Add/Edit Patient Records

Patient Status

Active is the default. To inactivate the patient, select a reason from the drop-down list. Examples include:

• Deceased

• Inactive - Lost to follow-up

• Inactive - No longer a patient

If selecting a status other than Active, a confirmation message appears. Click Yes or OK to continue.

First Name

Enter the patient's first name. This is a required field. These can also be used as a first name at the birthing hospital when a baby does not have a name:

• BABY

• BABY BOY

• BABY GIRL

• NEWBORN

• GIRL

• FC1

• FC2

• FC3

• MC1

• MC2

• MC3

Middle Name

Enter the patient's middle name.

Last Name

Enter the patient's last name. This field is required.

Suffix

Select the patient's suffix from the drop-down list. Example: Jr., Sr., IV.

Birth Date

Enter the patient's birth date.

If an attempt is made to change a patient's birthdate to a date earlier than the first immunization, an error displays. A determination must be made as to whether the birthdate or the immunization date is incorrect. The same error appears in the case of an import-based birthdate change.

Birth File #

Enter the patient's birth file number.

Sex

Select the patient's gender from the drop-down list. Depending on state configuration settings, if the patient's sex is changed, a confirmation message may appear.

Mother's Maiden Name

This may or may not be a required field, depending on state settings. Enter the patient's mother's birth-given last name. This is not required if the patient is 19 years old or older. For family validation, the Guardian First Name, Mother Maiden Name, and Guardian SSN may be required.

Military

Select this option if the patient was in the military.

Comments

Enter any additional information about the patient.

Race

Select one or more races from the list.

Ethnicity

Select the patient's ethnicity from the drop-down list. This field may or may not be required.

Language

Select the patient's language from the drop-down list.

SSN

Enter the patient's Social Security Number, either the full number or the last four digits, depending on display settings. This field is only fully available when adding a new patient and is stored in the database for deduplication purposes. However, if the Administration > Settings > Properties > Patient Settings > Prevent Display of Patient and Guardian Social Security Numbers option is enabled, only the last four digits are displayed on the Patient Demographics page.

Medicaid #

Enter the patient's Medicaid number.

Birth Order / Multiple Birth Indicator

This field is used when adding twins, triplets, etc. Enter a single whole number indicating the patient's birth order. For example, when entering twins, the birth order would be 1 or 2. When combined with the multiple birth count field, the end result is 1 of 2 and 2 of 2. A confirmation dialog box appears to confirm that you are entering multiple births; click OK.

The Birth Order and Multiple Birth Indicator fields are merged on the Patient Demographics page. The field is Multiple Birth and the data is the birth order (first number) and multiple birth count number (second number). After the birth order has been saved, only a Registry Client user can edit the field.

VFC Status (Wyoming: Program Eligibility Status)

Select the VFC /WYVIP status if the patient is under age 19. This field may or may not be required. New patients added at age 19 or older are automatically marked as ineligible.

Block Recall

To limit the types of reminder/recalls the patient receives, select the HL7 publicity description from the drop-down list. Examples:

Vaccine Supply

On Patient Demographic Master View page only (cannot be edited). Denotes the type of vaccine supplied by the health plan and VFC status eligibility for patients under age 19. Displays either Public or Private and is based on the VFC status.

• If the VFC status is ineligible, the vaccine supply displays Private and a selection from the health plan drop-down list may be required.

• If the VFC status is anything other than ineligible, the vaccine supply displays Public.

Comments

Enter any comments.

Consented (Montana)

Select Yes, No, or Undetermined to signify whether or not the patient (or guardian)  has consented to be part of the registry.

Address / Address 1 & 2

Enter a PO Box or the first line of a street address.  If this field is labeled Address 1, enter the PO Box in this field and the street address in the Address 2 field. The following abbreviations can be used:

• Box (BX)

• Highway (HWY)

• Center (CTR)

• Expressway (EXPY)

• Heights (HTS)

• Junction (JCT)

• Lake (LK)

• Square (SQ)

• Station (STA)

• Northwest (NW), northeast (NE), southwest (SW), southeast (SE)

• Lot (used in context of apartment or space number)

• Martin Luther King (Martin L King, MLK)

For Alaska Users: When two addresses are added, make sure the valid checkbox is selected. If it is not, the secondary address does not appear on the patient detail page.

City

If not already populated, enter the city in which the patient lives. This field may or may not be required.

State

Select the patient's state. State must be entered before selecting the county or parish. This field may or may not be required.

Zip Code

Enter the patient's zip code. This field may or may not be required. If the country is other than the U.S. and zip codes have alphabetical and numeric characters, edit your personal settings to deselect the Automatic City / State / Zip Code / County Population option. Disabling this option allows both letters and numbers to be entered into the zip code field. Note that if more than one zip code exists for a city, the Select Zip Code dialog box appears. Otherwise, the zip code is automatically populated.

Country

Select the patient's country.  If the country is other than the U.S. and zip codes have alphabetical and numeric characters, edit your personal settings to deselect the Automatic City / State / Zip Code / County Population option. Disabling this option allows both letters and numbers to be entered into the zip code field.

County/Parish

Enter the patient's county or parish. The state must be entered first.

Address Type

This field appears only if set up in Define Lookups. Select the type of address entered. Examples include Shipping, Billing, Mailing, Physical, Legal.

Email

Enter the patient's email address, which is used for reminder/recall notices.

Valid

This field appears if configured. Select this option if the address is valid. If not selected, the address is not valid and mailings are not attempted.

For Alaska Users: When two addresses are added, make sure the valid checkbox is selected. If it is not, the secondary address does not appear on the patient detail page.

Primary

If multiple addresses are entered, select the radio button for the address that is the patient's primary address. Only one address can be primary. The primary address is stored in the Patient Master and Reserve tables; the remaining addresses are stored in the Many to One table.

Add

Click the Add button after entering the address information. The information is not saved until the Add button is clicked. After the button is clicked, the address information can be edited or removed by clicking the Edit or Remove button. Multiple addresses can be added.

Phone Number

Enter the patient's phone number. If set in the User Preferences, the area code is automatically populated. This field may or may not be required. If this is the primary phone number, select the radio button in the Primary column. To add additional phone numbers, click Add.

Extension

If applicable, enter the extension number for the patient's phone number.

Phone Use Code

Select a phone use code from the drop-down list. Examples include Primary residence number, work number, emergency number.

Equipment Type

Select the equipment type from the drop-down list. Examples include Telephone, Cellular Phone, Telecommunication Device for the Deaf.

Primary

Select the radio button in the Primary column for the patient's primary phone number.

Add

Click the Add button after entering the phone number information. The information is not saved until the Add button is clicked. After the button is clicked, the phone number information can be edited or removed by clicking the Edit or Remove button. Multiple phone numbers can be added.

Guardian 1 First

Fields are state-configurable and may be labeled differently. Enter the first name of the patient's first guardian.

Guardian 1 Middle

Enter the patient's guardian's middle name.

Guardian 1 Last

Enter the patient's guardian's last name.

Contact Type

If available, select the patient's family contact type from the drop-down list. Contact types are created by the System Administrator in Define Lookups.

Guardian Work Phone

Enter the work phone number for the patient's guardian.

Guardian 1 SSN

Enter the patient's guardian's Social Security Number. This field is only fully available when adding a new patient. If the Administration > Settings > Properties > Patient Settings > Prevent Display of Patient and Guardian Social Security Numbers option is enabled, only the last four digits are displayed on the Patient Demographics page.

Guardian 2 First

Enter the first name of the patient's second guardian.

Guardian 2 Last

Enter the last name of the patient's second guardian.

First Name

Enter the parent or guardian's first name.

Middle Name

Enter the parent or guardian's middle name.

Last Name

Enter the parent or guardian's last name.

Contact Type

Select the contact type from the drop-down list.

SSN

Enter the patient's guardian's Social Security Number. This field is only fully available when adding a new patient. If the Administration > Settings > Properties > Patient Settings > Prevent Display of Patient and Guardian Social Security Numbers option is enabled, only the last four digits are displayed on the Patient Demographics page.

Guardian?

Select this option if this person is the patient's legal guardian.

Address 1

Enter the first line of the parent or guardian's address.

Address 2

Enter the second line of the address.

City

Enter the parent or guardian's city.

Country

Select the parent or guardian's country from the drop-down list.

State

Select the parent or guardian's state from the drop-down list.

Zip Code

Enter the parent or guardian's zip code.

Phone

Enter the parent or guardian's phone number.

Email

Enter the parent or guardian's email address.

Add

Click the Add button after entering the information for each parent, guardian, or other family member. The information is not saved until the Add button is clicked. After the button is clicked, the family member or contact person is listed and can be edited or removed by clicking the Edit or Remove button.

First Name

If the patient uses (or has used) another first name, enter it here. Alias fields are included in searches.

Last Name

If the patient uses (or has used) another last name, enter it here. Alias fields are included in searches.

Allergies

Enter any noted allergies for the patient.

Monthly Income

Enter the monthly gross income of the patient's family.

Association

Select an association to which the patient may belong, such as Fire Station, Police, etc., from the drop-down list. This is state-configurable and may not contain any entries.

Number in Family

Enter the total number of family members.

School

Enter the patient's school name. The School Nurse module may automatically pre-populate this field. Otherwise, click Click to select to open a pop-up window and search for the school.

If the school is changed in IWeb, the change is not automatically sent to the School Nurse module. However, if the school nurse changes the school name in the School Nurse module, the change is automatically sent to IWeb.

School Entry Date

Enter the date the patient started the school named in the School field. For Washington users, this is a required field for School Nurse users.

Health Plan

Select the patient's health plan from the drop-down list. This is a required field for patients whose VFC status is ineligible and who are 18 years old and younger.

Other Health Plan

If Other is selected in the Health Plan drop-down, enter the plan name in the textbox.

NAIC Code

Enter the NAIC code number.

Enroll Date

Enter the effective date for health plan enrollment.

Medicare ID

Enter the patient's Medicare ID number (US only).

Billing ID

Enter the patient's billing number.

Physician

Select the patient's primary care physician from the drop-down list. If set in User Preferences, it automatically populates.

Facility

Select the medical home facility from the drop-down list. If set in User Preferences, it automatically populates. The abbreviated name of the Facility may be used in the list instead of the full name.

Admission Date

Enter the date the patient was admitted to the medical home facility, or the date of entry if this is a new patient. If the user does not belong to an owning Organization (IRMS), this field is disabled. It cannot be edited.

District/Region

Enter the medical home facility's district or region. If set in User Preferences, it automatically populates.

Next Appt. Date

Enter the date of the patient's next appointment. This date is used in reminder/recall.

Chart Number

Enter the patient's chart number.

Medicaid Provider #

Enter the patient's Medicaid provider number (US only). It can be populated either by Medicaid bath imports or by provider data entry.

Birth Facility

Enter the patient's birth facility.

Birth Country

Select the patient's country of birth from the drop-down list.

Birth State

Select the patient's birth state from the drop-down list.

Date of Death

If applicable, enter the patient's date of death. This field is available only if the patient has been inactivated with the reason of Deceased. This cannot be a date in the future.

Certificate of Immunization Status (Washington)

Click the Certificate of Immunization Status (CIS) link to open the Certificate of Immunization Status (CIS) page. Select the Certificate Type from the drop-down list (i.e., Child Care, School Nurse) and then the Series from that drop-down list, then click Create PDF. The PDF version of that certificate for the selected patient automatically downloads.

Adult Immunization Record (Tennessee)

See Adult Immunization Record.

HIPAA Private Practices Form Given

Select this option if the patient was given the HIPAA Private Practices form.

Date Given

Enter the date the HIPAA Private Practices form was given to the patient.

Signature

If a signature pad is connected and the related software installed, have the authorized person sign the form and then click:

• Edit - To make edits to the form data (date given, re-signature)

• Clear - To erase the input fields

• Done - To save and store the signature

HP Patient ID

Enter the patient's health plan ID number.

Block Health Promotion Reason (Washington)

Select a reason to explain why health promotion mailing should not be sent to the patient. This field is called Block Mail Reason in manual deduplication.

Recall Count Attempts

Displays the number of times the patient has been sent a reminder recall. Automatically generated by the system.

High Risk

High risk categories are added at the state level. These categories make it easier to identify patients with possible special immunization needs.

If this field is highlighted in red, (s)he may have special immunization needs.

Campaign Name/Tier Name

If the Required Campaign option is enabled (selected) on the Campaign Add/Edit page, this fields may appear on the Vaccination Detail, Contraindications, and Patient Demographics Detail/Edit pages to identify the campaign or tier name.

SIIS Patient ID

The patient's SIIS number.

IRMS Owner

The Organization (IRMS) that "owns" the record. This field can be configured so that it appears blank on patient demographics and vaccination detail pages.

Entry Date

The date the patient was entered into the application.

Last Update Date

The date the patient's information was last updated.

Entered By

The username of the person who created/entered the patient record.

Last Updated By

The username of the person who last updated the patient record.

Include in CASA

Select this option to include the patient in CASA for the current session. This only appears when enabled in Administration >  Settings > Properties > Registry Settings > Allow CASA Export by Session. See CASA Export for more information.

Do Not take Ownership of This Record

Select this option to prevent the Organization (IRMS) from taking ownership of the patient record. When enabled (selected), a message appears at the top of the Vaccination Detail page when shots are administered, notifying the user that upon saving the vaccination(s), ownership will not be taken by the IRMS. Ownership remains with the previous owning IRMS and is not changed to the IRMS making the edit or adding the shot(s). However,

• If the user account does not allow changes to records, or if the IRMS is blocked from ownership, then this option does not appear.

• If the IRMS that the user is logged in as already owns this patient, this option does not appear.

Opt Out

When this option is selected, a warning message appears: Are you sure you want to opt out for this patient? Click OK to confirm or Cancel to abort opting out. After this option is selected, all personal data is removed from the Patient Master and Patient Reserve tables. The remaining data includes the IRMS ID, patient birth date, VFC status, and inactive status. The record is also flagged as anonymous. Note: In order for this option to display, the organization selected by the Registry Client user at login must be the same organization that last updated the patient record.

Share with Other Registries

This is a state-configurable option. If enabled (selected), the patient record can be exported via HL7 to remote registries (both the state central registry and state-to-state). Records that are not selected are not exported. This option does not affect incoming updates to patient records (vaccsync, queries, etc.). The option cannot be transferred or changed during updates from external systems.