In December 2016, MacPractice made some changes to the way Immunizations are entered to comply with new government standards. Please check with State Registries to ensure that all local requirements are met.
The Immunizations widget is a record of a patient's Immunization information.
At the top right you will see the Info button, Historical button, More button, Export button, and the Add button. The green plus Add button allows you to search and select immunizations to add for the patient.
Clicking the Historical button will bring up a window to enter a past immunization for the patient.
Clicking the More button will bring up this window.
- VFC Eligibility Status: The patient's Vaccines for Children (VFC) Eligibility Status as defined by the CDC.
- Registry Reminder for Immunizations: The selected menu item is added to the HL7 export file and may be used by the registry for contact purposes.
- Reminder Effective Date: The date on which the Registry Reminder becomes effective.
- Member of a special risk group: Enabling this checkbox indicates the vaccination schedule may need to be modified due to a special characteristic of the patient, such as exposure to an infection or a chronic health condition.
- Rabies Exposure Date(s): Here you can enter when the patient was exposed to rabies. Clicking the green plus will create a new record (that defaults to the current day, but can be edited by clicking on it).
The Export button exports HL7 files for every immunization in the patient's file to the path set in Preferences > HL7/Immunization.
To add a new Immunization, click the plus button in the Immunization widget.
A popup window will appear that allows a user to search for the proper Immunization. The search will pull up any matching terms typed in the bar (as long as there are at least 3 characters entered).
This will pull from the Immunization Reference. Once highlighted, click the select button.
The columns of Immunization table for the Immunization item will be populated based on the information in References > Immunization.
- Immunization: Displays the immunization that is associated to the patient.
- # in Series: If multiple immunizations are entered, this designates in which number this immunization falls in the series.
- Date: The date on which the immunization was administered. This field defaults to today's date
- Incident: The incident related to the immunization, which will display on the clinical ledger.
- Incident: The incident in which the immunization was administered. This will display on the clinical ledger.
- Date: The date on which the immunization was administered, which is the current date by default.
- Time: The time in which the immunization was administered.
- Ordered By: The provider who ordered the immunization.
- Administered By: The user who administered the immunization.
- Office: The patient office or office in which the immunization was administered.
- Status: The status of the immunization, such as complete, refused, partially administered, and so on.
- Refusal Reason: The reason for which the immunization was refused, such as Parental Decision or Religious Exemption.
- Other Refusal Reason: If “Other” is selected as a reason by which the patient refused the immunization, this field is where the explanation is entered. This field is required if “Other” is selected.
- Manufacturers: (Required) The creators of the immunization that was administered.
- Dose: (Required) The immunization dose.
- Unit: (Required)The immunization unit. (MacPractice recommends using mL for units, unless the immunization registry specifically requires a different unit. Each registry may have different requirements for data submission, so please check with the registry if they require any additional information than what MacPractice requires. MacPractice is set up based on the CDC's basic data requirements, but each registry may have stricter requirements.)
- Route: The route through which the immunization was administered, such as Intravenous, Dental, Inhalation, and so on.
- Site: The site through which the immunization was administered, such as Left Arm, Chest Tube, Nebulized, and so on.
- Lot Number: (Required) The immunization lot number.
- Expiration Date: The date on which the immunization expires.
- Number in Series: If multiple immunizations are entered, this designates in which number this immunization falls in the series. The number on the left is the number of this immunization, the number on the right is the total number in the series.
- Reaction: Any applicable patient reaction to the immunization, such as rash, convulsions, fever, and so on.
- Evidence of Immunity: Select any plausible evidence that a person has already developed an immunity to a particular disease. This is a local decision, but best practice would suggest serological evidence.
- Contraindications: Any applicable factor for withholding treatment, such as an allergy, pregnancy, disease, and so on.
- Contraindication Date: The date of the contraindication finding.
- Notes: Any notes related to the immunization.
- Vaccine Groupings and Information Statement Distribution: This table documents the distribution of Vaccine Information Statements (VIS) created by the CDC and given as a vaccine is administered. Consult the CDC or view this link for instructions on using VISs, including requirements.
- Vaccine Name and CVX Code: These columns are automatically populated based on the immunization selected.
- VIS Given: Enable this box if the CDC's Vaccine Information Statement (VIS) was given to the patient.
- Given Date: The date on which the VIS was given.
- Published Date: The date on which the VIS was published.
For more context on the requirements for Immunization data attributes, see the Implementation Guide for Immunization Messaging from the American Immunization Registry Association, Department of Health and Human Services, and Center for Disease Control.
- VFC Eligibility Status: (Required) The patient's Vaccines for Children (VFC) Eligibility Status as defined by the CDC, such as Not VFC Eligible, Medicaid Managed Care, Uninsured, Underinsured, and so on.
- National Drug Code: The NDC is an identifier assigned to the Immunization from the Manufacturer. If clicking on the this brings up an empty pop up, select a different manufacturer.