Vaccines: Medical Miracles, Implementation Insanity

Vaccines: Medical Miracles, Implementation Insanity

Vaccines have completely changed how we practice medicine. Pediatricians will be the first to tell you their tremendous impact on patient care. However most folks who don’t practice pediatrics for a living don’t realize that the delivery of appropriate immunizations to our patients every day is a daunting task! The addition of new vaccines, combination vaccines, shortages, distribution variability, VFC vs private stock discrepancies, inadequate payment for vaccines and their administration…I could write a book! The problem gets more complex every day, and I can’t imagine it will get easier any time in the future.

Here’s where I am grateful that I have an EHR that is committed to pediatrics. Probably the biggest reason I purchased Office Practicum 6 years ago, is their vaccine module and commitment to updates. If you have the new release, you will notice that the logic for incorporating PCV-13 is already in place. Patients who are between the ages of 14-59 months who completed the Pneumococcal series with PCV-7 will have a “Pneumococal #4 due” indication on their chart. Office Practicum is already working on a release to deal with the current FDA temporary suspension of Rotarix. Combination vaccines are accounted for in their vaccine logic engine, so when I get a new patient whose prior doctor used a different schedule/combination of vaccines than I currently do, I don’t have to stop and think about all the implications.

In the past few months, I have noticed quite a few older patients who seemingly all of a sudden indicate they are “due” for a polio vaccine. This happened when OP incorporated the ACIP guideline that all children should receive one IPV on/after their fourth birthday. As it turns out, some of my older patients had indeed had 4 polio vaccines, but all at 2, 4, 6 and 18 months. With the new recommendations, the logic was quickly embedded into OP and now those patients are easy to identify. Doing HIB recall after the shortage ended, was a breeze with the vaccine patient recall mechanism.

Recently there was a post on the COCIT (Council on Clinical Information Technology) listserv about how practices handle vaccine inventory. I had to say to myself, “Wow, I don’t even ever think about that. It’s all integrated.” Same with my bi-directional interface with the PA State Immunization Information System. Recently, there have been more and more states who are implementing bi-directional interfaces with their IIS. If you are not currently bi-directional, find out what is going on in your state. OP is committed to supporting us in these efforts. And for those of you who didn’t know, the #1 resolution at the AAP’s ALF (Annual Leadership Forum) was to develop AAP support/technology to integrate immunization registries between states.

There’s always a lot going on with vaccines. Office Practicum is committed to helping us with the ever-changing landscape.