Patients these days get vaccines at pharmacies, urgent care centers and primary care clinics, among other places.

THE PROBLEM

It's difficult for providers to keep track of them. Different portals and platforms make that challenging. When asked about a particular vaccine, patients often respond, "I don't know. I think I got that one."

Susan Freeze, RN, provider applications manager at St. John's Health in Jackson, Wyoming, shares an example from her own healthcare journey.

"I was helping a friend move, and it was January," she recalled. "I slipped on the ice and split my head open. I was asked, 'When was your last tetanus shot?' I replied, 'I couldn't tell you.'

"But with the Oracle Cerner Immunization Registry Reporting and Query technology connected to the EHR, clinicians were able to see I had the vaccine three years ago," she continued. "While another shot wouldn't necessarily have harmed me, it saved me the cost of having it again, and it saved the supplies. And, of course, no one wants to have extra shots."

Before the Oracle Cerner technology was set up, St. John's Health clinicians had to log in separately to the Wyoming Immunization Registry to view and record vaccines.

If immunizations were given anywhere across the St. John's Health system, someone would need to document that information in both the EHR and the Wyoming Immunization Registry. It meant maintaining spreadsheets and inputting that data into the systems at the end of each week.

PROPOSAL

The Oracle Cerner registry tool electronically sends vaccine data to the Wyoming Immunization Registry and retrieves information from the EHR to reduce manual processes like spreadsheets.

It's a tool that's used all day, every day, across the ambulatory clinics and in the inpatient space to exchange vaccine data almost immediately.

"When you can automate manual processes, it helps prevent staffing burnout and provides a more complete picture of patient healthcare."

Susan Freeze, RN, St. John's Health

"This interoperable solution works to give patients and clinicians a more complete view of health histories, including immunizations," Freeze noted.

MEETING THE CHALLENGE

"It's much more efficient to have that bidirectional interface of the Oracle Cerner tool," Freeze stated. "When we give vaccines, those automatically get transferred over to the state without any extra effort upon completion of our documentation in the Cerner CommunityWorks EHR.

"Our nursing team does not have to manage as many separate logins or push any buttons," she continued. "Instead of having to complete those hundreds and thousands of manual and duplicate data entries, clinicians could do all of their work in the EHR."

St. John's Health implemented the technology in 2019. When the COVID-19 pandemic struck, the tool became critical for reporting vaccinations to the state.

RESULTS

"In order to release COVID vaccine shipments to different entities, Wyoming required that all vaccines be reported to the state within 48 hours of administration," Freeze remembered. "We worked with the Cerner team to quickly get everything in place to electronically push these new vaccines to the state registry.

"The Emergency Use Authorization came out on a Friday, and St. John's Health gave its first doses on the very next Tuesday," she added. "Almost instantaneously, the immunizations were recorded in the Wyoming Immunization Registry."

St. John's Health is a small but mighty organization, she contended.

"With the first round of COVID vaccines, we were able to administer around 10,000 doses to our most exposed population, including the elderly, immunocompromised persons, healthcare workers and others," she said.

"Without the functionality to get those doses recorded in the Wyoming registry within that required 48-hour period, we wouldn't have been able to continue getting shipments, give those second doses and get people vaccinated as quickly as we did," she continued.

As the flu season approaches this year, the healthcare organization is planning ahead.

"We intend to apply the lessons learned from our prior COVID-19 experience to future flu seasons," she noted. "I'd estimate that we're saving several minutes per patient and then hours per week because of this capability."

ADVICE FOR OTHERS

"I wholeheartedly encourage other facilities to implement this interoperability strategy," Freeze advised. "Yes, it's some work up front. You have to dedicate staff to attend implementation meetings as well as complete testing and monitoring.

"There is a little bit of ongoing maintenance, such as reviewing a monthly report from the state, correcting any errors in transmission," she said. "While there is follow-up there, the benefits far outweigh any of this maintenance."

The time saved for nursing staff as far as manually entering all vaccines administered into state registries is definitely worth it, she added.

"When you can automate manual processes, it helps prevent staffing burnout and provides a more complete picture of patient healthcare," she concluded. "The greatest benefit for clinicians: less time in front of a computer, more face-to-face time with the patients."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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