SAGE Immunizations Guideline

SAGE Cycle 5 Immunization guideline All patients eligible for vaccination regardless of age and clinical condition

Recommendation Set (Activity Graph): Neonatal Hepatitis Immunization Guideline

Newborn (Inpatient) Hepatitis Immunization Scenario This scenario is triggered upon admission of a newborn. The logic 1) determines whether Hepatits B vaccine is due, checks upon deferral and places orders when appropriate. 2) Orders followup testing at nine months of age for infants at risk 3) Determines whether Hepatitis B Immune Globulin is due and places order 4) Checks maternal record for information of Hepatitis B status. If these cannot be found, orders are placed for maternal testing and time drive event is set for 12 hour rechecks until receipted or the baby is more than 24 hours old.

)

Recommendation Set (Activity Graph): Primary Care Immunizations

Recommendation Set for outpatient immunizations (adult and pediatric patients) This scenario begins when nurse accesses medical record after check-in of patient to primary care clinic. All eligible vaccines are checked and contraindications reviewed. For patient who is due for vaccine, the user is prompted for verification of consent and absence of deferral reason such as illness. For all vaccines not deferred, orders are placed.

)

Recommendation Set (Activity Graph): Population management scenario

Assumes that a background engine indexes through patient population from a list and issues alerts for those eligible for vaccinations with no known contraindications.

)

Recommendation Set (Activity Graph): Test trial

Test guideline features for execution verification

)

Recommendation Set (Decision Map): Adult Immunization Subguideline

Adult Immunization Subguideline Computes eligibility and contraindications for all vaccines applicable to patient 19 years old or older.

)

Recommendation Set (Decision Map): Pediatric Immunization Subguideline

Pediatric Immunization Subguideline Computes eligibility and contraindications for all vaccines applicable to patients younger than 19 years.

)

Recommendation Set (Decision Map): Vaccine eligibility master subguideline

Grouped into Adult and Pediatric Immunizations Each subguideline evaluates eligibility criteria for each vaccine for age group, including indications and contraindications, and loads transient SAGE variable "Vaccine XXX is due" with one of three states: "false", "true" or "contraindicated". These results are employed by originating scenario to proceed with ordering or administering of eligible vaccines. Pediatric subguideline applicable to age < 19 years, adult are all older patients.

)

Recommendation Set (Decision Map): Compute deferred vaccines

Systematically checks for deferral reasons for all vaccines currently listed as due vaccines

)

Variable: DAY

  • label: DAY
  • referenced_as: ?DAY
  • datatype: CodedValue
  • derivation_expression: day (qualifier value) [SNOMED CT]

    • Variable: Date of birth

  • label: Date of birth
  • referenced_as: ?DOB
  • datatype: PointInTime
  • derivation_expression: select most_recent value from Observation of 'Date of birth (observable entity) [SNOMED CT] ' '

    • Variable: Patient weight variable

  • label: Patient weight variable
  • referenced_as: ?Weight
  • datatype: Observation
  • derivation_expression: select most_recent value from Observation of 'Body weight [SAGE SNOMED CT] ' '

    • Variable: Patient height variable

  • label: Patient height variable
  • referenced_as: ?Height
  • datatype: Observation
  • derivation_expression: select value from Observation of 'standing height (observable entity) [SNOMED CT] ' '

    • Variable: Age

  • label: Age
  • referenced_as: ?Age
  • update_expression: update Observation set code=<Age> value=?Age valid_time=?NOW
  • datatype: PhysicalQuantity
  • derivation_expression: age formula ()

    • Variable: Today (mid-night to midnight)

  • label: Today (mid-night to midnight)
  • referenced_as: ?Today
  • datatype: TimeInterval
  • derivation_expression: Today (midnight to midnight)

    • Variable: NOW

  • label: NOW
  • referenced_as: ?NOW
  • datatype: PointInTime
  • derivation_expression: Now ()

    • Variable: Current month

  • label: Current month
  • referenced_as: ?currentMonth
  • datatype: IntegerNumber
  • derivation_expression: Month of now ()
  • prompt: What is the current month (1=Jan, etc)?

    • Variable: Name

  • label: Name
  • datatype: PersonName
  • derivation_expression: select value from Observation of 'Patient name data ' '