Vaccines Section

1. In the patient chart, click the Vaccines chart tab at the left side of the page.
   Note: If a vaccine order was created using the Prescribe option but the vaccine has not been administered, the vaccine may appear on the Vaccines tab under the header "Ordered, not Administered." Click the vaccine and then click Administer.
2. Click the plus icon , then search for and select the vaccine name.
   Note: Brand name vaccines do not appear in the search results because these order names are updated annually and are often unknown.
   
   The vaccine names in the search results are the CVX code descriptions maintained by the CDC; the CVX codes are reported to immunization registries. For assistance in finding CVX code descriptions, see this CDC website: Mapping product names to CVX and MVX.
3. Administer date — Enter the date that the vaccine was administered to the patient.
4. Administered by — Enter the name of the person who administered the vaccine.
5. Amount/units — Enter the quantity of the vaccine and then select the unit of measure from the menu.
6. NDC — If the ordering provider did not specify the NDC in the order, click the plus icon to search for and select the vaccine's NDC. You can select one of the NDCs that appear for the vaccine order, or you can search for a different NDC (with or without hyphens) and then select it from the list.
   Note: For more information, see NDC numbers in medication and vaccine orders.
7. Route — Select the route (how the vaccine was administered), for example, Buccal, Subcutaneous, or Intramuscular.
   Note: Certain vaccines were previously mapped to the route Injection, but regulatory requirements now require more specific information. You must specify the route as Intramuscular (the default value) or Subcutaneous.
8. Site — Select the site where the vaccine was administered, for example, Arm, Left Upper; Oral; or Thigh, Right.
   
9. Lot # — Enter the lot number of the vaccine.
10. Manufacturer — Select the name of the vaccine manufacturer from the menu. To select a manufacturer that is not in the list, select Other (not listed).
    Note: The manufacturer name is associated with the MVX (manufacturing vaccine) code for the specific vaccine. These codes are maintained by the CDC; you can verify the MVX codes on this CDC website: Mapping product names to CVX and MVX.
11. Exp. — Enter the vaccine expiration date.
12. VIS Given — Enter the date that VIS information was given to the patient.
13. Date on VIS — Enter the date from the vaccine information statement.
14. Click Add (or click Add Another to add an additional vaccine to the chart).

1. In the patient chart, click the Vaccines chart tab at the left side of the page.
2. Click the vaccine in the list to expand the vaccine details.
3. Administered on — Enter the administration date.
4. Record any additional details in the fields provided.
5. Click to add a note about a vaccine.
6. Click Administer.

1. In the patient chart, click the Vaccines chart tab at the left side of the page.
2. Click the plus icon , and then search for and select the vaccine name.
3. Record the details in the fields provided.
4. Click Add Another.
   The vaccine appears on the Vaccines chart tab, and a new form appears with the name of the vaccine populated.
5. Record the details of another administration of this vaccine in the fields provided.
6. Repeat steps 4 and 5 until you record all past instances of administering this vaccine.
7. Click Add.
   Tip: If you accidentally click the Add Another button, you can click outside the form to close the form.

 

If a patient received a vaccination for COVID-19 outside your practice, you can record the vaccine as a historical vaccine on the Vaccines tab of the patient chart. For two-dose vaccines, record separate entries for each dose.

Note: Do not use this procedure if the vaccine is administered at your practice.

1. In the patient chart, click the Vaccines chart tab at the left side of the page.
2. Click the plus icon , and begin typing "covid" in the search bar.
   

Select the correct vaccine, if you know it

3. If you know which vaccine the patient received, select the vaccine from the menu. Here are some of the available COVID-19 vaccine options:
   • Moderna — COVID-19, mRNA, LNP-S, PF, 100 mcg/0.5 mL dose (Moderna)
   • Pfizer (12 yrs and up) — COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose (Pfizer-BioNTech)
   • Pfizer (12 yrs and up) — COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose, tris-sucrose (Pfizer-BioNTech)
   • Pfizer (5 to 11 yrs) — COVID-19, mRNA, LNP-S, PF, 10 mcg/0.2 mL dose, tris-sucrose (Pfizer-BioNTech)
   • Pfizer (2 to 4 yrs) — COVID-19, mRNA, LNP-S, PF, 3 mcg/0.2 mL dose, tris-sucrose (Pfizer-BioNTech)
   • Janssen (J&J) — COVID-19 vaccine, vector-nr, rS-Ad26, PF, 0.5 mL (Janssen)
4. If you do not know which vaccine the patient received, select COVID-19 (SARS-COV-2) vaccine, unspecified from the menu.
   Note: If the unknown COVID-19 vaccine was administered outside the U.S., you can select Non-US Vaccine COVID-19, Product Unknown from the menu.

Complete as much information about the vaccine as you can

5. Administer date — If you can enter only an approximate date, follow your practice's convention. For example, some practices use 1/1/year to indicate an approximate date.
   Note: For vaccines that require two doses, such as the Moderna and Pfizer vaccines, make sure that the Administer date for the second vaccine is after the Administer date for the first vaccine.
6. Administered by — Enter the location where the patient received the vaccine, that is, the pharmacy name, mass vaccination site, or other practice (for example, CVS or Walgreens).
7. Amount/units — You can enter the quantity of the vaccine and then select the unit of measure from the menu (the amount and units are specified in the vaccine name).
8. NDC — If you know the NDC information, click the plus icon to search for and select the vaccine's NDC.
9. Route — Select the route (how the vaccine was administered), for example, Intramuscular.
10. Site — Select the site where the vaccine was administered, for example, Arm, Left Upper or Arm, Right Upper.
11. Lot # — If you have this information, enter the lot number of the vaccine.
12. Manufacturer — If you selected the Moderna, Pfizer, Janssen, or AstraZeneca vaccine from the list of vaccines, select the appropriate manufacturer from the menu.
    Note: If the manufacturer is not listed and you see only the Other (not listed) option in the Manufacturer menu, select Other (not listed).
13. If you have the following information, enter it in these fields:
    • Exp. — Enter the vaccine expiration date.
    • VIS Given — Enter the date that VIS information was given to the patient.
    • Date on VIS — Enter the date from the vaccine information statement.
14. Click Add, or click Add Another to add an additional vaccine to the chart (for example, the second dose of the Pfizer or Moderna vaccine).
    Tip: If you accidentally click the Add Another button, you can click outside the form to close the form.

 

Document adverse reactions to the COVID-19 vaccine

To document any adverse reactions to the COVID-19 vaccine, follow these instructions.

1. In the patient chart, click the Allergies chart tab at the left side of the page.
2. Click the plus icon , and type "covid" in the search bar.
   
   
3. Select the COVID-19 vaccine that the patient received.
   Input fields appear.
4. Reaction — Select a reaction from the menu.
5. Severity — Select the severity of the reaction.
6. Onset date — Enter the date of onset.
7. Reaction — Click to add additional reactions, if needed.
8. — Click to add a free-text note.
9. Click Add.

1. In the patient chart, click the Vaccines chart tab at the left side of the page.
2. Click the vaccine to expand and view the details.
3. Record the details in the fields provided.
4. Click outside the section to save the updates.
   Note: To maintain consistency in the vaccine information displayed, immunizations documented in the MAR are read-only within the Vaccines tab. If a provider documents an administered vaccine in the MAR, any updates or deletions made to that entry must be made within the MAR.

1. In the patient chart, click the Vaccines chart tab at the left side of the page.
2. Click the vaccine to display the vaccine details.
3. Click the X icon .
4. Scroll down and click .

Tip: If the vaccine was added in error through an order group or encounter, you can remove it from the Vaccines tab in the chart by deleting the order document. For more information about deleting a document, see the Document View page.

 

Note: To maintain consistency in the vaccine information displayed, immunizations documented in the MAR are read-only within the Vaccines tab. If a provider documents an administered vaccine in the MAR, any updates or deletions made to that entry must be made within the MAR.

 

 

If you see an administration site with the suffix - (deleted), the site was removed from our global list and is no longer available for selection. athenaOne will not make any changes to the options you already selected in previous or open documentation.

 

 

athenahealth provides vaccine interfaces from athenaClinicals to local and state immunization registries. These interfaces can be unidirectional (the registry receives electronic transmissions from athenaOne) or bidirectional (the registry and athenaOne exchange immunization information).

 

For more information, see Immunization Registry Interfaces.

 

If your practice submits or receives information through an interface with a state vaccine registry, you can view the registry status details for a patient's vaccine list at the bottom of the Vaccines section in the patient chart. This information includes the name of the state vaccine registry, the date that information was last submitted to the registry, and the date that information was last received from the registry.

 

Vaccinating providers are sometimes unable to administer a vaccine to a patient, often due to patient refusal or contraindications. During the patient encounter, you can record when and why a vaccination was not given (see To record that a vaccine was not given).

 

Vaccinations that were declined by the patient or parent or that were not administered for another reason do not appear on printed vaccination records, but they do appear in the patient health history. You cannot reopen declined vaccine orders.

Note: athenahealth sends information about vaccines that were not administered to your state's immunization registry if your state can receive this information.

 

When a patient declines a vaccine or when a vaccine cannot be administered for another reason, you must select the reason from the Not Given Reason menu in the vaccine order. These reasons support Clinical Quality Measure (CQM) documentation and are backed by SNOMED codes that are used for denominator exceptions for vaccine-related quality measures.

 

Reasons are categorized as PATIENT DECLINED or PROVIDER DEFERRED.

If you select one of the reasons under the PROVIDER DEFERRED heading — for example, Contraindication, Immunity serologic, or Reaction — a list of more specific reasons opens. Select the specific reason from the list.

 

The Not Given option and associated fields are also visible in the document view of the vaccine order.

You can select and deselect the Not Given option in the document view and change the Not Given Reason and the Not Given Date until you approve and close the vaccine order. Any change made in the document view is also visible in the order view.

 

athenahealth enables you to indicate that a vaccine was not given as part of our ongoing effort to meet ONC 170.315(f)(1) certification (Transmission to Immunization Registries), which ensures that your practice can share important vaccination details with immunization registry information systems and can participate in quality payment programs.

 

Vaccine administration status (not given) is visible in these sections of the patient chart:

• Vaccines tab (under the Not Given heading)
• Find tab
• Visits tab

 

 

 

For vaccine and medication orders, you can document the National Drug Code (NDC) in:

• Assessment and Plan during a patient exam
• Document view of the order for vaccines and medications that were ordered earlier in the encounter or in a different encounter
• Vaccines section of the patient chart at administration time

Note: You cannot add NDC information in the document view if the order was entered as a prescription.

 

For vaccines only, athenaOne automatically displays the NDC number in the NDC field when you administer a vaccine (you can change the displayed number, if needed). In addition, you can scan the vaccine barcode to populate the NDC, Lot #, Manufacturer, and Expiry fields in the order (see Scan Vaccine Barcodes for more information).

 

To add the NDC number to a medication or vaccine order, click the order to expand its details and then click the plus icon in the NDC field.

• If the ordering provider specified the NDC in the order, that NDC appears in the NDC field.
• If the ordering provider did not specify the NDC in the order, you can select one of the NDCs that appear for the vaccine or medication order, or you can search for a different NDC (with or without hyphens) and then select it from the list.
  Important: When selecting NDC numbers, use the NDC on the vaccine or medication itself, not the NDC listed on the package.

The suggested NDCs that appear in the NDC field are based on a feed that athenahealth receives from First Databank, Inc., (FDB) and are determined by the type of vaccine or medication and the dispense form selected in the order.

 

 

Occasionally, a provider is unable to administer the full, intended dose of a vaccine to a patient, for example, because the patient is moving or coughing, or because of some other complicating factor. The provider can document the partial administration of a vaccine during the order workflow (see To create a vaccine order).

After you complete the required vaccine order fields, you can click the Administered or Partially administered button (these buttons are grayed out until the required fields are completed).

• Click the Administered button after you administer the vaccine. The date and time appear to the right of the field.
• Click the Partially administered button if you were unable to administer the full intended dose of the vaccine.

Important: Partial administration of a vaccine does not apply to vaccines that require multiple doses. Partial administration of a vaccine refers only to cases where the full, intended dose of a vaccine is not successfully administered.

 

The partially administered status is also visible in the document view of the vaccine order.

You can toggle between the Complete and Partial options in the document view until you approve and close the vaccine order. Any change made in the document view is also visible in the order view.

 

athenahealth enables you to indicate the partial administration of a vaccine as part of our ongoing effort to meet ONC 170.315(f)(1) certification (Transmission to Immunization Registries), which ensures that your practice can share important vaccination details with immunization registry information systems and can participate in quality payment programs.

 

Vaccine administration status (complete or partial) is visible in these sections of the patient chart:

• Vaccines tab
• Find tab
• Visits tab

The vaccine status appears when you click the Menu icon to print chart sections or to export a patient chart.

 

 

 

When a Marketplace partner makes a change to a patient's Medications, Problems, Vaccines, or Vitals, you can see the name of that partner within the encounter.

 

Before printing or faxing vaccine prescriptions, verify the selections for printing vaccines for your practice.

1. Display the Order Routes page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Order Configuration, click Order Routes.
2. Order type group — Select Vaccine.
3. Clinical order form — Select the appropriate prescription order form for your practice.
4. Click Save.

To print a vaccine prescription:

1. Locate the vaccine document task in SUBMIT status.
2. Click Print.

 

The following two options are available for vaccines so that you can route prescription and administration follow-ups differently:

• For vaccine prescription orders: Approve (next status SUBMIT).
• For vaccine administration orders: Approve (next status ADMINISTER).

 

The provider who orders a vaccine may not be the same person who administers the vaccine. To maintain consistency between the vaccine that was ordered, the default or scanned NDC information, and the vaccine being administered, athenaOne does not allow you to change the clinical order type (COT) for vaccines in the document view.

 

If a provider creates and signs an order for a vaccine with a specific clinical order type (COT), but the person who is to administer the vaccine needs to change the order type (for example, in response to current practice inventory), the administering provider must locate the order, delete it, and create a new order for the correct vaccine.

 

For example, if Dr. Smith orders the Moderna COVID-19 vaccine, but the nurse who administers the vaccine finds out that the practice is out of Moderna vaccines and has only Pfizer vaccines, the nurse must locate the vaccine order with the Moderna clinical order type, delete the order, and then create a new order for the Pfizer vaccine.

 

 

To support participation in the Federal Vaccines for Children (VFC) program, athenaClinicals captures the following information for each vaccine order that you administer:

• VFC status — This field indicates how the patient qualifies for the Federal Vaccines for Children (VFC) program, for example, because the patient is a member of a federally recognized tribe. This field is not required for order sign off and should be reviewed by the user before submission.
• Funding source — This field indicates the funding source for an individual vaccine (private funds, federal funds, tribal funds, and so on).
• Reminder/Recall — This field indicates whether and how immunization registries can notify the patient about vaccination recalls and reminders.

athenahealth sends this vaccine information to your state's immunization registry if your state has the ability to receive this information.

 

Note: For more information about the Federal Vaccines for Children program, see the CDC Vaccines for Children Program (VFC) website.

 

 

Your organization must have Surescripts prescription routing services enabled. Most ePrescribing organizations already have this enabled; no other configuration or setup is required.

 

Note:

If you're unsure whether your organization has Surescripts routing services enabled or if you need assistance enabling Surescripts for use with athenaOne, contact us at 1 (800) 981-5084.

 

Prescribe vaccines and sign for them as you would a prescription for a medication. After you've signed, check the transmission status of your prescription by clicking View More and then View Document.

 

Scroll to the History table to view the mode of transmission — This vaccine will be submitted electronically via Surescripts appears, followed by a confirmation from Surescripts that the pharmacy has received the prescription.