The overall phased COVID-19 immunization plan requires identification of eligible patients in each phase.
You can use your practice Electronic Medical Records (and even your billing system) to identify patients that meet the public health eligibility criteria in each phase. This will help to ensure the right people are immunized (if they wish) at the right time.
To assist in identifying patients in your practice, we have outlined below a primary care focused approach, that you can use to help identify patients eligible for immunization.
NOTE: The approach will, of course, adapt to new science, vaccine supply, and clinical capacity constraints. We will endeavour to update this information.
Identify Eligibility Criteria
Even if you are not directly involved in immunizing in your practice, it may be very helpful to review your practice for higher risk and eligible patients and engage with a select population of those patients to help ensure they are immunized.
Also confirm who might be excluded (e.g. those with allergies) from a specific vaccine.
The criteria are described in the Current COVID-19 Immunization section.
Using Your EMR to Identify Patients
Your electronic medical record (EMR) can help you identify patients who meet criteria for immunization. It is critical – as we move to phases where community clinics will be immunizing – to be able to quickly and easily create recall lists of eligible patients.
Does My EMR Have a Built-in Report Already?
Some Canadian EMRs already have reports being developed (by them or related groups). Check below to see if your EMR has tools to help identify patients in each phase of the COVID-19 immunization:
Does My EMR have built-in reports?
I Am Part of CPCSSN
Many of the CPCSSN regional data managers are looking at how to embed provincial queries into CPCSSN. If these are in place, this could be an easier way to generate your list of eligible patients. Contact your regional CPCSSN network director or research assistant to determine if you have access to the Data Presentation Tool (DPT).
- LINK: CPCSSN Regional Networks
Building My Own EMR Queries and Reports
If your EMR does not have pre-built queries you can work with your local EMR coach (if available) or build your own reports in your EMR. Depending on how data ready you are, your comfort level, and your EMR’s features, you will be able to identify many eligible patients in most phases. We have provided a few approaches to EMR report, depending on your comfort level with your EMR.
NOTE: these are not specific to any one product, speak to your EMR support person for help with how to create queries and reports.
What if I have Paper Charts?
You can still use your billing or scheduling system to create a simple recall list.
Reflect and Review Your Practice for Missed Patients
Higher Risk Patients with Uncoded Data
When you are using queries beyond age brackets, some data may not be well coded. Make sure you do not miss high risk patients due to gaps in coded clinical data in your EMR.
Review the generated lists and discuss across your team who is NOT on the list that should be. Consider those who may have a higher risk condition but that has not been recorded or has been recently confirmed by a specialist.
For many provinces, eligibility guidelines have adjusted the age criteria for Indigenous Peoples to reflect a relative increased risk from COVID-19. Race or ethnicity is often not well documented in our electronic records in a way that can be easily searched.
While identifying people who are eligible, take time to review your practice to make sure Indigenous Peoples are not missed when you use age brackets in your queries. One way to help better identify patients is to re-run your queries using adjusted age groupings (e.g. instead of 80+, use 65+) and then manually review the list.
Take this time, if you have it, to update problem lists for the future immunization cycles and ongoing care.
Patients Missed from Previous Phases
As we move through the different immunizations phases, patients may temporarily decline the vaccine. It is important to track those who have declined and revisit the options with them over time. Additional information, experience with the vaccines, etc. will become available and may change people’s perceptions of the vaccines.
In future steps we highlight how and when to record who has declined to ensure follow up within your EMR.