In the new 2015 Certified build Build 11 of MacPractice, we've made some extensive changes to our Immunizations widget in the Clinical Ability. This article will give an overview of these changes and go over the workflow for adding and managing Immunizations for your patients in MacPractice.
If you
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're unfamiliar with the changes made to the Clinical Ability in MacPractice 11, please refer to the Clinical Ability article here.
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It is important to stress that without connecting to an Immunization registry, that this information will strictly stay in your MacPractice database. If you wish to connect your MacPractice server to an Immunization registry for the purposes of downloading and uploading Immunizations record, you'll need to contact Support with all the necessary details so we can assist in configuring that connection. |
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Overview
The Immunizations Widget is located in the Clinical Ability. From here, you can review immunization records for the currently selected patient.
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By default, the widget displays all immunization records by chronological order. You can use the drop down menu at the top to filter out historical records or records downloaded from an Immunization registry. There's also the Info Button, which uses the Info Button standard to pull contextual information regarding the immunizations in question.
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Columns in the Immunization widget can be clicked to sort the displayed results in ascending or descending. Let's break down each column:
Immunization: The name of the immunization in question. In prior builds of MacPractice, this would also display the dosage and units; this has been removed from the name.
# in Series: If this immunization is one in a series of immunizations conducted, you can use this field to denote which number in the series the immunization record is for.
Date: The date of the immunization record in question.
Source: This column identifies where the Immunization record originates from. If this is "MacPractice", then the immunization record was entered in by the office. If this is "Registry", this was a record downloaded from an Immunization record.
Administered By: This column lists the provider that administered the immunization record.
Office: This column lists the office reference where the immunization was conducted.
Information Source: This column distinguishes whether the immunization record is new, or a historical record.
Immunization
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References
In the Clinical Sidebar, you'll note that there is a reference category for Immunizations. These contain all of the Immunizations that can be applied to a patient's record. On a brand new database, this category is empty, so the office will need to add all the immunizations they intend on conducting before being able to add them to patient records.
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It is important to clarify that you can add multiple references for the same immunization. The purpose behind multiple references is to pre-configure certain immunization configurations, such as setting up references for each number in a series, or utilizing a different lot number, or different dosages. This saves on manual data entry. However, when adding these immunizations to a patient's case, you can always adjust the fields as necessary.
Codifying
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Immunizations
If you are a previous MacPractice user and you've updated from 7.3 and earlier to this build, you'll likely have several Immunizations already entered into the database. However, these immunizations records may not be codified. A Codified Immunization is one that is standardized and recognized as an official immunization, and they can be uploaded to Immunization registries. Codifying your immunizations is necessary to utilize the Immunization registry upload/download functionality.
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Immunization Name (codified): The full name of the immunization in question.
Short Description (codified): A short description of the Immunization in question.
Status (codified): Whether the immunization in question is in active use or whether it's inactive.
Dose: The dosage of the immunization in question. This is usually paired with the Units field to determine the exact amount of the immunization to be applied.
Units: Paired with the dose field, Units describes how the dosage is measured, typically in millileters (mL).
Route: This drop down allows you to select the appropriate route for the immunization in question. You can read more about routes here.
Site: This drop down allows you to select the site where the immunization should be applied, such as left arm, right arm, etc.
Lot Number: The lot number of the immunization. This is used to track where the vaccine originated from, and is one of the key pieces of data that is required by law to record when applying immunizations.
Expiration Date: The expiration date of the immunization in question.
Number in Series: Some vaccines must be applied in stages of a series of vaccines. These fields allow you to indicate whether this vaccine is a stand alone vaccine (indicated by 1 out of 1), or whether there are several in the series (2 out of 3 for example).
Recommended Age: The recommended age for a vaccination to be applied.
CPT Code: This field allows you to link a CPT code to an immunization reference. By clicking the magnifying glass icon, you can search for and apply a CPT code to the immunization reference.
National Drug Code: This field allows you to link a NDC number to the immunization reference. By clicking the magnifying glass, you can select any applicable NDC numbers.
CVX Code (codified): The CVX identifier of the vaccine in question.
Manufacturer: This field allows you to select the manufacturer of the vaccine in question. Manufacturers in red are inactive, as in they are not currently distributing the vaccine.
Route Code: The shorthand route code for the route that the vaccine should be applied.
RxNorm Code: This field allows you to link an RxNorm code to the vaccine in question.
VIS Published Date: The Published Date listed on the Vaccine Information Sheet for the vaccine in question.
Vaccine Grouping by CVX Code: This field allows you to indicate whether the vaccine belongs to a group of vaccines intended to immunize against a particular disease. You can read more about vaccine grouping here.
Notes: A notes field to be used only by the office. This is a great place to insert notes for the intended usage of this immunization record.
Adding a new Immunization
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Record
After the complicated set up for immunizations, adding an immunization record to a patient is a relief, as it's much simpler. On the Immunization widget in the Clinical Ability, simply click on the Green Plus in the upper right corner of the widget. This will bring up a search window displaying your Immunization References. Simply select the immunization reference in question you'd like to add.
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The Dosage, Units, and Lot Number are required fields, as is the VFC Eligibility status (follow the link to be taken to the CDC site article that reviews VFC Eligibility). The other fields may be optional, but we strongly recommend that you review each field and complete them to the best of your ability. Once the required fields are entered, you can click the "Done" button to add the Immunization record to the patient's file.
Adding a Historical Immunization
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Record
A Historical Immunization Record is used when the office has not conducted the immunization in question but you are aware of prior immunizations in the patient's past. These records can be added, or they can be retrieved from an Immunization Registry as indicated by the Source column of the Immunization Widget.
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The data entry window for Historical Immunizations is much simpler than a normal Immunization record, as it is intended to simply document that the office is aware of a previous immunization. Simply detail the record to the best of your ability, and when you are satisfied, click the "Done" button.
The More
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Button
The More Button contains functionality that relates to immunization registries, and other miscellaneous data.
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