GRITS: Innovative Challenges and Solutions

44thth Annual Immunization Registry Conference Annual Immunization Registry Conference Atlanta, GAAtlanta, GA

October 27, 2003October 27, 2003

Tracy IngrahamBusiness Analyst

Georgia Registry of Immunizations Transactions and Services (GRITS)

Overview

BackgroundBackground GRITS ChallengesGRITS Challenges GRITS SolutionsGRITS Solutions ResultsResults ConclusionsConclusions

Registry Law OCGA 31–12-3.1 passed April 8, Registry Law OCGA 31–12-3.1 passed April 8, 19961996

Contract signed August 26, 2002Contract signed August 26, 2002 GRITS Pilot May- August 2003GRITS Pilot May- August 2003

4 Health Districts4 Health Districts43 counties43 counties150 provider participants150 provider participants

Available Statewide September 2003Available Statewide September 2003

Background

Pilot Results

Pilot Results – August 2003Pilot Results – August 2003 Change ProposalChange Proposal The Registry Law ImpactThe Registry Law Impact

Registry Law 31-12-3.1, Section 1, paragraph Registry Law 31-12-3.1, Section 1, paragraph (e) states: “All children shall be enrolled (e) states: “All children shall be enrolled unless a specific exemption is requested by unless a specific exemption is requested by the child’s parent or guardian….”the child’s parent or guardian….”

The Opt-out Challenge

Pilot results reflectedPilot results reflected Need to identify opted-out clientsNeed to identify opted-out clients Need to track inventory of clients who have Need to track inventory of clients who have

opted out of the immunization registryopted out of the immunization registry Need for reporting to reflect opt-out client Need for reporting to reflect opt-out client

vaccine usagevaccine usage

Solution Objectives

Flag client as opted out of the registry Flag client as opted out of the registry Reject attempts to amend opted-out client Reject attempts to amend opted-out client

records via user interface or batch up-loadsrecords via user interface or batch up-loads Allow mechanism to track vaccine inventory for Allow mechanism to track vaccine inventory for

opted out clientopted out client Allow mechanism for client to opt back into Allow mechanism for client to opt back into

registryregistry

Defining the Solution

Design Definition PhaseDesign Definition Phase Development PhaseDevelopment Phase Testing EvolutionTesting Evolution

Detailed Test PlansDetailed Test Plans User Test & AcceptanceUser Test & Acceptance

Design Specifics

Design PhaseDesign Phase Provider-side Q&AProvider-side Q&A State and Vendor brainstorm sessionsState and Vendor brainstorm sessions Detailed System Design DocumentationDetailed System Design Documentation Design Approval ProcessDesign Approval Process

Development Specifics

Development PhaseDevelopment Phase Vendor and state collaborationVendor and state collaboration

Routine update & feedback sessionsRoutine update & feedback sessionsNet-MeetingsNet-MeetingsSolution walk-thrusSolution walk-thrus

Testing Specifics

Testing PhaseTesting Phase Vendor TestVendor Test State Test (State-level users & SME’s)State Test (State-level users & SME’s) Lead Site Test Lead Site Test

Solution Implementation

State ProcessState Process Provider ProcessProvider Process Vaccine Inventory ImpactVaccine Inventory Impact User Interface versus Batch LoadsUser Interface versus Batch Loads

Process SpecificsTwo-Part ProcessTwo-Part Process The state officeThe state office

Receives opt-out requests from clientReceives opt-out requests from client Flags client record as opted outFlags client record as opted out Maintains original opt-out form for all clientsMaintains original opt-out form for all clients

The provider officeThe provider office Initiates opt-out form submissionInitiates opt-out form submission Identifies opted-out patientIdentifies opted-out patient Makes determination to decrement vaccine Makes determination to decrement vaccine

inventoryinventory

Provider Process

The GRITS UserThe GRITS User Identifies opted out clientIdentifies opted out client

System notificationSystem notification Chooses to decrement inventoryChooses to decrement inventory

System Inventory Option System Inventory Option Inventory Management Inventory Management

Ensures vaccine reports reflect usageEnsures vaccine reports reflect usage

Vaccine Reporting

Vaccine Reports Affected by Opt-Out SolutionVaccine Reports Affected by Opt-Out Solution Vaccine Usage ReportsVaccine Usage Reports Doses Administered ReportsDoses Administered Reports Vaccine Accountability ReportsVaccine Accountability Reports

Results

User input resulted in modificationUser input resulted in modification Validation of vendor-state design process post Validation of vendor-state design process post

pilotpilot Mechanism to track inventory of opted out Mechanism to track inventory of opted out

clientsclients Opt-out change as part of fully functioning Opt-out change as part of fully functioning

vaccine inventory management modulevaccine inventory management module

Lessons Learned

Bring users in early Bring users in early Keep users informed of delaysKeep users informed of delays Be mindful of public & private user perspectiveBe mindful of public & private user perspective Develop SME relationshipsDevelop SME relationships Expect ChangeExpect Change Change is goodChange is good Keep vendor informed of change Keep vendor informed of change

Lessons Learned

Utilize various informational resourcesUtilize various informational resources Subject Matter Experts (SME’s)Subject Matter Experts (SME’s) Public & Private Provider SitesPublic & Private Provider Sites AAP/Other partnersAAP/Other partners

Plan to train & retrainPlan to train & retrain GRITS State-level usersGRITS State-level users GRITS Statewide usersGRITS Statewide users GRITS TrainersGRITS Trainers

Additional Notes

Where are we today?Where are we today?Current number of registry usersCurrent number of registry users

Developing full functioning vaccine inventory Developing full functioning vaccine inventory management management Interim SolutionsInterim SolutionsImplementation DatesImplementation Dates

Next Steps

What Now?What Now? Additional GRITS Changes (Phased Additional GRITS Changes (Phased

Approach)Approach) Potential Legislation ModificationsPotential Legislation Modifications More users = More feedbackMore users = More feedback

Thank You!