Updated Vaccine Dosage Recommendations

NextGen® Enterprise EHR Help

Twinrix Immunization Administration Options

The Immunizations module includes the Twinrix vaccine for selection and administration. Twinrix is a combination vaccine, which includes Hep A and Hep B, and is administered to a patient in one injection. Twinrix is recommended for adult patients only (that is, 18 years of age and older) in the U.S. Twinrix immunizations can be administered in three doses, four doses (accelerated), and mixed dosing (that is, Monovalent and combination Hep A and Hep B vaccines). To help you make more appropriate Twinrix immunization order decisions, the system displays vaccine dosage selection warnings and recommendations. Parent topic: Ensuring More Accurate Immunizations Schedules

NextGen® Enterprise EHR Help

Twinrix Immunizations Dose Schedule Display Examples

When the user administers the Twinrix combination, the system displays the Status and Dose due dates on the Chart tab according to the Twinrix dosage interval recommendations. The system displays Twinrix in the Status column on the Chart tab to indicate that the dose being recommended is based on the Twinrix schedule. If a user selects to administer the Hep A and Hep B vaccines individually, instead of selecting Twinrix, the system displays the doses for each immunization on the Chart tab in separate rows and columns. For the Hepatitis immunization series, the immunization due dates display on the Chart tab according to the monovalent or combination dosing schedule, which is based on the last dose the patient received. After the patient receives the first vaccine (for example, Twinrix), if the provider selects a different vaccine in the Hepatitis immunization series for the second dose, such as monovalent Hep A or Hep B, the system calculates the next dose due date (Dose 3) based on a

NextGen® Enterprise EHR Help

Viewing the Td and Tdap Vaccine Information

The Recommendation and Chart view enables you to view Td and Tdap information as follows: Tdap and the Td vaccine status and schedule information displays on separate rows. Note: However, Tdap is still included in the Td calculation. If a patient received the Td or Tdap immunization less than 10 years ago, the Status column displays Current. If a patient has not received the Td or Tdap immunization for more than 10 years, the Status column displays Past Due. The Tdap immunizations is updated according to the CDC recommendations and the Age range and Gender you select in File Maintenance > Master Files > EHR > Practices > Preferences > Orders > Imm. For the Tdap vaccine only, the system does not consider the “Ignore Pediatric Recommendation for Adults” practice preference when calculating the Tdap Immunization status for adults or patients 11 years of age and older. Note: If you are accessing Historical Immunizations for a patient, the Status column indicates Past Due or Current for the

NextGen® Enterprise EHR Help

Ensuring More Accurate Immunizations Schedules

The Immunizations module includes rules and conditions to guide the system in displaying the proper vaccines to be administered to a patient. These conditions and rules are based on Centers for Disease Control and Prevention (CDC) immunizations scheduling recommendations and other governmental guidelines. As new regulations and patient safety considerations occur in various iterations, the schedules and different vaccine dosage rules that the Immunizations module uses are updated. The system also evaluates the components of a patient’s chart to determine if additional doses of a vaccine are needed, such as the patient age, dates of previous doses administered, and number of doses already completed. Immunization rules and vaccine information displayed enables you to do the following: Determine when a patient should receive an immunization. View whether a dose is valid and the reason if it is not valid. Make more informed clinical decisions when selecting vaccines for an immunization. Mo

NextGen® Enterprise EHR Help

Viewing the Immunizations Statuses on the Chart or Recommendation window

The Immunizations statuses, which display on the Chart view and Recommendation view, provide information about each immunization using symbols, colors, and other visual representations. The Immunization status calculations incorporate the patient's age and the interval between doses for all vaccines in a series, and reflects the CDC vaccine catch-up schedules. Refer to the following table for a brief description of Immunization statuses. Status Description Due Now Due within a recommended dose period, for example, 4 to 6 years Past Due Due after the recommended dose period Current No doses due at this time Current* No doses due: The patient has reached the maximum age to receive further doses No further doses due because of how the vaccine series has been administered previously Due xx/xx/xxxx Dose is due but should not be given until date shown Pending The immunization is ordered and awaiting administration. Past Due [excluded] The immunization (or dose) does not need to be administer

NextGen® Enterprise EHR Help

Vaccine Dose Validation

The Enable Vaccine Dose Validation practice preference helps the provider and other clinical staff determine the best schedule for administering immunizations to complete a patient’s vaccine series. This practice preference enables the system to verify if a dose interval for an administered immunization is valid. If an immunization was administered before the minimum dose interval, the system marks this dose as an exception, and displays this notification on the Chart tab for the specific vaccine. With the Enable Vaccine Dose Validation practice preference selected, you can also use the Disable Adult Dose Validation practice preference to control validation of the intervals between vaccine doses given to patients at 18 years of age or older. If you select this preference, the intervals between vaccines you administer to an adult patient are not evaluated for validity. This preference does not affect vaccine doses you explicitly mark as an exception. Disable Vaccine Dose Validation Disa