Slide 1
Vaccine Management Business Improvement Project (VMBIP)

National Immunization Conference
Atlanta, GA
March 18, 2008

Slide 2
Agenda

•	Status of resuming rollout and performance metrics - Brad Prescott

•	Hib allocation process - Greg Wallace

•	VACMAN/NIPVAC update - Karron Singleton

•	VMBIP updates - Julie Orta

•	McKesson updates - Tom Hart

•	Questions and Answers - Panel

Slide 3
Centralized Distribution Recap

•	First grantee transitions 2/5/07

•	37 grantees transitioned by 12/17/07

•	Pause for CQI implementation 12/17/07 – 2/25/08

•	3 additional CQI teams formed mid-February

•	Sacramento Distribution Center opened 2/25/08

•	Rollout resumed 2/25/08

•	Rollout to be completed by 6/30/08

Slide 4
Below are the metrics used to help CDC decide on resuming centralized distribution rollout

•	Metric
•	Ensure that 99.75% of vaccine order shipments arrive at the provider with a temperature monitor indicating product is viable
•	Ensure that 99% of vaccine order shipments arrive at correct provider with the correct vaccines and in the correct quantities
o	Perform Monthly Physical Inventories and Report Details to CDC
•	Complete Pilot Test with CA; provide system-wide implementation of Master Packing List (MPL) for all multi-box shipments
•	Receive vaccine within 24 hours for flu and 48 hours for other vaccines
•	Transmit Vaccine receipt status to CDC within 48 hours of bulk order receipt into McKesson IT System
•	Begin Scanning & Faxing all non-federally funded vaccine packing lists to grantees within 48 hours

Slide 5
McKesson Specialty has maintained at least a 99% for their scorecard performance metrics

Number of Deliveries or Packages

Criteria: Temp Monitors
January: 191
February 13
March 0

Criteria: Non Compliant Pack
January: 2
February: 3
March: 0

Criteria: Mis-Ship
January: 11
February: 8 
March: 1

Criteria: Undeliverable or customer not available
January: 1
February: 2
March: 0

Accuracy Percent Packages Shipped

Criteria: Temp Monitors
January: 99.284 percent
February: 99.994 percent
March: 100.00 percent

Criteria: Non Compliant Pack
January: 99.993 percent
February: 99.987 percent
March: 100.00 percent

Criteria: Mis-Ship
January: 99.959 percent
February: 99.965 percent
March: 99.984 percent

Criteria: Undeliverable or customer not available
January: 99.996 percent
February: 99.991 percent
March: 100.00 percent

Criteria:  Carrier Damaged
January: 99.951 percent
February: 99.961 percent
March:  99.952 percent

Slide 6
CDC has expanded the CQI analysis and will cover three different areas

CQI Area: Information and Product Shipment Integrity
Description:
•	Discrepancies between the lot number and expiration date information received by the grantee and the physical product or McKesson-generated packing list received by the provider
•	Incorrect lot code information not only presents challenges in grantee administration but also would be a significant impediment in the event of a recalled vaccine
•	This CQI study will use McKesson-generated grantee data to analyze the different sources of product information:  the actual product and McKesson-generated packing list received by the provider, and the corresponding data file received daily by the grantee

CQI Area: Cold Chain Monitoring and Standardization
Description:
•	In January 2008, McKesson logged 117 instances of non-viable vaccine due to an issue with the cold chain process or temperature monitor
•	A non-viable instance occurred anytime the monitor recorded a variation in temperature outside the expected range throughout the duration of the shipment
•	These issues may be caused by improper packing or outside temperature conditions
CQI Area: Data, Systems and Reporting Issues
Description:
•	There are numerous CDC and McKesson systems used to facilitate centralized distribution.  To date, only a high-level understanding of how these systems interact has been documented and communicated to all parties.
•	This CQI analysis will focus on an end-to-end process review including mapping out all the touch points of existing and planned systems (both CDC and McKesson) and their roles and activities, understanding when data is generated, exchanged, and processed, and identifying all of the data outputs and their recipients

This document can be found on the CDC website at:
http://www.cdc.gov/vaccines/programs/vmbip/downloads/nic/08-nic-vmbip-overview.rtf