Slide 1
National Immunization Conference
Kansas City, MO
March 6, 2007
Vaccine Management Business Improvement Project (VMBIP)
VMBIP Ad-hoc meeting
CDC Logo
Safer Healthier People

Slide 2
Agenda
Overview of current go-live schedule
Overview of VMBIP planning to date
Planning strategy for non-early planning in-house grantees
Pilot Progress to date
Successes and Challenges 
Lessons Learned
Next Steps

Slide 3
Roll-out will run from early Feb 2007 through Mar 2008 with a 12-week pilot period and a 24-week Phase 1 roll-out
VMBIP Centralized Distribution Roll-out 
Effective February 22
Key Assumption: Vendors allow for contract extensions

Legend: Preparation, Implementation, and Pilot Period

Phase:  Centralized Distribution
Description:  Pilot: CA, Chicago, Washington, Maryland
January 2007:  Preparation
February and March 2007:  Pilot Launch:  Feb 5 - March 19
February, March, and April 2007: Pilot Run:  Feb 5 – April 27
October 2007:  End FY ‘07
October and November 2007: Peek of Flu Vaccine Shipment Period

Phase:	Centralized Distribution
Description:  Phase 1: Third party grantees and RI
January, February, and March 2007: Preparation
April through September 2007:  Implementation
Phase 1 Launch: April 2 – September 17
September 2007:  60 percent of vaccine transitioned
October 2007:  End FY ‘07
October and November 2007: Peek of Flu Vaccine Shipment Period

Phase:  Centralized Distribution
Description:  NC, NY and remaining other in house grantees
March through August 2007: Planning and Preparation
April 30, 2007 NY MS Expiration 
Assumes the Yew York Multi State is unilaterally extended one month from March 31 to April 30
October 2007:  End FY ‘07
October and November 2007: Peek of Flu Vaccine Shipment Period
Phase 2 Launch:  December 3 through March 17
Some preparations in November, December, and January 2008
Implementation from December through March 2008

Phase:  Centralized Distribution
Description:  Pacific Islands
Preparation and Planning August and September 2007
October 2007:  End FY ‘07
October and November 2007: Peek of Flu Vaccine Shipment Period
Preparation and Planning December through March 2008
Implementation:  March 2008

Slide 4
With the exception of in-house non-early planning grantees, most grantees have initiated some degree of VMBIP planning
Status of Grantee VMBIP Planning

Third Party Early Planning with Modules Deployed
Arizona
Colorado
Connecticut
Delaware
DC
Hawaii
Idaho
Indiana
Kansas
Maine
Missouri
Nebraska
New Jersey
New York
New York City
Nevada
North Carolina
Oregon

Pennsylvania
Philadelphia
Tennessee
Texas
Utah 
Virginia

In-House Early Planning with Modules Deployed
Alabama
Arkansas
Iowa
Michigan
Mississippi
New Mexico
New Hampshire
Rhode Island
South Carolina
Vermont
West Virginia

Third Party Early Planning with Modules Deployed
Kentucky
Minnesota
Oklahoma
Wyoming

Third Party Early Planning - No Modules Deployed
Montana

In House No Early Planning – No Modules Deployed
Alaska
Florida
Georgia
Illinois
Louisiana
Massachusetts
Ohio
Puerto Rico
North Dakota
San Antonio
South Dakota
US Virgin Islands
Wisconsin

Slide 5
Proposed VMBIP Planning Activity Timeline (2007)
We anticipate planning for remaining grantees will begin mid-March 2007

Module:  Kickoff/Current Processes
March 12 – April 9
Module Due:  April 6

Module:  Communications Planning
March 12 – April 9
Module Due:  April 6

Module:  Inventory Transition Planning 
(Typically deployed to grantees 6 months before go-live date)
Starts 6 months prior to go-live
April 9 – July 2007 and beyond

Module:  Near Term Ordering Planning
April 9 – End of April
Module Due:  May 4

Module:  Distribution Transition Planning
May 1 –  End of May
Module Due:  June 1

Module:  Emergency Planning
June 1 – End of June 
Module Due:  June 29

Module:  Funds Management Planning
July 9 – End of July
Module Due:  August 3

Module:  Systems and Process Testing
To be determined

Slide 6
Since February 5, three Pilot grantees have transitioned to McKesson and over 147,000 doses have been shipped
Washington State and Maryland transitioned on February 5
Chicago transitioned on February 13
California is currently scheduled for March 19
Grantee:  Chicago  
Doses:  22,910
Providers Ordering:  139

Grantee:  Maryland
Doses:  50,549
Providers Ordering: 273

Grantee:  Washington
Doses:  74,015
Providers Ordering: 295

Total Doses:  147,474
Total Providers Ordering:  707

Percentage of Total Doses
Chicago:  15.53%
Maryland:  34.27%
Washington:  50.18%

 Data is as of 2/23/07 
Source: Data was compiled from NIPVAC

Slide 7
The pilot period has been an exciting time, characterized by celebrated successes and rapidly addressed challenges
 
Challenges and Resolutions

A collection of ~70 WA orders was unaccounted for during one of the overnight processing sessions.
– Extensive research concluded the orders had not been processed by NIPVAC
– A “check” is under investigation to monitor data packages as they are received from the grantee to ensure they are processed by NIPVAC

The master list of vaccines within VACMAN did not contain the proper list of vaccines
– The master list has been reviewed and updated to reflect more comprehensive picture of the vaccines available through McKesson
– VSAB will continue to review and correct the vaccine master list on a regular basis to ensure its accuracy

California has experienced delays and bugs with VACMAN 4.1.1 installation and Beta testing
– The systems team is actively researching the issue, including facilitating multi-user testing with satisfaction with McKesson

Successes
Pilot grantees have commented on their satisfaction with McKesson
- Orders are being delivered appropriately and in a timely manner
– McKesson Customer Service has been very helpful
– “Fast, friendly and courteous”

VACMAN error messages have been less frequent
– Grantees have been able to, on most days, enter orders and transmit without problems

The VMBIP team meets daily with McKesson to discuss any issues that have arisen and develop solutions to address them

Slide 8
The Pilot period has provided us with lessons from which other grantees can benefit

Ensuring grantee IT staff are available the full week prior to go-live is critical to work through any technical issues that may come up during the transition period

Grantees need to confirm the list of vaccine presentations that will be used to ensure the seed orders are accurate and complete

Communication is extremely important.
– You can never underestimate the need for very open, comprehensive, and timely communication with more people than you ever initially thought.
– Prepare daily or weekly communications to all identified stakeholders as well as all your staff and include all relevant details

This task should not be taken lightly
– Develop, with group input and consensus, plans to support the changes to your systems.
– There may be issues or delays that are caused by actions outside of your control and a well constructed backup plan will be needed

Slide 9
Next steps
 
Monitoring of pilot progress will continue
– Please continue to check the VMBIP web site, participate in AIM calls, and look for
ISD communications to update you on how pilot projects are doing
 
Project Officers and VMBIP Analysts will continue planning activities with grantees
– Some early planning grantees need to send VMBIP planning module data to Project
Officers and VMBIP Analysts
–We have developed the VMBIP Implementation Checklist to help grantees tie up loose ends associated with planning (Appendix)
– Grantees should contact their Project Officer and VMBIP Analysts to obtain a copy of the VMBIP Implementation Checklist
 
Remaining grantees who did not participate in early planning will begin planning activities on March 12, 2007 (Current Processes and Communications module kick-off calls)
 
Questions?

Slide 10
A critical step in the planning process is completing the VMBIP Implementation Checklist

Key Elements of VMBIP Checklist

Use of the VMBIP Implementation Checklist ensures all transition activities are completed prior to go-live

Grantees undergoing planning have already addressed most of the items on the checklist

Grantees can use the checklist as a guide to address any outstanding planning items one to two months before go-live

This checklist would be delivered approximately two months prior to your transition date
– Content may be enhanced based on lessons learned from other grantees

Create a check list documenting activities to do, due date, and date completed.

Slide 11
Next steps
 
Monitoring of pilot progress will continue
– Please continue to check the VMBIP web site, participate in AIM calls, and look for
ISD communications to update you on how pilot projects are doing
 
Project Officers and VMBIP Analysts will continue planning activities with grantees
– Some early planning grantees need to send VMBIP planning module data to Project
Officers and VMBIP Analysts
– We have developed the VMBIP Implementation Checklist to help grantees tie up loose ends associated with planning (Appendix)

– Grantees should contact their Project Officer and VMBIP Analysts to obtain a copy of the VMBIP Implementation Checklist
 
Remaining grantees who did not participate in early planning will begin planning activities on March 12, 2007 (Current Processes and Communications module kick-off calls)
 
Questions?

Slide 12
McKesson Specialty Overview
March 6, 2007
CDC Logo
McKesson 

Slide 13
Pilot Learnings so far
 
Delivery Instructions: Accuracy is Important!
 
Receipt Process
• Check contents and Temperature Monitor Immediately upon receipt
 
Weather issues
• Communicate if Provider hours change
 
Proactive Communication is Helpful
• Help us serve the Providers and the Children, eliminate waste

Slide 14
Pilot Shipment Results to Date
 Orders Processed: 872
 Doses Shipped: 160,890
 Order Cycle Time: 24-48 hours
 Average Lines per Order: 5
 
Delivery Issues:
2 instances of Wrong Address
2 instances of Open Hours Incorrect
1 Order Refused
1 Temperature Monitor issue

Slide 15
Picking the “First Order”
This slide shows pictures of the first order being prepared for shipment

Slide 16
System Double Check the “First Order”
This slide shows pictures of the first order being checked for accuracy

Slide 17
Pack Out the “First Order”
This slide shows pictures of ice packs being placed in the first order

Slide 18
Memphis Team with the “First Order”
This slide shows a group of McKesson staff holding the first order

Slide 19
McKesson Specialty Open House McKesson Specialty Open House
Memphis, TN April 18, 2007
View McKesson Specialty Operations
Meet CDC VFC Team
 
Tour of Facility
• Security
• Emergency Generator
 
Details on Hotels and Logistics will be Distributed Soon
 Questions? Contact Eric Doss or Brock Lamont

Slide 20
NIC March 5-8, 2007
Questions?

Slide 21
National Immunization Conference
Kansas City, MO
March, 2007
Vaccine Management Business Improvement Project (VMBIP)
Systems Project Update

Slide 22
Systems Workstream Update
VACMAN 4.x support for VMBIP’s
Centralized Distribution Implementation

Slide 23
VACMAN 4.x to support Centralized Distribution
• Grantees / Projects familiar w/ VACMAN
• Accelerated timeline
• CDC support infrastructure in place
• Fills gap between Centralized Distribution and VODS
• Modified to support centralized distribution only
• Only minor enhancements
– New Import / Export functionality for distributor provider orders

Slide 24
VACMAN Modifications to support Centralized Distribution
• New and modified capabilities
– Entry of non direct-ship Provider Orders* has been added
– Entry of Provider Receipts has been added
– Entry of Federal-funded Bulk Orders has been disabled; the Projects will only be able to enter State-funded Bulk Orders in VACMAN 4.x
– Entry and saving of Non Frozen Flu Orders with capabilities to edit and browse the orders prior to transmitting to the distributor
– Entry and editing of Distributions and Adjustments has been disabled; the Projects will only have this screen to view historical data
– Reporting capabilities will include historical information from the data migrated from VACMAN 3.0.11
* Provider Orders refers to CDC contracted vaccines as well as non CDC contracted vaccines – all provider orders, regardless of contract should flow through VACMAN

Slide 25
There have been a variety of modifications to the Data Tab
Data Tab Updates in VACMAN 4.x vs. VACMAN 3.0.11

Modification:  New Provider Order Screen
Current VACMAN 3.0.11: Does not exist in 3.0.11
Future VACMAN 4.x: 
• New screen used to enter and distribute non direct-ship & non flu provider orders
• Radio buttons enable the user to select whether the order is a CDC contracted vaccine or a non CDC contracted vaccine

Modification: Provider Receipts
Current VACMAN 3.0.11: Does not exist in 3.0.11 for non direct-ship provider orders
Future VACMAN 4.x: 
• New screen used to enter provider order receipts, including non-frozen flu and non-CDC orders
• Carrier, Tracking, and Depot fields are populated by the System; the depot field will be populated with McKesson

Modification:  Non-Frozen Flu Orders
Current VACMAN 3.0.11:  Does not exist in 3.0.11
Future VACMAN 4.x:  New Influenza Orders screen used to enter and save non frozen flu orders with capabilities to browse and edit until the user is ready to transmit the orders

Modification:  Transactions
Current VACMAN 3.0.11: Two different screens, one to access provider transactions and one to access direct-ship transactions
Future VACMAN 4.x:  One screen to access both provider transactions and direct ship transactions

Modification: Adjustments and Distribution
Current VACMAN 3.0.11: Screen used to enter, edit, save and view adjustments and distributions, and to view adjustments and distributions
Future VACMAN 4.x:  Screen used to access historical information about project vaccine inventory. It represents adjustment and distribution data prior to the installation of VACMAN 4.x; it is view only

Modification:  Enroll Providers
Current VACMAN 3.0.11: • Does not exist in 3.0.11; Enrollment screen used to access enroll demographics
Future VACMAN 4.x: Screen used to enroll demographics for a provider

Slide 26
Some additional changes to VACMAN v4.x are included in the list below
• Import and Export options have been modified to include the ability to import and export New Provider Orders
• Provider Order Entry Screen allows the input of multiple vaccine orders per provider per screen instead of one at a time
• Transaction code 2 has been removed as a possible transaction; there is no longer the ability to ship viable vaccine to the distributor or to the manufacturer
• There have been a few reporting changes:
– Reports Tab 1 no longer includes Distribution and Project Inventory Reports
– Reports Tab 2 no longer includes Depots, Suppliers (Manufacturers), Funding Source Transactions, and Funding Codes and Balances reports
– All references to Varicella orders in the System have been changed to Direct-ship

Slide 27
Early Pilot Grantee results from VACMAN 4.x implementations suggest we’re headed in right direction
• Successful launches of Washington, Maryland, and Chicago in February
• In process of launching California
– Additional beta testing required to address complexity of running VACMAN 4.x on California’s network environment
• Next group of grantees implementing include Tennessee (3/19), Rhode Island (4/2), Nebraska & Oklahoma (4/23), and Hawaii & Arizona (4/30)

Slide 28
Centralized Distribution implementation is contingent on readiness of VACMAN 4.x
• Grantees and Providers can expect the following from VACMAN 4.X
– Grantees place provider vaccine orders on behalf of the provider and also Grantee-funded bulk vaccine orders
– Order receipt data receipt data sent from Distributor to NIPVAC and accessed via VACMAN Provider receipt screen
– Spend Plan Monitoring Reports will be generated from the Allocation database and are available via request from your POB Project Officer
– CDC Project Officers will have access to the data warehouse and can generate the following reports:
• Shipment Status, Inventory Threshold, Bulk Shipment Receipt, Backorder,
Adjustments, Transaction, Physical Inventory, Physical Inventory Reconciliation, Grantee-Specific Virtual Inventory Reconciliation, Distribution Summary, Nonviable Vaccine, Stockpile/Short-Dated Vaccine & Distributor to Provider Shipment Invoicing

Slide 29
Systems Workstream Update
Vaccine Order Distribution System (VODS)

Slide 30
Commercial-off–the-Shelf Software (COTS)
• COTS – a system which ‘is’ manufactured commercially, and then may be tailored for specific uses.
• Office of Management and Budget (OMB)
– Advocates COTS solutions
– Reviews all VODS contracts and proposals
• SAP
– Enterprise Resource Planning (ERP)
– Industry standard best practice
– Used in 80% of distributors and vaccine manufactures in the US

Slide 31
Gaps from VODS requirements and SAP • Requirements gaps can force “customizations” vs. “configurations”
– Conflicting example – Reqt allows Grantees to control the viewable formulary by the Provider vs Reqt limits the number of formularies to the number of groups that have been created…need to determine way to limit the number of formularies
– Contradicting example – Reqt allows Provider to maintain an individual provider account for each provider vs reqt restricts Provider from making changes without an approval
– Disconnecting example – Reqt allows Grantees to determine frequency for submitting support documentation vs reqt alerts Grantees if all the required supporting documentation hasn't been submitted by Providers…associating the vaccine request to its supporting documentation needs more definition.

Slide 32
VODS Plan of action
• Requirements solidification to fill “Gaps”
• VODS SME Team resources identified and secured
• SME for requirements
• SME for external information system connections
• To be completed once gaps are filled
• Finalize VODS rollout timeline based on additional FMO requirements
• VODS Pilot Site selections to be completed
• Begin VODS user testing
We are committed to working with you closely as the VODS deployment plan and schedule is solidified!

Slide 33
Questions?

Slide 34
National Immunization Conference
Kansas City, MO
March 6, 2007
Vaccine Management Business Improvement Project (VMBIP)
Funds Management Update

Slide 35
CDC has developed the “Spend Plan Development, Monitoring and Updating Guide” to assist grantees in proper spend planning

Goals of the Guide:

Communicate the Purpose and Importance of the Spend Plan
– Spend plans provide critical information to a number of planning processes and activities
– As we transition to centralized distribution, CDC will be relying even more heavily on the spend plans for effective planning and management of inventory and funds

Clarify expectations for the Spend Plan
– Pre-transition spend plans should reflect bulk purchases, while post-transition spend plans should reflect provider orders
– Spend plans are CDC’s best estimate for future purchases – they must be monitored closely and updated to reflect current information

Provide “Best Practices” Suggestions and Tools to Aid Grantees in Spend Plan Development
– Historical distribution data and future program plans should form the basis for the spend plan
– VOFA is a transmit tool only - it does not accommodate the data gathering and analysis work necessary for a good spend plan

Grantee Spend Plans include the following:
Estimated Target Budgets
Virtual Inventory Estimations
Excise Tax Credit
Grantee Replenishment Orders
Federal Vaccine Inventory Estimations
Obligations to the Manufacturer Contracts
Provider fulfillment Order Allocations
Distributor Replenishment Orders

Slide 36
The “Grantee Spend Planning Workbook” is an optional tool grantees can use to profile monthly ordering, do scenario planning, and calculate their VOFA inputs

An example of a worksheet is displayed.  The one side of the example is for VFC.  The second side is a monthly display for the last quarter in 2007 where doses and dollars are documented.  

Vaccines are listed down the page, with several columns for each vaccine.  

The vaccines shown are: DTaP, DTaP, DTap-HepB-IPV, eIPV, HepB-Hib, Hep A pediatric, Hep A adult, HepA-HepB, Hepatitis B Pediatric/Adolescent, Hepatitis B Pediatric/Adolescent, Hep B2 Pediatric, Hib, Hib, HPV, MMR, Meningococcal.

Columns for each vaccine are:  Brandname/Tradename, Packaging, Cost per Dose, Contract End Date, and Manufacturer.

Slide 37
Detailed instructions for using the workbook are contained in the left-most 
Worksheet/Tab  

Instructions:

1. For State & Local and 317 worksheets only:  Your Annual "Spend Target" for is 
highlighted in Blue at the top of each sheet.  For the State & Local worksheet, you will need to enter in your annual "Spend Target" based on the expected amount of your State & Local funding that you will be using to purchase vaccine that is available on the federal contracts there is no place in the workbook for any vaccine presentation (NDC) that is not available on the federal contract, you should subtract the amount you plan to spend on those vaccines out of your stat/local  target before entering it.  For the 317 worksheet, you should populate the Annual Target cell based on what CDC has told you that you have available for FY08. This information can be found in your FY08 VOFA.

2.For State & Local and 317 worksheets only:  Your Annual "Spend Target" for is 
highlighted in Blue at the top of each sheet.  For the State & Local worksheet, you will need  to enter in your annual "Spend Target" based on the expected amount of your State & Local  funding that you will be using to purchase vaccine that is available on the federal contracts there  is no place in the workbook for any vaccine presentation (NDC) that is not available on the  federal contract, you should subtract the amount you plan to spend on those vaccines out of your stat/local  target before entering it.  For the 317 worksheet, you should populate the Annual Target cell based on what CDC has told you that you have available for FY08. 

This information can be found in your FY08 VOFA.

3.For the VFC worksheet only:  Populate the "Total Doses w/ wastage" column for each antigen from VOFA at the bottom of the worksheet.  This section begins on row 80 of the 
VFC worksheet. 

4.On each sheet, for the respective funding source, enter the total number of doses you 
anticipate that providers  will order per vaccine and package type into "Doses" Column” 
under each Month.

5.The total cost by vaccine and package type will be automatically calculated in the 
"Dollars" Column for each Month and will be subtracted from the "Spend Target" 
(for 317 and State) amount to show the "Remaining Target"  or the budgeted amount that 
you have not yet allocated to specific vaccine.  The "Remaining Target" will be 
highlighted in red if it is negative, indicating that you have gone over your "Spend Target" amount and need to adjust your monthly doses downward.

6.On the VFC worksheet only:  There is a section to the right of the "Annual Totals" 
that checks the total doses for each antigen against the total allowable doses you entered from VOFA at the bottom of the sheet.  This section alerts you with an "Over - xxx"  message in the applicable vaccine rows if you have exceeded your allowable doses for any particular antigen.  If you anticipate that you will need to go over the total allowable doses w/ wastage from VOFA, you will need to adjust your vaccine schedule (in both VOFA and the workbook) and enter an "Over-Order Justification" in VOFA.  The section at the bottom of the worksheet provides a summary view by antigen of the total doses you have populated per funding source, the total doses available considering the VFC allocations, and calculates the number  of doses you are over (red) or under your VFC allocation.  The over/under calculation allows you to go over your VFC allocated doses by 0.5% to account for rounding of the percentage distributions across the months. 

7.On the 317 and State/Local worksheets, the section at the bottom of the worksheet 
(beginning on row 80) will show what your vaccine schedule should be in VOFA for those funding sources.

8.Use the totals by brand in the FY08 Total Doses column to complete your brand allocation  section of VOFA.  The brand allocation does not have to total to 100%!  It cannot exceed 100%, but can be less than 100%.

9.The percentage distribution by vaccine, by month will be calculated out to the right 
of the annual totals for entry into the "Purchasing Plans" sections of VOFA.  You can easily print each worksheet for your reference by clicking the Printer icon in your toolbar or selecting "File: Print".  The worksheets are already formatted for printing.
9.The 'Summary Doses' Tab totals the doses and dollars by NDC and month across 
all funding sources and provides an aggregate breakdown of % by month and brand.

Slide 38
Chicago’s Implementation of TOF
Marcia Levin, MPH
Chicago VFC Manager
NIC March 6, 2007

Slide 39
Cartoon with two men speaking.  One is standing pointing at a chute.  The other is sitting at desk.  The quote is: “First the poop will hit the fan, then it will travel down this chute to your desk.”

Slide 40
Tiered Ordering Frequency (TOF)
 Based on annual vaccine usage & provider storage capacity
 Providers “scheduled” to place orders
 * Once a month (Monthly)
 * Once every other month (Bi-Monthly)
 * Every three months (Quarterly)
 Intended to increase order size, reduce the frequency of orders, and reduce order processing workload

Slide 41
Preparations for Implementation
Evaluated each provider’s annual distribution volume
Created a spreadsheet with above data
Collected provider storage capacity info
Sent a blast fax to all providers with request for info
VFC staff followed up on those who did not respond

Slide 42
TOF-based categories were determined by annual usage
Order less than 500 doses/year 
Order vaccine every 3 months (quarterly)
 Order 500-2000 doses/year
Order vaccine every 2 months (bi-monthly)
Order more than 2000 doses/year
Order vaccine every month

Slide 43
Storage capacity also factored into TOF-based categories
Storage Capacity: 2-6 cubic feet of total storage in refrigerator
Frequency:  MONTHLY (only small amounts allowed)
Storage Capacity: 7-14 cubic feet of total storage in refrigerator
Frequency: MONTHLY OR BI-MONTHLY (depends on annual usage)
Storage Capacity:  15+ cubic feet of storage in refrigerator
Frequency:  MONTHLY, BI-MONTHLY OR QUARTERLY (depends on annual usage)

Storage Capacity:  Freezer capacity for varicella, Pro-Quad, FluMist
Frequency:  Separate, insulated door MANDATORY!!

Slide 44
Chicago’s 678 VFC Provider Segmentation
 
Monthly Ordering Frequency 
 202 providers
 
Bi-monthly Ordering Frequency
113 B-1 Providers ( Order in Odd numbered months)
100 B-2 (Order in Even numbered months)
 
Quarterly Ordering Frequency
 105 Q-1 (Order in Months 1, 4, 7, 10)
 88 Q-2 (Order in Months 2, 5, 8, 11)
 70 Q-3 (Order in Months 3, 6, 9, 12)

Slide 45
Providers follow staggered starts for TOF-based orders

Category: M
Frequency:  Monthly
Order Every: Month
Begin TOF (2006): July

Category: B1
Frequency:  B-Monthly
Order Every: Odd Months
Begin TOF (2006): July

Category: B2
Frequency:  Bi-Monthly
Order Every: Even Months
Begin TOF (2006): August

Category: Q1
Frequency: Quarterly
Order Every: Jan, Apr, July, Oct
Begin TOF (2006): July

Category: Q2
Frequency: Quarterly
Order Every: Feb, May, Aug, Nov
Begin TOF (2006): August
Category: Q3
Frequency: Quarterly
Order Every: Mar, June, Sep, Dec
Begin TOF (2006): September

Slide 46
2006 VFC Provider Meeting(s)
 
Hosted annual VFC provider meetings
As providers entered, each was given:
Their assigned order frequency and set of detailed instructions
Chicago Pediatric Vaccine Order and Accountability Form
 Extensive Q&A session

Slide 47
TOF VFC Provider Guidelines
Order according to assigned schedule
Order ALL vaccines needed for ordering cycle
Contact VFC Program if there are changes to practice volume or if appliance is replaced

Slide 48
Monitoring TOF
Utilized VACMAN custom category to identify provider’s TOF segment and track ordering activity via reports
 
Providers given time to adjust to ordering changes
-some months will be better than others
 
Field staff and order processing unit remind providers of the their TOF ordering schedule
Allow for exceptions should providers misjudge their order volume or experience an emergency

Slide 49
Future of TOF
 Further order monitoring and guidance of providers
 Continued TOF communications through field staff visits, blast faxes, order follow-up, and general provider communications

This document can be found on the CDC website at:
http://www.cdc.gov/vaccines/programs/vmbip/downloads/nic/05-opening.rft