Correcting Vaccine Entries in patients records arriving via GP2GP (DEGRADE entries)

Correcting Vaccine Entries in patients records arriving via GP2GP (DEGRADE entries)

When patient records are transferred to your practice via GP2GP from a practice that uses a different clinical system, the data will often arrive in EMIS as a "Degraded" data item.  This means that a code cannot be appropriately matched to a corresponding SNOMED code and therefore will not be picked up by searches or concepts.  One of the most significant impacts we see is where patients, even if vaccinated, will not count towards your QOF performance.

It is important to ensure that you have a practice process for reviewing newly registered patients to:
  1. check for an correct degrade entries
  2. identify where they are up to with their vaccinations and ensure they receive appropriate invites quickly if the time for their vaccination is due or approaching

How to identify existing "degraded" entries

In each of these patients,  go to the patient care record and view the consultations around the time you would have expected them to have had vaccinations.  If there is a data migration issue with degraded entries you will see vaccinations entered as below:


You can confirm that these are degraded entries by going to the corresponding date in Care History (shown by the red square) tab:


Note the red [DEGRADE] alerts next to the data, which confirm that these are degraded codes transferred via GP to GP.

How to correct "degraded" entries

To correct these, edit the consultation where the entries were entered.  Do this by finding the consultation in "Consultations" and selecting the blue bar at the top by clicking on it.  Then right hand mouse click and select "Edit Consultation" :


Open the OneTemplate Non-Prescriber template and use this to replicate the data that already exists in a degraded form. Ensure that all attributes are replicated to maintain information integrity (eg: batch number, expiry date, site). Once you have done this the original (degraded) data can be deleted.  This will have solved the degrade issues and the patient's vaccination history in Care History should be complete, as well as showing correctly in searches and protocols. 
When replacing codes be sure to set the GMS flag to "No"