by Dmitry Kachaev
Flu season is now upon us, and since it takes two weeks for the body to develop immunity following administration of the vaccine, it was time for me to get my shot.
At Amida, we are working to make personal health data easy to access and use, so I decided to make a fun experiment out of the immunization process: first I would get my flu shot, and next I’d attempt to get a digital health record of that encounter.
As I was commuting home from work, I took a detour and stopped at a local CVS Minute Clinic. There was a 90+ minute wait, and some of the flu vaccines were out of stock, so I went home to do some Googling before the next attempt.
Getting (a) shot
Ultimately, I chose to go back to the CVS Minute Clinic. I was lucky on my second attempt and didn’t have to wait at all. I registered at the electronic kiosk and entered all my information, picked ‘flu immunization’ as the reason for my visit, and then clicked through the checklist for contraindications. So far, so good.
Getting the flu shot took less than 5 minutes. There were several options to choose from, including trivalent and quadrivalent vaccines. I picked the latter, but was advised that it might not be reimbursed (I found out why later).
Getting my health record
After I received the flu shot, I asked the pharmacist if I could get my immunization record. I received a paper copy of my Clinical Visit Summary as well as a printout of the Charges/Claims.
Surprisingly (or maybe not so surprisingly), there was no way to get my records electronically, neither by email nor any other digital means. I asked if my record would be transmitted to the State Immunization Registry, and if not, where I could opt-in to do so. Unfortunately, MinuteClinic doesn’t report to the registry, so I was out of luck.
Recently, I heard that CVS MinuteClinic is partnering with the MedStar hospital system and can now electronically transfer records there. It is indeed theoretically possible, but can only be done by directly messaging the primary care provider (PCP). Since I don’t have a PCP, I wasn’t able to complete the transfer.
Going digital
Because I failed to get a digital immunization record for my flu shot from CVS, I decided to DIY and see how hard it would be. After about 2 hours of somewhat boring and time-intensive coding, I created a CCDA that could be absorbed into my personal health record.
Conclusion
Well, that was a lot of work for a simple result. It’s pretty clear that digital health records (and patient portals) are not quite ready for the mass market. But there’s hope. Last February the White House reported that CVS took the Blue Button pledge to provide “…its customers with the ability to securely access and download their medication lists and prescription history…”. So maybe they’ll consider doing this with immunizations too.
My next step will be to find a PCP and try to do the same with my next physical. The quest continues, so look for a future post exploring this area.
P.S. Want to know why some health insurance plans don’t pay for the quadrivalent vaccine? Here are my procedure codes from the claim/charges printout:
I Googled the procedure codes (CPT codes) and apparently 90688 is one of the new codes for the flu vaccine that some health plans don’t recognize, so they will decline claims for it : (
Mystery solved!
