AFIX Online Tool User Guide

Version 2.0 Effective January 2015

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Introduction

The AFIX Online Tool is for assessing immunization practices within a clinic, private practice, or any other

environment where immunizations are provided. This software is designed to be used in conjunction with the

AFIX strategy.

The AFIX Online is a data collection tool. After AFIX site visit information data is entered into the AFIX

Online Tool, data analysis capabilities can be utilized to pinpoint strengths and areas of improvement for

an individual immunization provider/clinic.

Coverage data for the AFIX Online Tool will need to come directly from your IIS or IIS and CoCASA.

The user guide describes how to utilize this system for recording, managing, and aggregating AFIX site visit

information. Any questions or comments about the AFIX Online Tool should be communicated to the

following personnel:

Akash Dongol Tel. 1-800-803-5212 E-mail: afixonline@cdc.gov

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Table of Contents

Getting Started …………………………………………………………………… 3

AFIX-Home ………………………………………………………………………… 5

Provider Information ………………………………………………………………. 6

General Site Visit Information ……………………………………………………... 7

Questionnaire …………………………………………………………………….... 10

Assessment Results …………………………………………………………………. 11

Feedback ………………………………………………………………………….. 12

eXchange ………………………………………………………………………….. 13

Summary …………………………………………………………………………... 15

Files ………………………………………………………………………………... 16

Notes ……………………………………………………………………………..... 16

AFIX-Help …………………………………………………………………………. 17

AFIX-Reports ……………………………………………………………………...... 17

Submitting the AFIX Annual Report ………………………………………………... 19

AFIX Online Tool Required Fields ………………………………………………...... 20

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Getting Started

Accessing the AFIX Online Tool will require you to have a Secure Access Management Service (SAMS)

account and an access to the Program Annual Report and Progress Assessments (PAPA) application.

1) Log into SAMS website (https://sams.cdc.gov).

For help with SAMS account assistance, please contact the SAMS Help Desk at the toll

free number: 877-681-2901, Email: samshelp@cdc.gov.

For assistance with the AFIX Online Tool, please contact the AFIX Online Tool Help

Desk (Akash Dongol) at the toll free number: 800-803-5212, Email:

afixonline@cdc.gov

2) From the PAPA Welcome Page, click the AFIX Online Tool hyperlink.

3) AFIX Online Tool – Home Page

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4) AFIX Online Tool Site Visit Navigation Tabs

5) Required Field Status included in each site visit information page.

a. Complete: if you see a complete status displayed on the page, this implies that all

required fields have been entered, validated, and page is considered complete. In order

for the entire site visit to be complete and to show up in the aggregate reports, you must

ensure that each page status is marked as COMPLETE. You must enter all required fields,

and check acknowledge (refer to the check box displayed in the screen under point 6)

that all responses are final and the page is complete, then click on SAVE AND CONTINE

to mark required field status as COMPLETE.

b. In-progress: if you see an in-progress status displayed on the page, this implies the page

is either missing a required field or has not been validated for completeness.

6) Data SAVE Options at bottom of each site visit questionnaire page.

a. SAVE: Clicking here will allow you to save the data for later and remain on the page. It

doesn’t check for page completeness or required fields.

b. SAVE AND CONTINUE: Clicking here will save the data and move users to the next page.

It only checks for page completeness if you select the acknowledgement box. If you

acknowledge that the page is complete and all responses are final, clicking save and

continue will check the completeness of a page so that if required fields are missing you

will need to complete them or the data will not save using this button.

c. SAVE AND QUIT: Clicking here will save your site visit data and exit the AFIX Online

Tool. You will be logged out of the PAPA application.

Navigation Tabs

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AFIX-Home

Use this page to search and locate the provider you are planning to visit or add a new provider. From the

search results, you will be able to begin a new site visit, edit the provider information or add data to an

existing site visit record.

To Search for a Provider

1) Search Criteria: To search for a provider, use any of the search criteria available including

(Provider PIN number, Name of the clinic or practice, City, and ZIP code). You can also perform

the search using parts of those search criteria. The Search Results will list all providers that match

your search criteria.

2) Search: Click here to submit the search. If you leave all 4 search fields blank and click here it will

provide a list of all providers.

3) Reset: Click here to reset all search fields and the search results list.

To Add or Edit a Provider Information

4) Add a New Provider: Click here to go to the provider Information page to add a new provider.

You will not have the ability in the AFIX Online Tool to delete enrolled VFC providers.

5) PIN: Click on the provider PIN hyperlink to go to the provider page to edit the provider

information.

To Add or View Previous site visits

6) Previous Visits: Click on this hyperlink to generate a list of all previous site visits for the selected

provider.

7) New Visit: Click here to add a new site visit.

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Provider Information

Your provider information is preloaded into the system with the exception of 3 required fields; VFC

Provider Type, Public Provider Details, and provider phone number in the Provider Address section. Make

sure to enter those fields or review and confirm them if they’d already been entered through prior visits.

Entering those required fields is only required once and the information will carry over to following visits.

Use this page to add a new provider or edit existing provider information. Once the provider information

is SAVED, you could click on Go to General Site Visit Information to enter the new site visit data. All

required fields are marked with red asterisk (*).

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General Site Visit Information

The assessment specific fields in the header section of this page are auto populated as you start filling out

the Site Visit Information.

The provider specific information fields in this page are auto populated for you. All Fields marked with a

red asterisk (*) are required fields. Please note the “Not a full AFIX” visit function has been added to the

General Site Visit Information tab for recording partial AFIX visits.

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General Site Visit Information

Field Name Answer Tips

Site reviewer Click on Choose reviewer to select a reviewer from the existing list or

enter a new one.

Assessment date Enter the date of your assessment. A calendar will pop-up for you to

select the date.

Assessment name A default name will be provided for this. The name will include the

Provider name and the assessment date. You will have the option to

change the Assessment name in this free text box.

Assessment questionnaire Based on your assessment criteria, select the appropriate questionnaire

for the age group selected for your assessment. If conducting a childhood

assessment, you would select the Childhood Assessment Questionnaire,

while if conducting an adolescent assessment, you would select the

Adolescent Assessment Questionnaire, and if conducting a combined

(childhood/adolescent) assessment, you would select Both Assessment

Questionnaire. The questionnaire is the same for both age groups with

the exception of question 6 (Do you have a system in place to schedule

wellness visits for patients at 11-12 years of age?) which is only

applicable to adolescent assessments.

Assessment age cohort Choose your patient age cohort for the site visit. If conducting a childhood

assessment, you would select the Assessment Age Cohort 0-3 years and if

conducting an adolescent assessment, you would select the Assessment

Age Cohort 13-18 years and if conducting a combined

(childhood/adolescent) assessment, you would select both age cohorts.

Antigens Antigens are auto populated based on the Assessment Age Cohort

selected.

Number of age eligible

(children/adolescents) in practice

Enter the total number of children within the assessment age group (0-3

years) and/or the number of adolescents within the assessment age group

(13-18 years) that belong to the practice.

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Ages assessed If age assessed is different than the standard 0-3 years or 13-18 years

as of assessment date, then specify the ages assessed. Example,

childhood [0-3 years by age 3] or

age 24 – 35 months (all 2 year olds).

The previous AFIX visit

4:3:1:3:3:1:4 Percent

Enter the provider’s coverage (%) for the last childhood site visit, or leave

it blank if you don’t know it.

The previous AFIX visit Percent Enter the provider’s coverage (%) for the last adolescent site visit, or

leave it blank if you don’t know it.

Date of previous/most recent

AFIX site visit

Enter the most recent AFIX site visit date for the provider.

AFIX visit If the site visit is completed in conjunction with VFC site visits then choose

Combined, otherwise choose Separate.

Type of VFC visit conducted If the AFIX visit is combined with a VFC site visit, indicate if the VFC site

visit is a VFC Compliance or Unannounced visit.

AFIX Assessment method used IIS is the new AFIX standard method, however, if patient charts are

reviewed to confirm the accuracy and completeness of IIS data then select

the IIS and Chart data option.

AFIX Assessment tool or

combination of tools used

If you don’t use the CoCASA application for running provider coverage

rates then select IIS only. However, if you export IIS data into CoCASA to

generate provider coverage rates then select IIS combined with CoCASA

as your assessment tool.

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Questionnaire

The YES or NO answer to each question in this page is required. In addition, at least 2 or more quality

improvement (QI) strategies are required to select if the provider answers no to any of the questions. If the

provider answers Yes to all questions then the selection of 2 or more QI measures is not required. The

questionnaire contains the same questions for childhood and adolescent assessments with the exception of

question #6 which applies to adolescent visits only. Question #6 will not appear if you select to conduct a

childhood only assessment. In the case where you select both ages for an assessment, you will only have the

ability to answer it in the adolescent column.

Frequently Asked Questions

QUESTION: I’m missing the Childhood or Adolescent column for a YES or NO radio button.

ANSWER: The displayed questionnaire columns depend on the selected questionnaire in the

General Site Visit Information page.

QUESTION: What do I do if the Site Visit Questionnaire is not used?

ANSWER: If you don’t use the Site Visit Questionnaire for a visit, set the Assessment

questionnaire answer in the General Site Visit Information page to Questionnaire not used

for this site visit. The system will require you to provide the reason/s for not using the

questionnaire.

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Assessment Results

The assessment outcome measure percentage results need to come from either your IIS, or CoCASA’s

Assessment Results tab. All fields marked with a red asterisk (*) are required based on the Site Visit

Information you select. If you don’t have a percentage result at the time of the site visit, click the SAVE

button which will allow you to skip the required responses and return to them later when the rates are

available.

Your program may select to track all the antigens provided in the childhood coverage list and/or the

adolescent list. The items required for reporting are marked with the red asterisk (*).

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Feedback

A response to the Type of Feedback Method Used and the Delivery Method of Assessment Results are

required for completeness and continuation to the next page. The Feedback Checklist Questions serve as

a reminder on what to address during the feedback session. All checklist responses default to Yes,

however, you have the option to modify the responses where applicable.

Any place you see the “Upload/Attach files” link, you may attach program documents and

documents specific to the AFIX visit. All this data will be saved online for record keeping and

review.

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eXchange

The initial eXchange or follow-up should take place with every provider that receives an AFIX visit no later

than six months following the feedback session. Using your Immunization Information System or the re-

import registry data functionality in CoCASA, re-assess the Assessment coverage rates for the same

provider and same age group but NOT the same list of patients. As you enter the percentage for

Assessment Outcome Measures, the Percent Point Increase in coverage and Percent Point Decrease in

missed opportunities are automatically calculated. The Percentage Coverage Goal for following Year is

an optional entry and may be used to define a provider’s coverage goals for the following year. All fields

marked with red asterisk (*) are required for completing this page and continuing with data entry.

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A response to Progress toward implementing selected QI strategies is required for each Recommended

Quality Improvement Activity selected for implementation.

The QI measures to report progress toward implementing are based on the QI selection made in the Site

Visit Questionnaire for each visit. Please note once QI measures are selected, initial and subsequent follow-

up fields will appear in the eXchange tab. If progress completion for the initial follow-up is marked at

100%, subsequent follow-up field will not appear. If no QI measures are selected, initial follow-up and

subsequent follow-up fields will not appear.

In the example above, the Selected QI measures for follow-up (X) are for questions 3 and 5 in

the Site Visit Questionnaire.

Entering a Subsequent eXchange of Information

Subsequent follow up is a follow up process that takes place when the initial follow up does not yield

100% completion on implementation of selected QI measures. You determine the subsequent strategy to

use and the timing for it based on communication with the provider. You are to record and document all

your subsequent follow-up site visits and telephone call dates. As part of this process, you are to update

the implementation progress for the list of selected QI measures.

You are not required to re-run the coverage rates as part of the subsequent follow-up process; the only

requirement is to mark status toward implementation of selected QI strategies. Your program may

however choose to re-run the rates a 3rd time, this process is up to your program to decide.

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To Add

1) Date of contact (follow up visit, educational visit, follow up telephone call): Pick a site visit

date from the pop-up calendar.

2) Add: Clicking this button will add the selected date to the list of subsequent X selections.

To Delete

3) Select a Date: Click on date to select.

4) Delete: Clicking this button will delete date from the list of visit dates.

A QA Review function was added to the eXchange of Information tab. This allows awardees to approve

the quality of the conducted AFIX Site Visit.

Summary

The site visit summary provides a summary of all site visit information you documented. You have the option

of printing this page and sharing it with the provider or with others in your program. Click on Expand to

view the site visit information details in each page (tab).

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Files

Here you will find a list of all files you’ve uploaded and attached as part of the site visit information. Click

on the file name hyperlink to view the selected document, and click on Remove this file hyperlink to delete

the selected file.

Notes

The site visit notes can be documented on this page for record keeping and review purposes. You can

enter text into the free text box and once you click “save notes”, all notes will be archived in the table.

These notes will not appear on any report, they are intended for your program use only.

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AFIX-Help

This tab contains the AFIX Online Tool’s help desk information as well as a copy of the user guide and

any other helpful resources relevant to the AFIX Online Tool.

AFIX-Reports

AFIX Site Visit Tool Printable Documents

1. AFIX Site Visit – Full Document: A hardcopy of the complete AFIX Site Visit

2. AFIX Site Visit - General Site Visit Information: Hardcopy of the general site visit information

portion of the AFIX Site Visit

3. AFIX Site Visit – Questionnaire: Hardcopy of the questionnaire to be used during site visits

4. AFIX Site Visit – Assessment Results: Hardcopy of the assessment results for childhood and

adolescent visits to be recorded during site visits

5. AFIX Site Visit – Feedback: Hardcopy of the feedback portion of an AFIX site visit.

6. AFIX Site Visit – eXchange of Information: Hardcopy of the Initial eXchange and the Subsequent

eXchange portions of an AFIX Site Visit

7. AFIX Site Visit – Notes: Hardcopy of the notes section.

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Management Reports

1. AFIX Annual Report: An aggregate summary of all site visit data for the CY year. This report is

annually required by CDC.

2. AFIX Site Visit Status Report: Status of Site Visit Completion by provider clinic/practice

3. AFIX Assessment Questionnaire Aggregate Report: An aggregate summary of all data items

collected in the Questionnaire page.

4. AFIX Assessment Results Aggregate Report: An aggregate summary of all data items collected

in the Results page.

5. AFIX Assessment Results and Follow-up Results Aggregate Report: An aggregate comparison

between initial and follow-up assessment results.

6. AFIX Feedback Results Aggregate Report: An aggregate summary of all data items collected in

the Feedback page.

7. AFIX eXchange of Information Results Aggregate Report: An aggregate summary of all data

items collected in the Exchange of Information page.

8. AFIX Provider Follow-up Report: A list of all providers due for follow-ups.

AFIX Resources

1. AFIX Policies and Procedures: First edition manual for the AFIX Program.

2. Additional Resources: List of additional resources on the AFIX Program.

3. AFIX Logic Model: Example of intended inputs, activities, outputs and outcomes for the AFIX

Program.

4. Suggestions to Improve Your Immunization Services: Checklist for providers for best

approaches in decreasing missed opportunity and increasing vaccination rates.

Training Resources

1. AFIX Online Tool User Guide: Comprehensive Guide for using AFIX Online Tool

2. AFIX Online Tool Required Fields: Complete list of required fields to be completed in the AFIX

Online Tool

3. AFIX Site Visit Questionnaire Answer Guide: Complete list of answers to the 2015 AFIX Site

Visit Questionnaire

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Submitting the AFIX Annual Report

AFIX Online Tool users can submit the Annual Report using the AFIX Online Tool. The AFIX Annual Report

is located in the Management Reports section of the AFIX-Reports in the Online Reporting Tool. After

entering the AFIX Annual Report (AFIXAR) tab, please fill out the first 3 questions. The rest of the

questions will be read only. Please review this section, if you do not wish to add any additional Site

Visits, please approve and submit your Annual Report to PAPA AFIX Annual Report. To print, please

press Ctrl P or Right Click and then print.

Note: In the AFIX Annual Report (AFIXAR) only the completed Site Visits are aggregated. To consider a

Site Visit complete, please complete the first 4 tabs (General Site Visit Information, Questionnaire,

Assessment Results, Feedback) mark Final and Submit the report.

After submitting the Annual Report in the Online Tool, please enter the Annual Reports tab in PAPA and

then access the AFIX Annual Report. The Site Visits entered in the AFIX Online Tool should automatically

be transported into PAPA. Please fill out the identifying information section of the AFIX Annual Report in

PAPA and save and submit the Annual Report.

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AFIX Online Tool Required Fields

Required Fields

Site Visit Page Name Required Field Name

1 General Site Visit Information

1. Assessment date 2. Assessment name 3. Assessment questionnaire (childhood or adolescent or both) 4. Assessment age cohort 5. AFIX visit (separate or combined) 6. If combined: Type of VFC visit conducted (compliance or

unannounced) 7. AFIX assessment method used 8. AFIX assessment tool or combination of tools used

2 Questionnaire

1. A response to each question is a required entry. There are 17

YES/NO questions for childhood and 18 YES/NO questions for adolescents. If both age groups, childhood and adolescent, are assessed then a response to all 35 YES/NO questions is required.

2. The selection of QI measures is a required entry.

3 Assessment Results

1. Childhood Vaccine Coverage Level Results

1.1. 4 DTaP 1.2. 3 IPV (Polio) 1.3. 1 MMR 1.4. 3 Hib 1.5. 3 HepB 1.6. 1 VAR 1.7. 4 PCV13 1.8. Coverage level results (series 4:3:1:3:3:1:4) 1.9. Missed opportunities results (series 4:3:1:3:3:1:4)

2. Adolescent Vaccine Coverage Level Results

1.1. 1 Tdap 1.2. 1 MCV4 1.3. 3 HPV

3. Adolescent Missed Opportunities Results

1.1. 1 Tdap 1.2. 1 MCV4 1.3. 3 HPV

4 Feedback

1. Type of Feedback Method Used 2. Delivery Method of Assessment Results

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Required Fields

Site Visit Page Name Required Field Name

5 Exchange of Information (follow-up)

1. Childhood Vaccine Coverage Level Results

1.1. 4 DTaP 1.2. 3 IPV (Polio) 1.3. 1 MMR 1.4. 3 Hib 1.5. 3 HepB 1.6. 1 VAR 1.7. 4 PCV13 1.8. Coverage level results (series 4:3:1:3:3:1:4) 1.9. Missed opportunities results (series 4:3:1:3:3:1:4)

2. Adolescent Vaccine Coverage Level Results

2.1. 1 Tdap 2.2. 1 MCV4 2.3. 3 HPV

3. Adolescent Missed Opportunities Results

3.1. 1 Tdap 3.2. 1 MCV4 3.3. 3 HPV

4. Progress toward implementing selected QI strategies: Initial

eXchange of Information (follow-up) 5. Was a follow-up letter sent to provider? 6. Subsequent eXchange of Information (addition of a date and

selection of implemented strategy) 7. Were the eXchanges of information documented? 8. Progress toward implementing selected QI strategies:

Subsequent eXchange of Information (follow-up)