TISWG

Vaccine Choice Update

May 20, 2010

Agenda

Choice Legislation Current Ordering/Reporting

Process Choice Strategies Timeline

Choice Legislation HB448 requires vaccine choice in Texas

Vaccines for Children and Adult safety net programs

Recommended through ACIP Available through CDC Adult safety net vaccine available from DSHS

Includes 115% cost containment clause

Choice not applicable in emergencies

August 31, 2010 implementation

DSHS Guiding Principles

Offer Choice by September 1, 2010

Minimize impact on providers

Manage Choice with existing public health personnel

Maintain existing vaccine delivery timeframes

Vaccine Ordering/Reporting Current Process

Texas Infrastructure

Choice in a Paper System

Region Jan-10

1 189

2/3 855

4/5 322

6 468

COH 357

7 415

8 232

SAM 215

9/10 249

11 501

Total 3803

Austin Office

Health Service Regions

Local HealthDepartment

ProviderProvider

ProviderProvider

ProviderProvider ProviderProvider

Distributor

CDC Electronic

Paper

Curre

nt

Ord

erin

g/Re

porti

ng

Proc

ess

Choice in a Paper System

Approximately 70 products Providers

Increase in paperwork (C-33 example) Additional time to complete Likely increase in reporting errors

Choice in a Paper SystemLHD/HSR and Austin Office

Additional staff to maintain existing workload and timeframes

Likely increase in order entry errors (AO) Impact on other business needs

Customer support Training Promotions Quality

Choice in a Paper System : Vaccine Delivery 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 8 9 10

Provider sends order XC

HSR/LHD receives order X CHSR/LHD reveiws and forwards X C

AO Receives X C

AO Places order X CProvider receives confirmation X* C*

CDC forwards to Distributor X C

Distibutor receives order X C

Distributor ships order X C

Order arrives X X C* After 4 PM

DSHS Choice Strategies

Electronic Vaccine Inventory Operating ProceduresCommunication PlanResources and Training

Electronic Vaccine Inventory (EVI)

Providers/LHD/HSR/AO Reduce paperwork Reduce processing time Potentially decrease delivery time

Simplify Ordering/Reporting and Improve Quality Create “recommended order” Automated reminders and exceptions Auto mathematical calculation features Pre-population of previously entered inventory information (lot number,

NDC, expiration dates)

Allow to Texas to Interface with CDC System

Benefits

Ordering/Reporting PossibilitiesCurrent Situation Existing Paper System with 70 choices added

(necessary for providers without internet access)

Long Term Goal Fully Electronic System – (could take through 2011 to

fully develop)

Reality for the Next year Interim System that includes some electronic and

some paper (using current IT resources)

DistributorElectronic

Interim Ordering/Reporting Process

Paper

Approval Approval

Austin Office

CDC

Health Service Regions

Local HealthDepartment

EVI Database

ProviderProvider

ProviderProvider ProviderProvider ProviderProvider

Choice Operating Procedures

TVFC/Provider ManualsStand Alone Documents

1. Outline legislative requirements 2. Day-to-day operations under electronic

system How to order and report How to report vaccine losses How to receive vaccines

3. Provide answers to the implementation questions

Choice Operating ProceduresImplementation Question Tools

FAQ New Vaccines Unavailable Vaccines (shortages) How to handle existing vaccine inventory (Can it

be returned?) Provider fails to choose Initial Vaccine Choice Duration

Provider Vaccine Information Sheet Storage Calculator Survey, Tips, and Instructions

Communication Plan

Providers and other Internal (HSR, AO) Memos on updates Training – group and individual Conference Calls Tools such as FAQ and Storage Calculator

External Stakeholder Input from Choice subcommittee of TISWG Presentations on Choice to TISWG, Texas Association of Local

Health Officials (TALHO), and other agencies

Choice Website Development

Call Center

Resources and Training Roles

AO Roles Develop messaging, tools and other

communications as necessary Kick-off Training for LHD/HSR to introduce

training materials Develop Online or web-based trainings Manage the helpdesk after Sept 1

Resources and Training Roles LHD/HSR Roles

Conduct group presentations and/or individualized training for providers in jurisdiction

Negotiate storage space and Tiered Ordering Frequency

Primary resource for general questions on choice processes

Manufacturer Roles Education on vaccines Communicate with Providers

Provider Responsibilities

Survey of Choices Internet/Email Access Provider Agreement

Provider Choice Agreement Ensure that enrolled provider has been notified of choice options

Inform provider about their right to choose brand and presentation

Limitations 115% cost containment, and not applicable in public health emergency

Choice fundamentals use all brands prior to expiration date duration of choices

Sign Form and fax to 512-458-7346 prior to the July 31, 2010

Timeline for Vaccine Choice Implementation

Ma

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Ma

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Au

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2011

RFP Release, Bid period, Acceptance Period X X X X X X XRelease Introduction Memo X Develop Choice Protocol Recommendations X XManufacturer Discussions XConvene TSWIG Choice Subcommittee 4/30Inform contractors about kick-off X Develop survey, instructions, tips, and release X 5/14Test Storage Calulation Tool XIdentify EVI processes for providers and get screen shots XDevelop training tools, presentations for LHD/ HSR trainings X X

Provider Choice Agreement X

Manager's Meeting Preveiw 5/18Kick-off Training for HSR/ LHD 5/26LHD/ HSR Trainings for Providers X XTrain Staff on Changing Roles X XDevelop and Test Paper System (Electronic Reports) X X X EVI testing X X X Develop/ Implement Online Training X X X X Call Center Implementation X XInterium EVI Statewide implementation 9/1EVI Systems Enhancements X X X X

2010

Current StatusSurvey up getting responses Next week HSR/LHD Meeting Website www.immunizetexas.com Select “Providers”

Click on Communications Provider information Training EVI Other Resources

Vaccine ChoiceTexas Vaccines For Children

Thank you

Provider next steps Go online to the survey at

http://tvfcchoice.questionpro.com/ and select preferred vaccines.

Review email confirmation when received (same week)

Look for the Provider Agreement, sign and fax back to 512-458-7346

Await an email notifying you of your User name and password (August)

Look for memo announcing online training and ensure all appropriate staff take prior to September 1.

Beginning September 1, go online to enter information from Biological Report and Order (C-33, C-68).

Fax temperature log to HSR or LHD as usual.