On August 12th, an issue was reported regarding the MCIR/SIRS grade promotion algorithm. This issue has been resolved. School and childcare centers can now resume all MCIR/SIRS activities related to rosters, grade advancement, and letters to parents.

To correct the grade promotion error, digital non-medical waivers issued on August 12, 2024, were overwritten.

MCIR has identified a subset of missing waivers including those added or edited on August 12, 2024. All missing waivers have been identified and restored to MCIR, as of August 14, 2024. MCIR IDs that have been reported to date are confirmed to be part of this restoration process. LHDs are asked to please check MCIR before reporting any missing waivers.

Secondly, as of August 14, 2024, the issue with LHD signatures within the digital non-medical waiver has been resolved.

LHDs can now resume activities related to the digital, non-medical waiver process.

Finally, we are researching a resolution for a remaining digital non-medical waiver issue involving the Overall Assessment of a child’s MCIR and SIRS record. Children who received digital non-medical waivers and subsequently received immunizations are not assessing as Complete.
If the LHD identifies any additional issues regarding digital non-medical waivers after the restoration process, please email the MCIR Help Desk at MDHHS-MCIRHelp@michigan.gov.

In recognition of recent inquiries regarding HL7 messaging and vaccine inventory management MCIR would like to provide updated information.  Our analysis of these inquiries reflects the area of highest impact surrounds the borrowed dose process and expiration date validation.  Please know we working to resolve these issues as quickly as possible and apologize for any inconvenience this may be causing.

Resolution will be communicated to you via the MCIR Release notes.

We are providing contact information below to our ETA teams who can provide direction and answer questions pertaining to inventory management until a resolution is released.

Please review the map (located at the end of this message) and contact information below.  When reaching out via email we would ask you to include “Inventory” in the subject line of your email.

Northwest Region
MDHHS-MCIR-NorthWest@michigan.gov

East Central Region
MDHHS-MCIR-EastCentral@michigan.gov

South Region
MDHHS-MCIR-South@michigan.gov

For the doses that were administered and were not deducted from your inventory, you can do a manual transaction to deduct them by following these steps:

1. From the “Manage Inventory” screen, click on the appropriate lot that needs a dose count correction.
2. Click “Add New Transaction”
3. Enter the correct date in the date field.
4. Enter the number of doses that need to be deducted.
5. From the “Action” drop down options, choose “Adjustment”.
6. From the “Reason” drop down options, choose “Inv On Hand/Data Correction”
7. For “Inventory Effect” select Subtract
8. For “LWB Effect” select N/A
9. In the comment field, enter the reason you are manually deducting the doses, for example: “Doses were not deducted from inventory due to incorrect expiration date.”
10. Click submit.

For doses that were supposed to be deducted as a borrowed dose but were not deducted from inventory, you can do a manual transaction to create the borrowed dose and deduct them from your inventory using following these steps:

Form the Manage Inventory Screen:

• Click on the name of the lot you need to deduct the borrowed dose from to open it.
• At the top of the Transaction Log, click “Add New Transaction”
• Enter the date
• Enter the number of borrowed doses.
• From the “Action” drop down menu choose “Adjustment”
• From the “Reason” drop down menu choose “Inv On Hand/Data Correction”
• For “Inventory Effect” select “Subtract”
• For “LWB Effect” select “Add”
• Enter a note explaining the borrowed dose in the comment field.
• Click Submit

Important Update: New Warning for RX6 Segment in HL7 Messaging

HL7 Messages are used to transmit vaccine information from immunization providers to MCIR.  Some of the vaccine details are expressed in a segment prefixed with RXA.  Included in that segment are the Dose Volume (a number) and Unit (cc or ml). Those values are contained in RXA-6 (volume), and RXA-7 (unit)

Starting July 31, 2024, MCIR will indicate a warning in the acknowledgment message returned when the RX6 segment is missing or incomplete. This initiative aligns with best practices for HL7 messaging to ensure the accuracy and completeness of patient information. The warning will display as:

“Warning: MCIR highly recommends providing a dose volume and a dose unit of cc or ml”

Example of a Complete RX6 Segment: RXA|0|1|20140221||115^Tdap^CVX^58160-0842-52^Boostrix (Tdap)^NDC|0.5|ml^milliliters^UCUM||00^Administered^NIP001||||||K7164HI||SKB^GlaxoSmithKline^MVX||||A

If you have any questions or need further assistance, please contact us at MDHHS-HL7@michigan.gov

The MCIR System release dated June 26, 2024, introduced an update to the criteria applied to inventory matching.  Please refer to this information or contact MDHHS MCIR Help Desk with any questions.

HL7 – Lot Expiration Date:  Matching Criteria

To ensure precise handling of vaccine inventory information, MCIR is including the lot expiration date when executing a reduction in inventory, this includes private inventory.

In confirming the effectiveness of this process MCIR performed data analysis and reviewed the following:

A limited number of messages received contain lot expiration dates that do not match other inventory criteria, such as:

• Lot Number
• Eligibility Inventory Category
• CVX
• Inventory Type

This mismatch prohibits the automatic reduction in the vaccine inventory.

Inventory Transfer Error – How to address:

1. Updating your EMR:

Correcting the information within the EMR will ensure proper inventory reduction and eliminate transfer errors for mismatched or missing lot expiration dates.

While these messages will update the MCIR record correctly, the transfer report will reflect an error when attempting to update the inventory.  This is due to an incorrect/missing lot expiration date extracted from the HL7 message.

• Confirming the lot expiration date is valid
• Confirming the HL7 message contains your lot expiration date

2. Manually updating Inventory in MCIR:

Impacted MCIR inventory: Error message received in MCIR “Lot not found in inventory”.

To resolve this error, perform the following steps:

Under Manage Inventory:

1. From the “Manage Inventory” screen, click on the appropriate lot that needs a dose count correction.
2. Click “Add New Transaction”
3. Enter the correct date in the date field
4. Enter the number of doses that need to be deducted
5. From the “Action” drop-down options, choose “Adjustment”
6. From the “Reason” drop-down options, choose “Inv On Hand/Data Correction”
7. For “Inventory Effect” select Subtract
8. For “LWB Effect” select N/A
9. In the comment field, enter the reason you are manually deducting the doses, for example: “Doses were not deducted from inventory due to incorrect expiration date”
10. Click submit

Data transfer/HL7 questions should be directed to MDHHS-HL7@michigan.gov. Contact the MCIR Help Desk for assistance with the form at MDHHS-MCIRHelp@michigan.gov or 888-243-6652.

After dose of Hep B, HBIG can be added to the record.  For more information MCIR System Release PDF. 

DTaP and Tdap updates, removal of PCV13 from status forecasting for routine assessments for all.  For more information MCIR System Release PDF

HepB doses not evaluating, HPV not showing in status screen.  For more information MCIR System Release PDF

Forecast and evaluate CVX 316 MenABCWY (Penbraya)  For more information MCIR System Release PDF

We have been notified that the Michigan Care Improvement Registry (MCIR) is not accurately forecasting, displaying, or assessing Hepatitis B and HPV9 vaccine histories. These issues are currently being worked on with the highest priority. We apologize for any inconvenience this may cause in your efforts to keep your patients up to date.

Please refer to the Child and Adolescent Immunization Schedule by Age and the Adult Immunization Schedule by Age for any questions or concerns you may have when reviewing your patient’s immunization records for vaccine recommendations and intervals.

After dose 1 of PCV/PPSV23 (trigger assessment), forecast dose 2 of pneumococcal vaccination.   For more information see MCIR Release Notes PDF