UC Davis Health System
H1N1 & Seasonal Flu Vaccination Tracking
Application for UC Sautter Award 2010
Application for 2010 University of California Larry L. Sautter Award for
Innovation in Information Technology
Date:
May 17, 2010
Project Title:
H1N1 & Seasonal Flu Vaccination Tracking
University of California Davis Health System
Submitted by:
Dan Cotton, Education Technology and Application Development Manager
(916) 734-2019
Mike Minear
Chief Information Officer
(916) 734-7131
TABLE of CONTENTS
A. Summary 3
B. Project Leaders and Team Members 3
C. Project Description 4
D. Technology used to Create the Vaccination Application 6
E. Project Timeframe 7
G. Customer Satisfaction 8
A. Summary
With the massive outbreak of H1N1 Virus throughout the United States in 2009 the UC Davis Health System started taking the steps to require all employees at the UC Davis Sacramento Campus to be immunized for both seasonal influenza and H1N1. In 2009, the University of California Davis Health System (UCDHS) initiated a project to assist in the tracking of H1N1 and seasonal influenza flu vaccinations administered to 12,000+ staff, students and faculty via a web application. This new web application would also store the data into the recently implemented a new Employee Health EMR system (STIX HER). There were several factors that contributed to the need to capture this data electronically:
§ The health concerns over a possible pandemic of the H1N1 flu
§ Brand new H1N1 vaccinations
§ Concerns over outbreaks of H1N1 and the ability to track back to departments and persons who did or did not receive vaccinations
§ Ability to track the various lot numbers associated to the H1N1 vaccinations
§ Patient, staff, student and faculty safety & exposure concerns
The main project goals were to create a web based application that allowed departments to track individuals who either received the vaccinations by UCDHS, received them elsewhere, or who declined to received the vaccinations. By collecting this information, UCDHS leadership has real-time and detailed data to manage whatever issues arose from the H1N1 or seasonal influenza vaccinations. Clinical and administrative leadership knows by department, by building, by area; who did or did not get vaccinated should an outbreak or exposure concerns arise. They would also be able to report on the various lot numbers of the H1N1 vaccinations should the need arise.
B. Project Leaders and Team Members
One of the key elements leading to the success of this project was the deep level of partnerships created throughout UCDHS. The collaborative efforts of the IT teams and several business teams allowed the project to reach a successful conclusion.
Executive Leadership
§ Allan D. Siefkin, MD - Chief Medical Officer
§ Stephen Chilcott, J.D. Interim Executive Director, Human Resources
§ Michael Minear, Chief Information Officer
Information Technology
§ Daniel Cotton - Application Development Manager
§ Mark Pratt - Application Development Supervisor
§ Jeff Chilton - Application Developer, technical lead
§ David Haake - Application Developer
§ Kevin Stead - Project Development Analyst
§ Andre Chu – Database Administrator
§ Donna Davis - Database Administrator
§ Sue Walker - Programmer, People Soft
§ Amy Mentjox - Manager Information Technology
Clinical and Employee Health Leadership
§ Susan Sutherland, RN - Manager of Employee Health Services
§ Neil Speth, MD - Employee Health Services
C. Project Description
The UCDHS IT department in cooperation with Employee Health services and clinical leadership outlined a plan and process that would leverage existing software applications, services, and technologies; to deliver an integrated application that would provide comprehensive information regarding UCDHS employees and their vaccinations. This new electronic process would replace a previous paper based system that only allowed departments to review their own departmental compliance after sorting through stacks of paper vaccination forms. The legacy paper-based system was not efficient and did not support real-time compliance and data reporting. There was a process where this paper based information was collected and entered manually into STIX but this process was usually 3-4 months post vaccination; long past the time of relevance in an influenza outbreak.
The new flu software application leveraged existing user Active Directory authentication, departmental employee listings from the payroll application, and the STIX employee health management application (that is used throughout UC medical centers).
UCDHS held a number of ‘flu vaccination rallies’ throughout the campus and in multiple buildings with the intent on making it easy and convenient for employees to receive the unusual number of multiple vaccinations required in late 2009 (the regular seasonal flu vaccination and H1N1).
The data collected was entered into the new flu vaccination application was fed directly into the employee health services application called STIX. Employees attending either the rallies or coming to employee health services for vaccinations have their vaccination status noted as Received at UCDHS. Employees also had the ability to bring in proof of vaccination done elsewhere and have that recorded as Not Received at UCDHS – but still compliant. If employees were allergic or had other reasons for not wanting either of the vaccinations they would be logged with Refused.
Many features were created in the new vaccination tracking application in a matter of weeks to support the requirements of employee health.
§ Support the ability to log the potential two vaccinations required for H1N1 as well as record the Lot number administered
§ Employee Health Services has the ability to add to a “drop down list” all the lot numbers UCDHS received in their shipments of the vaccinations – to accurately record the Meta data of the vaccine drug lot numbers
§ Department managers can be assigned multiple departments if appropriate, and managers can delegate required data entry task to staff of their choosing
§ Reporting and compliance checks - the application provides each department manager to ability to review their departments’ compliance with all three influenza vaccinations
§ Provides the UCDHS Chief medical Officer the ability to review compliance across the organization as well as drill down reports for each department
§ Department Managers or their assignees are shown their departments compliance at the top of their summary screen
§ Data and trending analysis provided for clinical and administrative staff to help assess staffing impact and requirements in the event of an outbreak – including clear summaries of staff who have or has not been vaccinated (and is therefore safe and eligible to care for or assist patients)
§ Supports a number of online and printable reports on various aspects or levels of vaccinations
Reports can be generated based on the overall organization, by department, by individual cost centers within departments, by the individual employee and by lot numbers associated to the H1N1 vaccinations
The granularity of reporting provides levels of reporting that the organization did not have with the previous process, in addition the new reporting function provides access to data real-time, not data that is months old.
Figure 1 shows a typical example of the information that department managers have on display. Included is a summary at the top listing the employee count and percentages.
Figure2 Sample Compliance at a point in time
D. Technology used to Create the Vaccination Application
§ Windows 2003 Active Directory - Used for user authentication. This existing service eliminated the need for users to have another username and password combination.
§ WhoAmI Service - Used to display the full name of the person currently logged in
§ Authorization Service - Used to authorize which cost centers(departments) the person logged in can be view and updae
§ Rest/Ajax Technologies – Used to retrieve and insert records via a URL call. This technology eliminates the needs for the entire web page to refresh/reload which minimizes page refresh time and load on the server
§ Jasper Reports – Used to generate the PDF reports
§ Java and JavaScript – languages used to process data within the forms
§ SQL Server – Database used to store data (part of eth STIX application).
Figure 3 Shows the high level integration of the self developed application and STIX
E. Project Timeframe
Need Identified for Flu management application - Initial Planning August 2009
Influenza Compliance Entry Module Online October 2009
H1N1 Compliance Entry Module Online November 2009
Reporting Function Online December 2009
Figure 4 - H1N1 Outbreak Timeline
Image source HHS Flu site, http://www.flu.gov/timeline/
G. Customer Satisfaction
“The key in management of public health issues, for a city or state, or for a large employer like UCDMC, is DATA. The information must be timely, accurate, and specific to the issue and the organization.
The Flu tracking application came out of the most recent outbreak and the UCDMC and UCDHS response. It supplied us with the information necessary to make decisions about incidence, resource deployment, and workforce planning. While Sacramento County and UCDMC were hit very significantly with H1N1 this year, we were fortunate that this virus was not as virulent as it might have been.
The attack rate was very high and we had many patients and employees infected, but not so many hospitalized that we could not manage. Our vaccination campaigns were wildly successful, which likely also reduced the incidence of our infection among our workers. Running the code green over the past year for 7 months prepared us for the next major or minor influenza or other infectious outbreak. the Flu Tracking application has and will continue to play a key role in our disaster planning and management.”
Allan D. Siefkin, M.D.
Chief Medical Officer, UC Davis Health System
“There was a Pandemic flu outbreak on top of the normal seasonal flu. It was a novel strain that emerged. Administration was looking to track all employees for both the seasonal and the H1N1 novel strain; otherwise the employee would be mandated to wear a mask. In very little time, our IT department was able to assist us by building a web based Flu/H1N1 site. The tracking was decentralized for each unit to track their own employees. This system in turn fed data to the employee’s health record. It was easy to use, managers loved it. There was no resistance in using it as it was easy to use and find.
The IT team did an outstanding job in a time frame that was crucial to this program. The system was able to pull data for a compliance summary site in real time for administration to view during the season. This site was so successful, it was asked to be cloned for another activity.”
Susan Sutherland, RN
Manager of Employee Health Services
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