Funchess, IIS Training and Support

2. What is imMTrax? Montana’s Immunization Information System (IIS) Immunization Information Systems (IIS) are confidential, population- based, computerized databases that record immunization doses administered by participating providers residing within a given area. imMTrax is: A Lifetime IIS – all ages, all stages of life An Opt In IIS – consent to participate in imMTrax is required by Montana law

3. What is imMTrax? imMTrax seeks to help providers and families by consolidating immunization information into one location. By age two, over 20% of children in the U.S. have seen more than one healthcare provider.

4. What is imMTrax? The consolidation of immunization records allow for additional features: Reminder and Recall Immunization Coverage Estimates and Reports Inventory Management Immunization Forecasting

5. imMTrax by Numbers

6. imMTrax: Active Users Over 2,000 Active imMTrax Users

7. imMTrax: Participating Sites Over 550 Enrolled Locations/Offices

8. Add All IZ Given Add Some IZ Given Read Only imMTrax: Levels of Participation Montana imMTrax users and sites participate in a variety of ways.

9. imMTrax: Method of Record Entry

10. Administered Immunizations Captured by Year Does not include immunizations entered but given in a previous year. Immunizations, in Thousands 201320152014

11. Timeliness of Immunizations Entered in 2015 Children and Adolescents (0-18 years) START FINISH ≤ 1 day 1 -7 days 8 – 14 days 15 – 30 days 30 + days

12. Timeliness of Immunizations Entered in 2015 Adults (19 + years) START FINISH ≤ 1 day 1 -7 days 8 – 14 days 15 – 30 days 30 + days

13. Population Participation: Children Ages 4 months to 5 years X Excludes H1N1- only records X Excludes H1N1 X Excludes Travel Vaccines Healthy People 2020 Objective = 95 % MT Census Data MT imMTrax Count 101 % 2 + Immunizations Recorded in imMTrax

14. Population Participation: Adolescents Ages 11 – 17 years Doses administered age 9 – 17 X Excludes H1N1 X Excludes H1N1- only records X Excludes Travel Vaccines Healthy People 2020 Objective = Increase the number of US States that have over 80% adolescent participation to over 40. MT Census Data MT imMTrax Count 71 % Only Includes: Tdap/Td, HPV, Influenza, Pneumococcal, Meningococcal, Hep A, Hep B, Polio, MMR, Varicella. 2 + Immunizations Recorded in imMTrax

15. Population Participation: Adults MT Census Data MT imMTrax Count 55 % 1 + Immunizations Recorded in imMTrax Only Includes: Influenza, Tdap/Td, Varicella, HPV, Zoster, MMR, Pneumococcal, Meningococcal, Hep A, and Hep B. Ages 19 and older Doses administered age 19 and older X Excludes H1N1 X Excludes H1N1- only records X Excludes Travel Vaccines

16. Population Participation Over Time

17. Improvements 2015-2016

18. imMTrax: Ongoing Projects Improve Electronic Data Exchange quality Increase Volume- Electronic Data Exchange Meaningful Use Improve match rules for incoming electronic messages Improve merge clients functions

19. imMTrax: Ongoing Projects Vaccine-level duplication prevention Improve imMTrax data utilization capabilities Improve end-user overall experience

20. imMTrax: Improvement Highlights Updates to the imMTrax-generated School Entry Form following School Rule updates in 2015.

21. imMTrax: Improvement Highlights Insert and Last Update Dates Displays initial entry date for an immunization, as well as the last time that immunization was updated.

22. imMTrax: Improvement Highlights New Immunization Forecaster “More Information” indicator Forecasting displays immunizations up to a year in the future (Earliest Date). Changes and improvements to previous forecaster limitations.

23. imMTrax: Improvement Highlights Auto-generated Immunization Coverage graph and reports to include Primary & Secondary Medical Home Associations

24. imMTrax: Improvement Highlights Immunization Coverage Reports: Age Range option added (Months or Years) with As Of date selection Ability to edit Immunized as of date. Additions to the By Vaccine Group options: Rotavirus Hep A

25. imMTrax: Improvement Highlights Immunization Coverage Reports: Addition of three pick list options

26. imMTrax: Improvement Highlights Immunization Coverage Reports: Output Changes Client A

27. imMTrax: Improvement Highlights Immunization Coverage Reports: Output Changes

28. imMTrax: Improvement Highlights Reminder and Recall Functions: Addition of three pick list options Inclusive Vaccine Group selection options

29. imMTrax: Improvement Highlights Merge Vaccine Level Display: Vaccines being evaluated in Merge will display the vaccine information rather than the vaccine group. -adult-pediatric

30. imMTrax: Improvement Highlights Provide User Feedback Available on every screen

31. imMTrax: Improvement Highlights Provide User Feedback

32. Looking to the Future

33. imMTrax: Looking to the Future Bidirectional Electronic Data Exchange A process where a site sending electronic immunization information can also send a query message to imMTrax. imMTrax will receive the message and perform a record search on the information provided. A response message will be sent back to the site with the existing record information or search result (no matches found).

34. imMTrax: Looking to the Future Bidirectional Electronic Data Exchange Q: Any records in imMTrax for Suzy Smith? A: Yes. Here you go. Your EHR

35. imMTrax: Looking to the Future Electronic Dose Decrementing imMTrax functionality that can enable a site sending electronic immunization information to have doses in their inventory automatically deducted as messages are received.

36. imMTrax: Looking to the Future Electronic Dose Decrementing Your EHR John Smith DOB 06/29/2003 --------------------------------------- HPV- Gardasil 9Lot K026246Given 08/24/2015 MCV4- MenactraLot U5021ABGiven 08/24/2015 John Smith

37. imMTrax: Looking to the Future Electronic Exchange – Provider Portal An imMTrax module that would allow sites sending immunization information electronically to view, search, and analyze the status of patient information from initial receipt of information through imMTrax processing and filters.

38. imMTrax: Looking to the Future Electronic Exchange – Provider Portal

39. Ongoing Considerations

40. imMTrax: Ongoing Consideration Importance of “hands on” involvement in imMTrax: Data quality and correction Site-specific Medical Home Associations MOGE (Moved or Gone Elsewhere) Prevention of duplicate records

41. Lisa Rasmussen IIS Manager lisarasmussen@mt.gov Michelle Funchess IIS Training and Support mfunchess@mt.gov Deb Belleau Interoperability Coordinator dbelleau@mt.gov