Programs & Tools:
VFC-AFIX Quarterly
Conference Call Minutes
October 17, 2007
Vaccines for Children Program Topics:
On this page:
Grantee Roll Call
The following grantees were on the conference call:
AK, AL, AZ, CA, Chicago, CO, CT, DC, DE, FL, GA, HI, IA, ID, LA, MA, MD, ME, MI, MN, MO, MO, NC, NH, NJ, NM, NV, NY City, NY, OH, OK, OR, PA, Puerto Rico, San Antonio, SC, TX, UT, VA, Virgin Is., VT, WA, WI, WY
Updates
VFC
-
Borrowing policy – Nancy Fenlon
Policy on the borrowing of VFC vaccine has again been modified, and is being allowed in limited circumstances. See VFC Operations Manual module 4 (revision date Nov. 2007) pages 4 & 5 for more details (http://www.cdc.gov/vaccines/programs/vfc/operations-guide.htm) - Review of enrollment forms – Nancy
Nancy gave a brief update on the review of these forms, and a reminder that they were due to her by Oct 1. - Dec. 31 Fraud and Abuse policies: reminder of due date – Nancy
- VFC Management Survey: announcement of presentation - Nancy
A future conference call was announced (likely to be held in January) to provide directions on how to complete the upcoming VFC Management Survey. Grantees are encouraged to attend the call in which the details of completing the survey will be discussed. - VFC Site Visit Questionnaire: reminder on website – Nancy
The 2008 Site Visit Questionnare is now posted on the VFC site. - CMS VFC Training- Nancy
The new VFC Ops guide encourages state Medicaid offices to work with immunization programs to complete their Fraud and Abuse policies, which are due Dec 31. CMS has a lot of expertise in the investigation of fraud and abuse. Nancy will be giving a series of presentations to CMS offices throughout the country over the next few months to ensure that they are aware of the new guidance within the VFC Ops guide. - Accountability workgroup: update and visits – Nathan Crawford
Nathan gave a brief update on the visits that have been planned to learn how grantees are doing VFC accountability, with a specific focus on how they are completing their provider profiles. Visits have been made or have been scheduled with GA, SC, NC, MI, and UT. These visits will be used to craft the final accountability guidance that will be released in the spring of 2008.
AFIX
- CoCASA - John Flynn
John gave a progress update on CoCASA 3.0, and asked for volunteers willing to be beta-testers. It appears that it will be released in December. - Qualitative AFIX visits -John
A qualitative AFIX visit is defined as a QI visit where the FIX components are implemented but the “A” coverage levels are not generated due to a small number of charts. According to the 2006 VFC Management Survey data, a total of 1,265 (which is about 4% of the 31,000 total site visits conducted nationwide) were conducted.
The challenge with this definition is that “a small number of charts” can be left for interpretation. Recently, it has come to our attention that there is a broad interpretation of what a small number of charts means. In addition, a Qualitative AFIX visit does not have the same weight and thoroughness as a full AFIX visit. We have spent the last few months conducting a literature review and the research points to the fact that a stronger, more intense process may lead to better outcomes in provider practice. A meta-analysis completed in 2007 by the Cochrane Collaboration (which included over 72 studies with more than 13, 500 health professionals), emphasizes the importance of the intensity of an intervention to impact provider practice which includes a stronger feedback and follow-up process combined with an accurate assessment.
Having said all of that, beginning in 2008, Qualitative AFIX visits will no longer be an option for grantees. A full AFIX visit should be conducted. If you conduct an AFIX visit where a provider has less than 50 charts, all charts must be included in the review. In terms of a manual review, we understand that this may be more time consuming. We continue to encourage grantees to build their IIS (registry) functionality in an effort to streamline the assessment portion of AFIX. More and more grantees are shifting toward IIS combined with CoCASA for assessment and some are even using the IIS alone for assessment. Working through a quality improvement initiative requires a sound methodology to produce the best data possible to not only establish solid baselines but goals as well for the provider. This assessment combined with a stronger feedback and follow-up protocol, according to the current research, may have a stronger impact on improving provider practice. We are spending millions of dollars every year on quality assurance and quality improvement activities. We need to assure that we are doing it in a way that is consistent with the most current research and aligns with the goals and objectives.
- Level I Standards: Reviewing of self-assessment worksheets – John
We are in the midst of finishing a review of the AFIX Self-assessment worksheets submitted with the 2008 grant application. The initial data analysis shows nine grantees self-reporting the completion of the Level I AFIX Standards. More information regarding the analysis will be shared at a later time. - AFIX site visits – John
As part of our review of current AFIX policies, we want to take an opportunity to visit a handful of grantees to observe their AFIX policies and procedures in action. We are in the midst of choosing grantees at this time and will contact grantees in the near future to schedule a meeting time.
VFC/AFIX
-
Vaccine U. 2008: Planning committees, site location – Nathan
Nathan gave a brief update on the two planning committees for Vaccine University 2008. The internal committee is the primary planning committee and includes representatives from 2 grantees. The external planning committee, also the VFC/AFIX workgroup (POB’s VFC/AFIX advisory group), is comprised of 6 grantees. Tentatively, Vaccine U. will be held May 28-30 in Baltimore, MD. More information will be provided as soon as it becomes available.
Grantee-Requested Agenda Items
- VMBIP- Brad Prescott & Julie Orta
34 grantees have now transitioned with many of those remaining to transition being the ones who, in the past, have done their own in-house distribution. Roll-out has been temporarily stopped because of flu season and because of lessons learned from the CQI process in California. Rollout will resume in March, although several more grantees will transition prior to that for specific reasons.
The data warehouse does not yet exist although there are weekly meetings to work on the issue. The back-order report will soon be available, although no definite date yet for data warehouse.
McKesson is building a second distribution center in Sacramento, which will be in operation by the time the roll-out begins again in March.
At the program managers meeting, there will be a lot of emphasis on central distribution.
- VaX.Net – Janet Kelly, Doug Correll & Nancy Fasano
Nancy Fasano explained that VaX.NET is the new name for VODS (Vaccine Ordering and Distribution System) although the name may be changed soon due to copyright issues.
The Contractor is taking a Blueprint/Prototype approach to VaX.NET in order to provide CDC with a tangible proof of concept prior to any development. There are two areas included in this first phase – VODS (vaccine ordering & distribution system) and Grantee monitoring. Grantee monitoring was formerly called Funds Management.
Blueprint sessions were held the week of September 10th with subject-matter-experts for the Grantee monitoring piece and follow-up meetings occur as needed. The Contractor will conduct a playback session for CDC in late October. A prototype session is scheduled for November 29, 2007 and AIM and AIRA representatives will be invited to participate.
Doug explained the current timeline for Phase I. He stated that the Ordering and Distribution design is ongoing through December 2007. In addition, the Contractor is performing a gap analysis to provide options and recommendations on the selected commercial-off-the-shelf (COTS) product’s functionality with VMBIP Grantee monitoring requirements. Phase II will initiate in December to begin detailed pandemic flu vaccine requirements analysis. Collected requirements and proposed solutions will later be incorporated into a system blueprint for eventual integration within the COTS product’s functionality.
A concurrent workgroup for the purpose of capturing requirements and identifying high-level electronic messaging standards for vaccine orders from external systems, such as immunization information systems, will begin the week of November 5 or 12. The workgroup will analyze VaX.NET business requirements, provide options, and make recommendations to CCID for addressing any requirement gaps.
Return to VFC-AFIX Quarterly Conference Call Minutes main page
Non-CDC Link Disclaimer: Links to non-Federal organizations found at this site are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization web pages found at these links.
Content last reviewed on December 18, 2007
Content Source: National Center for Immunization and Respiratory Diseases