Home Forums Discussions Problems VIPER and AC

When I enter a vaccine under Decision Support/M|HM Immunizations & Shots, and check "Vaccine given elsewhere" - I get a message: "Please enter the location and approximate date the injection was given." The default date is today's date. It will not accept any date I enter. The "Body Site of Injection" doesn't all data entry, thus I can't enter the "location." Therefore, I can't enter any "injections given elsewhere."

Also- to get a list of all immunizations given, you have to go to the Summary Sheet/Decision Support & Injections/Complete. This list should be under the yellow Decision Support Tab in R upper corner of the Most Recent Encounter Tab.

Am I missing something? Is there a tutorial video about this?

It should accept a different date for the vaccination. It sure used to. All you input for vaccinations given elsewhere is the place and the date (and the vaccination).

Yes to get a list of vaccinations you go to the Summary Sheet. The vaccination record still looks rather very unprofessional...back in V5 it looked respectable. Or was that V4?

I also has same problem. There is no place to enter location of previous injection. The pop up message says " Please enter the location and approximate date the injection was given" I wonder how others are recording the immunization records.

Good Morning my Name is Amanda and I am the office manger at Dr. Lauer's office. When entering the date, you must delete the date completely and replace it with the date it was done; in a two digit month, two digit day and four digit year format. It could be yesterday's date or a random date from 5 years ago.

You are correct when you are not able to enter the site. To enter the location you will need to place that in the comments area and click save. I hope this helps:)

yes I agree you have to highlight the date, delete, then re-enter. After clicking "given elsewhere" you DO have to comment. So I just type in "given elsewhere" in the comments. Then I copy it before moving on- so that the next one I enter I can just PASTE in the "given elsewhere" in the comments and don't have to type it out 20 times.

just a suggestion, instead of typing "given elsewhere" you can enter any single letter or symbol. A period would work "."
that might be fewer key strokes than pressing <CTRL>C to copy and <CTRL>V to paste.

This is a good way to use Shorthand for Windows - a simple software program. Just set up something like "vge" - which will complete as "vaccination given elsewhere."

For the 10,000th time, VIPER.

For those of us who are new Bert, may I dare ask what VIPER is? Somebody? Anybody?

I have tried Viper but CANNOT figure out how to put in vaccines given elsewhere.
I only see where I have to enter the vaccines I have in stock, then choose one.
I have asked on this blog for help but did not get an answer. So I don't use Viper. I find it easy to put them into AC, so why change?
I will look up the Viper website for you and get back to you.

I also do not need to ctl-v each time I put "given elsewhere" in the comments- I find it easier to right click-paste. Also, I do not have to take my hand off the mouse, which I would do if I put in a period or a dot. I find right click-paste the fastest way.

Also with Viper you have to enter your vaccine inventory, incl. exp. date. But in AC, I don't have to enter inventory; and when I enter the exp. date once, it comes up the next time, so I don't have to enter it again until next box. JUSt as easy, if not easier, than using yet another software and then combine the two.

http://www.medwaresoftware.com/

this is viper. if I remember correctly, it is the beta version you need

Putting in vaccines given elsewhere is extremely simple. You pick a vaccine and click in the checkbox "Given Elsewhere." You don't have to pick a location, cut and paste, type a period or anything. At least four to five times faster than AC.

I remember that thread. Not sure if you didn't have it set to email you. I have NEVER not answered someone's question. As I recall, my programmer and I were code to enable VIS for all vaccines AND have it pull the PDF automatically, but everyone that had asked went away, so we stopped.

I can appreciate that. But, I have found that most people who adopt VIPER find it MUCH easier to enter the vaccine and see the vaccine and not go into AC to enter the vaccine. While AC is much closer in my opinion to being as efficient as VIPER after v5, it still is not NEARLY as fast as VIPER. One can enter four vaccines in under 20 seconds. My MA routines enters four vaccines in under 10 to 15 seconds. I challenge anyone to do it that fast with AC. Until v6, it was more accurate and did not duplicate DTaP vaccines. We also opted to put in the actual vaccine like Comvax or Pentacel as the rules are different. The printout is better, and it is the only vaccine entry program that I have seen that documents the actual age so you don't have to calculate it.

This isn't about VIPER. In fact, Julia is referring to AC here. I think CTRL + V vs right-click and paste is completely a personal preference. AC sort of steers you toward CTRL + V, because right-clicks in a lot of fields do a lot of different things. You would not have to take your hand off the mouse if you used your left hand. You could also copy a paste a period. Or just use a "v."

[quote=Julia=Also with Viper you have to enter your vaccine inventory, incl. exp. date. But in AC, I don't have to enter inventory; and when I enter the exp. date once, it comes up the next time, so I don't have to enter it again until next box. JUSt as easy, if not easier, than using yet another software and then combine the two.[/quote]
AC enters the inventory. You have to enter the expiration date in the fields below. VIPER chooses to allow you to enter the vaccine with all of its associated data so you don't make an error. When you choose MMR, then the expiration date, company, route, amount all come with it. I would find that helpful. Actually, I do find that helpful. I find it unfair of you to say you enter the expiration date only once in AC. You only enter it once in VIPER as well. And, I am not sure if you were around for versions 3 and 4 where you had to enter ALL your data every time. Yes, AC is catching up. I, personally, would not call it easier. If someone finds it easier, then two software programs are fine.

It is version 5 on the website. Could be a better website. We only CALL it a beta. It has been a full release for years. We just don't charge.

Julia thanks for the explanation. Have you used the program? It is one thing to look at it and quite another to use it. It doesn't matter to me if anyone uses it, but I want them to have the full understanding of it.

Hi Bert,
I have tried Viper but looked everywhere and could not find that "given elsewhere" box. I will try to download it again and look for it again. Since I got frustrated with that one function, I stopped using it completely.
AC does save the exp. date and manufacturer info- until the box of vaccine changes, then I put it in once more and it pops up each time I choose that vaccine. It seems the same as Viper- I was just saying they seem the same so why need 2? I have not used older versions, though, so I don't appreciate how far AC has come; I just love it now! But I will try Viper again and see if I can figure out how it can save me time.
Thanks, JuliaPeds

If you give me five minutes, I will release the video. And, VIPER saves as well.

DoctorMel:

one good thing about this blog is that you can search for topics- and see what people have said in the past. try that with some of your questions, esp. if you need answers right away; lots of stuff in here already!

OK, here is the Given Elsewhere photo. The video is uploading.

Video showing VIPER. Then shows results in AC. Then delete in AC and see results in VIPER. They are basically the same.


http://www.box.com/shared/static/55ar8xc1iv9zo9ng24jb.zip

ok now I remember what my frustration was. question:
I just played with Viper again, and watched the video again.
I see that I can choose a pt, choose the given elsewhere box, but where do I choose or input a vaccine that is "unknown" for manufacturer, unknown for lot #? Because vaccines given elsewhere are usually just a date. Viper keeps prompting me to put this info in.

one more question: In AC, I can add more info to the area it was given in. Either next to R DELT or R THIGH I can add "upper" or "lower", or "SQ lateral" to further explain where the vaccine went. Or I can write it under comments. Needed when I give two vaccines in the same arm or leg. Where can I do this in Viper?

I really do want to use it if it is faster, I just can't seem to overcome these two problems yet

Are you sure you actually went to the right page? Did you buy VIPER somewhere else. Where does it ask you for that information.

Did you watch the video I made? I chose DTaP, I checked Given Elsewhere, I chose the date it was given and hit Save. It doesn't ask for those other things.

I have to admit, we have nowhere for comments. That could be nice. As far as detail, I guess we can't beat that either. Do you actually give vaccines in the lower leg? Or the forearm.

Part of the problem when you build software for yourself is you kind of make it how you work. Ed, always tells me that I need to consider other work flows. Probably would but at the time, we were considering selling it, but then changed our minds. I always have this crazy admissions, but I don't care much about where the shot was given or where. I don't mean that in a smart as.... way or anything. It's just that in 18 years, I have never seen where that has been helpful. I guess with a sterile abscess or call it a local reaction, going back to see it was the Hib vaccine, but to be honest, I would find that detrimental if the patient knew, because they would not look at it as an antigen thing but a great reason to never get the Hib again. I know, maybe not a good reason. But it does cover the four places we give shots.

We are also open to rapid improvement like comments.

We would have to be crazy to make people put in lot# and manufacturer. I don't see where it asks that.

right now, after chosing the pt, the drop-down box for chosing the vaccine is empty. To fill this box, or populate it with vaccines, I have to "add a vaccine", then choose one from the list, then try to save. Here is where it wants all that info. Otherwise, I cannot add the vaccine to the list to even choose from. Was this drop-down box supposed to auto-populate?

We are pediatrics, so we give alot of vaccines in the thighs. I understand you reasoning for not wanting to tell people which vaccine caused a reaction, but one time we were following it ourselves and discovered a batch of varicella giving large red, swollen reactions. 4 in a row. We returned that batch. We also find parents demand to know which vaccine it was- and look at us like we are crazy if we dont know- and then we talk them into just giving benadryl and tylenol next time. (just to ease their mind)

Yes, it should auto-populate. Anytime you see a patient, you bring up their name, click on that drop down box, select one of the vaccines you have selected for your practice. We have VFC and non-VFC.

OK, so I am not sure if you are doing this step. This is the Add/Remove vaccine box. To make it easier, Ed auto-populated the entire window with ALL of the vaccines taken directly from AC. You can use them or not. You can simply free hand them into the window on the right. If you notice on the right, I have selected Meningococcal vaccine. I have entered all the data (just as you would the FIRST time in AC). So, when Brianna gets a shipment of vaccines she changes all of the data such as Exp. date, Lot#, route, etc. The CPT code is there as well as the VFC vs non-VFC. You can enter inventory or not. If she gets 50 flu shots in, then each time she gives a flu shot, it automatically subtracts from her inventory, so she knows when to re-order. I think we have 24 vaccines total including Hep A, OPV, Rabies, etc. This file is SHARED from the server. So if VIPER is downloaded to a new computer, it has to browse to that file to have all of those vaccines.



This is the window with all of the vaccines showing that have been loaded into VIPER.



This is VIPER. On the left is the drop down box where you say there are no vaccines. That means you either did not enter them in the Add/Remove windows at the top (underscored in red) or you are doing something wrong. Not sure. Under that drop down list is the inventory. At the top right is an icon which says Set. This is how you browse to the vaccine database for other computers. So, you click on the vaccine and you click on Save. You have to choose a date of course.



Did you look at the video? It shows a lot of this.

Also, if you were interested, my MA would always be willing to talk to you. She has used it for three years.

Or, I could demo it for you by remote connection.

Practices are funny. We have never had a parent ask which shot it was. We give quite an informed consent about it before we give the shots. It is interesting that you followed that Varivax shipment.

In Viper

In add/remove vaccines window, Fluzone= code 90655 (for 6 to 35 months of age).

How do you enter/save Fluzone= code 90656 (for 3 yrs and older)?

Thanks

itom

Working on it. You can type it in, but it isn't automatic. When you use AC and you choose the Fluzone and it puts in the x56 code, do you know where that is stored?

We have 2 vaccines added under influenze 90655. One is the Fluzone for under 3yo with its own lot # and volume of 0.25 mL. Then we add another influenze 90655 for the Fluzone for above 3yo with its lot number and volume of 0.5mL. The MA just has to remember which lot # goes with which one when drawing the vaccines. I don't think having the wrong CPT for the vaccine matters since it doesn't automatically show up in your billing anyway.

Serene

Thanks Serene,

I am working on this with Ed. The database we got our vaccines from which is basically identical to ACs, didn't have that code.

Not sure if your MAs are remembering just from the non-code, but you can write in free hand (> 36 mo).

I didn't know you can just write in freehand. That's great. Thanks!

I'm not sure but I think fluzone code x56 is stored in the summary sheet section in ac.

I started using viper yesterday. It is now way much easier to enter vaccines given. One of the features I like is it gives a countdown of the remaining vaccine doses. Thanks for letting us use it.

After I give fluzone to 3 yrs and older pts and recombinx-hb vaccine- 90744, I just edit their entries in the summary sheet section of ac.

90746 - Hepatitis B vaccine, adult dosage, for intramuscular use
90744 - Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use

Hi Itom,

Thanks for the kudos. I don't see any CPT codes in the summary sheet or in the window that comes up when you click on a date. It does appear in the initial entry window.

Ed is working on insuring that all CPT codes appear with all vaccines.

I downloaded viper on my main computer today and tried to play with it. It picked up all my patients fine but as I try to add vaccines, I get the following error:

Microsoft JET Database Engine
Number: Operation must use an updateable query.

Also, when I tried to download Viper on a secondary computer, it was unable to find the database.

Appreciate any help.

=a.j. godbole md

Hard to say without looking, but first make sure you have a shared folder for the vaccines. You shouldn't necessarily have to do that on one computer, but you may as well do it now,and it may fix the problem. Make a folder on your server and call it VIPER Data. Share it out. Then click on Set -> Shared vaccination folder and browse to the folder. That will need to be done with every program on each computer.

As far as finding the database, make sure you go to Set -> Choose AC SQL Server. It will say Please Wait. It will find all SQL instances. Select the name of your server, then Test & Save.

Next make sure C:\Program Data\Medware Software Inc\ is shared. I haven't found this to be completely necessary, but it's best practices.

Let me know how it goes from here.

Okay, I did as you said Bert. New folder created, shared out. Browsed to shared folder after clicking set...>shared vaccination folder. As soon as I did that though, got the same 'Microsoft JET Database error'.

If you would like I can remote into your computer and see if I can set it up.

That would be fantastic. Let me know when would be a good time for you-- thursday or friday and I can let you in. you can pm me.

I have made many, many changes, here is a rundown.

1. Viper no longer will have the ability to add it's own vaccines, at the request of AC. It does in fact mess up ac's vaccine database.

2. Viper will now be much more secure, as you will need to enter a (Admin provided) password to use it.

3. Viper will now log the AC user instead of the Windows Users name when logging whom did what.

4. Viper will be 100% compatible with AC when complete, as AC has provided us with the information to make it compatible.

There are alot more changes but these are the most noticed.

Bert will be testing the new version this weekend. Also as AC has just relesed a version 6.3.3 I will also test the new and changed features until this weekend, and let Bert make the final ok.

Thanks
Ed

Thanks Ed. I know you have been working many hours on this.

I have found a few unforseen issues and will have to delay the weekend release.

Ok I have fixed the new issues that I found after updating everything, I just need to get together with Bert now.

Soon as he has looked at it and checked it out, I will once again, put VIPER back on http://www.medwaresoftware.com

Thanks

Ed, thank you very much for all your help in the past. I appreciate your continued work to make it the best it can be. I hope to have the updated version soon.