In 2011, Vanderbilt successfully completed testing to electronically send and retrieve vaccination records from the Tennessee State Immunization Registry. Piloted initially in the Pediatric Primary Care clinic, additional clinics have been added to the process whereby all immunizations administered in those clinics and documented that day by 10:30 pm are sent to the state registry each evening. Efforts are also underway to send immunizations administered in inpatient units and emergency rooms, beginning with the Newborn Nursery as of June 21, 2014.

In 2013, information was submitted on 94,906 vaccine doses administered during 58,558 encounters with patients of all ages. October was the busiest month, when the number of doses sent / number of patient encounters was: 18,458 / 14,327

Sending Data to the Registry

Clinics and Inpatient Units Sending Immunizations to the State Registry, as of 6/23/2014:

– began 01/02/2012 .. Peds Primary Care Vaccination Clinic
– began 01/07/2012 .. Peds Primary Care Central
– began 01/07/2012 .. Peds Primary Care North
– began 01/07/2012 .. Peds Primary Care South
– began 01/10/2013 .. 100 Oaks, Center for Womens Health
– began 01/11/2013 .. 100 Oaks, University Pediatrics
– began 01/16/2013 .. 100 Oaks, Peds Adolescent
– began 01/17/2013 .. Peds DOT 10 Medical Specialties
– began 04/29/2013 .. Adult Travel Clinic
– began 04/29/2013 .. Student Health
– began 04/30/2013 .. Williamson Family Medicine
– began 04/30/2013 .. 100 Oaks, Comprehensive Care Clinic
– began 05/01/2013 .. Franklin Womens Center
– began 05/02/2013 .. Internal Medicine, MCE Suite I
– began 05/02/2013 .. Internal Medicine, MCE Suite II
– began 05/02/2013 .. Internal Medicine, MCE Suite III
– began 05/02/2013 .. Internal Medicine, MCE Suite IV
– began 05/03/2013 .. Hillsboro Medical Group
– began 05/03/2013 .. Cool Springs, Center for Womens Health
– began 05/03/2013 .. 100 Oaks, Internal Medicine
– began 05/03/2013 .. Williamson Internal Medicine
– began 05/04/2013 .. Ob-Gyn, Midwife West End
– began 05/04/2013 .. Williamson Walk-In
– began 05/04/2013 .. Wmson – Brentwood Primary Care
– began 05/04/2013 .. Wmson – Spring Hill Family Medicine
– began 05/04/2013 .. Wmson – Spring Hill Walk-In Clinic
– began 05/09/2013 .. Wmson – Brentwood Shoppes
– began 05/09/2013 .. Adult Cancer Center
– began 05/09/2013 .. Adult General Surgery
– began 05/19/2013 .. Wmson Westhaven Family Medicine
– began 05/19/2013 .. Wmson Shelbyville Med Specialties
– began 05/19/2013 .. Green Hills, Primary Care
– began 05/19/2013 .. Adult IBD Clinic
– began 05/19/2013 .. Peds Eskind Diabetes Clinic
– began 05/21/2013 .. Adult Gastroenterology
– began 05/21/2013 .. Adult Pulmonary
– began 05/23/2013 .. Adult Infectious Diseases
– began 05/23/2013 .. VASAP
– began 05/28/2013 .. Dayani Center
– began 04/29/2014 .. Northcrest, Center for Women’s Health
– began 06/21/2014 .. Newborn Nursery (Unit 4CN)

Vanderbilt’s Policy Number CL 30-26.04 entitled ‘Vaccinations: Patient Administration and Documentation
Guidelines’ was updated in April, 2013 and can be found (login required) at:

https://mcapps.mc.vanderbilt.edu/E-Manual/Hpolicy.nsf/AllDocs/1DC11E6FB8752652862576E3005D59A2

Retrieving Data from the Registry

In addition to authorized users’ ability to access the registry online through the Tennessee Web Immunization System (TWIS), specific clinics have been identified, by inclusion of a ‘TWIS’ column in the clinic’s Outpatient Whiteboard, to participate in a process which automatically requests immunization records from the state registry. The requests include all patients scheduled in those clinics from the current day through 3 days in advance. For example, on a Friday, requests will be sent for all patients scheduled through Monday. A single request for a large batch of scheduled patients is submitted each evening. The TN registry currently does not support real-time queries, so additional requests are batched and electronically transmitted to the state at 20-minute intervals throughout the day, 7 days a week, to accomodate walk-in patients.

Immunization records received from the state are stored separately and are *not* automatically incorporated into Vanderbilt’s electronic record (Starpanel). Users can click in the ‘TWIS’ column and see an overlay view which integrates the state’s data with Starpanel’s data. This view can and has revealed discrepancies and data errors present in both systems. It can then be determined which records from the state should be added to Starpanel and if there are any errors in Starpanel that need to be corrected.

Additional in-House Resources

Confluence: TN State Immunization Registry (Log In required)
Confluence: Immunization Population Management (Log In required)
Confluence: TN Immunization Registry and the OPWB (Log In required)
VandyPoint: https://vandypoint.mc.vanderbilt.edu/PWA/HITECH%20and%20Meaningful%20Use%20Audit%20Readiness/default.aspx (Log In required)