Stage 2 Meaningful Use Immunization Message Submission to CHIRP - PowerPoint Presentation

Slide1

Stage 2 Meaningful Use Immunization Message Submission to CHIRP

Indiana State Department of HealthImmunization ProgramJune 17th, 2014Slide2

Stage 1 Meaningful UseStage 2 and ongoing submission

VFC Providers requirements versus Stage 2Meaningful Use Registration Web PortalDo I need to setup all of my facilities?Sending data to CHIRP – Transport LayersTroubleshootingWhen does Meaningful Use end?

Question and Solutions

ItinerarySlide3

Meaningful use is using certified electronic health record (EHR) technology to:

Improve quality, safety, efficiency, and reduce health disparitiesEngage patients and familyImprove care coordination, and population and public healthMaintain privacy and security of patient health informationUltimately, it is hoped that the meaningful use compliance will result in:Better clinical outcomes

Improved population health outcomes

Increased transparency and efficiency

Empowered individuals

More robust research data on health systems Meaningful use sets specific objectives that eligible professionals (EPs) and hospitals must achieve to qualify for Centers for Medicare & Medicaid Services (CMS) Incentive Programs. Source: HealthIT.gov

Meaningful Use DefinedSlide4

Source: HealthIT.govSlide5

Core Objective – Public Health ReportingStage 1 – maybe optional

Stage 2 - requiredIndiana State Department of Health is the Public Health Authority for the State of IndianaAccept, validate, document provider attestments for Stage 1 and Stage 2Where does ISDH and CHIRP fit in?Slide6

Children and Hoosier’s Immunization Registry ProgramBegan in September 2002 as state wide IIS

Prior to CHIRP Indiana used ImmTimeOver 4,000 providers and 8,000 users~42,000 HL7 messages accepted each dayAccepts HL7 2.0 through 2.5.1 VXU type messagesAll valid messages received will create an ACK responseConnected to all Indiana HIEs

What is CHIRP?Slide7

Life on the ISDH Meaningful Use Jargon Farm

CHIRP, CHIRP, CHIRP

MU, MU, MU

ACK, ACK, ACKSlide8

ISDH

Indiana State Department of Health

PHA

Public Health Authority

MU

Meaningful Use

MU(X)

Usually MU1 or MU2, referring to the stage of Meaningful Use

HL7

Health Level-7, a healthcare message standard developed by Health Level Seven International

VXU

Vaccine Update/Add HL7 Message type, can be 2.3.1 or 2.5.1 message

VXQ

Vaccine Query Message, used with 2.3.1 message

QPB

Vaccine Query Message, used with 2.5.1 message

HIE

Health Information Exchange

ACK

Acknowledgement response for VXU message submitted

Meaningful Use Jargon

And many more…

Common terms that pop during a Meaningful Use call/emailSlide9

HL7 VXU 2.3.1Required fields - 8VXU, VXQ and ADT

Test messagesAccepted versus failed messageOnetime and ongoingAdditional year attestmentsBegan in 2011First CHIRP Meaningful Use Attestment February 2011

Stage 1Slide10

HL7 VXU 2.5.1 message

Required fields – 42New segments for 2.5.1OBX – required and optionalRXRNK1 and PID patient guardianTesting requirements for Stage 2Message approval prior to submitting to production

30 day suggested timing by the ONC

Ongoing Submission – 90 days?

Does it need to be done during attestment

What if there is an errorStage 2 Meaningful Use AttestmentSlide11

MSH

|^~\&|EMR_VENDOR|SENDING_FAC|CHIRP|OR|20140521143722.057||VXU^V04^VXU_V04|2014052115856822|P|2.5.1|||AL| PID|1||123456^^^^MR||TEST_PATIENT^CHIRP^^^^^L||200001010000|F||2131-1^Undefined Race^CDCREC|||||EN||VAR|||||UN^Unknown^99USI||||||||N PD1||||""||||U|||01^No Reminder^HL70215|N|20140521||Y^Advanced Directive Code - Y|A|20140521|20140521 PV1||||||||||MED

RXA

|0|1|201405211437|201405211437|03^MMR^CVX|0.5|mL^milliliter^UCUM||00^New Immunization Record^NIP001|ABC123^RABBIT^BUNNY^^^^^^TEST|1234ABC^^^CHIRP TEST FACILITY||||6622554411||AB^Abbott Laboratories^MVX|||CP|A

RXR

|SUBQ^^HL70162|LD^LEFT DELTOID^HL70163||^SUBCUTANEOUS OBX|1|CE|64994-7^Vaccine funding program eligibility category^LN|1|V01||||||F|||20140521|||VXC40^Eligibility captured at the immunization level^CDCPHINVS OBX|2|CE|30956-7^vaccine type^LN|2|||||||F OBX|3|TS|29768-9^Date vaccine information statement published^LN|2|20140101||||||F

OBX

|4|TS|29769-7^Date vaccine information statement presented^LN|2|20140521||||||

HL7 2.5.1 MU2 Sample MessageSlide12

Provider registers each physical location with ISDH via Meaningful Use Portal

Providers registers each location to CHIRP via the Provider Enrollment AgreementHL7 user account setup for testingProvider or vendor submits messages to CHIRP review and approvalRecommend contacting CHIRP after submission for reviewProvider moves messages into productionOngoing 90 day clock begins

Stage 2 Overall ProcessSlide13

New VFC policy requirement including use of VFC codes and lot numbers in HL7 message

2.3.1 PV1 Codes2.5.1 OBX CodesWhat fields do I need to send to make sure my lot inventory will decrementIf I am sending the new 2.5.1 MU2 message do I meet the VFC policy?2.3.1 that meet VFC requirements vs. 2.5.1July 31st

– VFC policy date

VFC and Stage 2Slide14

MU 2.5.1 MessageOBX segment with V0 VFC eligibility code

OBX segment with lot number funding sourceRXA segment with complete lot number, manufacturer, and administering facility (RXA.11)Existing 2.3.1 MessagePV1 segment with V0 VFC eligibility code, code is located in PV1.20 placementAll messages with a valid VFC code, i.e. V02 (Medicaid) will be assumed Public Supplied by CHIRP

RXA segment with complete lot number, manufacturer, and administering facility (RXA.11)

What do I need to send for VFCSlide15

Only Stage 2 are required to registerStage 1 is optional registrationAll providers need to register

Each physical location to be attested should registerWe do not recommend registering each providerProviders may register for Immunization, Synrdomic, and ELR attestmentsEmail confirmation once registration is complete

Register for Meaningful UseSlide16

ISDH Meaningful Use PortalSlide17

Provider Group Indiana

PG Hosp Indy

PN West

PG Hosp Warsaw

PG Hosp Muncie

PG Physician’s Network

PN North

PN Indy

PN Main

PN South

PN East

Dr. Jones

Smith, MD

Dr. Jones

Smith, MD

Dr. Jones

Smith, MD

Specialist Team

PA Rogers

NP

Wishka

PA Rogers

NP

Wishka

PA Rogers

NP

Wishka

PA Rogers

NP

WishkaSlide18

PG Hosp Indy

PN West

PG Hosp Warsaw

PG Hosp Muncie

PN North

PN Indy

PN Main

PN South

PN EastSlide19

Providers can register for their Stage 2 Meaningful Use Attestment at anytime

ISDH recommends registering 30 days prior to the start of your 90 day attestment windowProviders must register by their 60th day of attestment time period

Registering later shortens the window to test and move interface into production

90 day ongoing and 90 day

attestment

window do not need to match upWhen to registerSlide20

How to get your data to CHIRPSlide21

Submitting from your HIE

HIE will act as a pass throughMeets Stage 2 transport layerConnecting to CHIRP directlyHTTPS Post/SOAP connectionStandard created by CDC and used by most Immunization Information SystemsMessage sent using secured SSL certificateSent from your EMR/EHR Cloud Vendor

Uses HTTPS connection

Only connections that support bidirectional messages can be used

Transport LayersSlide22

OBX SegmentsAll administered messages should include VIS data in OBX

VFC providers need to include VFC eligibility for all administered patient records 0 through18 years of ageHistorical vaccinesContains fewer details but still need to meet minimums including patient data and facilityWhen in doubt, do not submit historical dataSending via Cloud EMR

Each provider needs to register and attest individually

Cloud EMR will only need to test initial messages

Troubleshooting and Known IssuesSlide23

Stage 2 Year 1 Attestments90 day ongoing submission of data to PHA

Stage 2 Year 2 Attestments365 day ongoing submission of data to PHAStage 3 – 2016Improving quality, safety, and efficiency, leading to improved health outcomesDecision support for national high-priority conditionsCHIRP forecast included in message response

Patient access to self-management tools

MyVaxIndiana

90 Days and BeyondSlide24

We (ISDH) are not the Meaningful Use Police

Accept, validate, document provider attestments for Stage 1 and Stage 2

Official documents of Meaningful Use status can be downloaded from ISDH Meaningful Use PortalSlide25

Please feel free to ask any questions

Questions and ContactsRaymond Epps

317-233-8828

repps@isdh.in.gov

Cameron Minich

888-227-4439caminich@isdh.in.gov

CHIRP Contacts

Meaningful Use Email

ISDHMUa@isdh.in.govSlide26

CHIRP Web page

https://chirp.in.govISDH Meaningful Use Portal https://gateway.isdh.in.gov/MUSSE/Default.aspxIndiana Immunization Coalition

http://www.vaccinateindiana.org/

Help LinksSlide27

Thank you for attending!!!