Extend Microsoft Vaccination Management

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05/11/2022
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This article provides information about the data model, components, and Microsoft Power Automate flows used by Microsoft Vaccination Management. Administrators, developers, and users should be mindful of the solution and possible implications of other solutions that coexist in the same environment.

Integration and extension

Microsoft Vaccination Management uses several capabilities of Microsoft Power Platform, including:

Canvas and model-driven apps
Portals built using Microsoft Power Apps
Flows built using Power Automate

It's important to have some understanding of these components:

It's also important to learn about solutions and using them in implementing healthy application lifecycle management (ALM) practices in Microsoft Power Platform. As you plan to extend the out-of-box functionality in Microsoft Vaccination Management, go to these articles to learn more:

Guidance

You can extend multiple parts of this solution. The following are a couple of components where we give more guidance to customize or tailor them.

Copying a canvas app

The canvas app within Microsoft Vaccination Management can be tailored to your needs. We recommend that you copy the canvas app before you make any changes. That way your changes won't be impacted by new versions. To copy a canvas app:

Sign in to Power Apps.
In the left navigation pane, select Apps, select Frontline worker app, and then select Edit.
Select File > Save As. Select a new location and name for the app, and then select Save.

Security roles

The security roles included in Microsoft Vaccination Management are set up for test and demo purposes. They must be reviewed and understood thoroughly before moving to a production environment or when importing sensitive data.

To learn more about Microsoft Power Platform and Dataverse security, go to:

New security roles can be created and tailored to your needs. The security roles in the solution can serve as a template that can be copied. If the new roles need to be moved to different environments, they need to be added to a new solution.

To copy the security role:

Sign in to the Power Platform admin center.
Select your environment by clicking the environment name, and then select See all under Security roles.
Select the role you want to copy.
Select More actions, and then select Copy.

Accessibility considerations

As you plan to extend Microsoft Vaccination Management for your organization, ensure that you adhere to accessibility guidelines. As provided, Microsoft Vaccination Management components adhere to accessibility guidelines. You can find more information about each component here:

Entity relationship diagram

The following entity relationship diagram illustrates the tables and their relationships in Microsoft Vaccination Management. System-generated tables, relationships and columns, such as Created By and Modified By, aren't displayed in the diagram.

Browse information about all tables in your environment

You can install the Metadata Tools app by Microsoft to browse all the tables, columns, keys, relationships, privileges in your environment. More information: Browse table definitions in your environment

Metadata Tools app for browsing tables in your environment.

Microsoft Vaccination Management Foundation tables

The tables in this section are available in the Microsoft Vaccination Management Foundation solution and provide the core functionality.

Table	Logical name	Description
Account	account	Business that represents a customer or potential customer. The company that is billed in business transactions.
Contact	contact	Person a business unit has a relationship with, such as customer, supplier, or colleague.
Appointment (Vaccination)	msemr_appointmentemr	A booking of a healthcare event among residents, practitioners, related persons, and devices for a specific date and time. A booking might result in one or more Encounters.
Medical code	msemr_codeableconcept	A Codeable concept represents a value that's supplied by providing a reference to one or more terminologies. It can also be defined by the provision of text.
Country	msemr_country	Information related to countries.
County	msemr_county	Information related to counties within a state or province.
COVID Vaccination Eligibility	msemr_covidvaccineeligibility	Tracks a resident response to COVID-related questions.
COVID Vaccination Phase	msemr_covidvaccinephase	Information related to the phases that are used to manage vaccine registration and administration.
Ethnicity	msemr_ethnicity	The ethnicity that a contact identifies.
Gender	msemr_gender	The gender that a contact identifies.
Immunization	msemr_immunization	Describes the event of a resident being administered a vaccine or a record of an immunization as reported by a resident, a clinician, or another party.
Vaccination Document	msemr_immunizationdocument	Table that stores a document that is related to a vaccination administration.
Vaccination Education	msemr_immunizationeducation	Immunization educational material presented to resident.
Vaccination Performer	msemr_immunizationperformer	Person who performed the immunization event.
Vaccination Protocol Applied	msemr_immunizationprotocolapplied	Immunization protocol followed by the provider.
Vaccination Reaction	msemr_immunizationreaction	Details of an immunization reaction that follows immunization.
Vaccination Recommendation	msemr_immunizationrecommendation	A resident's point-in-time set of recommendations (that is, forecasting) according to a published schedule with optional supporting justification.
Vaccination Site	msemr_location	Details and position information for a physical place where services are provided, and where resources and participants may be stored, found, contained, or accommodated.
Vaccine	msemr_medication	Medications.
Vaccine Knowledge	msemr_medicationknowledge	Information about a medication that is used to support knowledge.
Vaccine Knowledge Administration Guidelines	msemr_medicationknowledgeadministrationguide	Guidelines for administration of the medication.
Vaccine Batch	msemr_medicationpackagebatch	Information about a group of medications produced or packaged from one production run.
Race	msemr_race	The race that a contact identifies.
Schedule	msemr_schedule	A container for slots of time that might be available for booking appointments.
Slot	msemr_slot	A slot of time on a schedule that might be available for booking appointments.
State/Province	msemr_stateprovince	Information related to States and Province values.
User	systemizer	Person with access to the Microsoft CRM system and who owns objects in the Microsoft CRM database.

Microsoft Vaccination Management Integration tables

The tables in this section are found in the Microsoft Vaccination Management Integration solution.

Table	Logical name	Description
Vaccination Data Sharing Notification Log	msemr_iisnotificationlog	Logs the HL7 information associated with the Vaccination record.
Immunization	msemr_immunization	Describes the event of a resident being administered a vaccine or a record of an immunization as reported by a resident, a clinician, or another party.

HL7 FHIR tables

Microsoft Vaccination Management also contains tables that align with the HL7 FHIR (Release 4) standards. These standards are the same as those used in Microsoft Cloud for Healthcare.

For information about these tables, see the Microsoft Cloud for Healthcare reference documentation:

Email flows

This section describes how to configure flows and provides information about Power Automate limitations to consider and email flows.

Power Automate limitations

Power Automate has sets of limitations per day and per user. For more information about these limitations, see Limits for automated, scheduled, and instant flows.

The main limits you need to consider are:

Flow limits
- Flow steps in 24 hours = 500,000
- Assumes customers have a per flow license. More information: How is Microsoft Power Apps and Power Automate licensed?
Connector limits
- Outlook Connector: 300 requests per 60 seconds (432,000/day)
- SendGrid Connector: 1200 requests per 60 seconds (1,728,000/day)
- Custom Connector: 500 requests per 60 seconds (720,000/day)

Exchange Online, independent of connectors, has a limit of 10,000 emails per mailbox per day. This limit isn't included in the following calculations of throughput of each flow.

Flow	Trigger	Steps in each run	Email child flow	Env Var child flow	Max run per day (daily throughput)	Scale-out possibility
Email Booking Confirmation	Every record created in Appointments (Vaccination) entity	2	Yes	Yes	250000	Yes (based on last name)
Send Email (Registration)	Child flow From Email Booking Confirmation flows	5	N/A	N/A	100000	No
Email Appointment Reminder	Every 1 hour (max 5,000 records per run)	7	Yes	Yes	71000	?
Email Booking Cancellation (Resident Cancelled)	Every record update in Appointments (Vaccination) entity and marked as canceled	2	Yes	Yes	250000	Not required
Email Booking Cancellation (Provider Cancelled)	Every record update in Appointments (Vaccination) and marked as canceled pending	3	Yes	No	166000	?
Email Vaccine Dose Reminder	When a row created in Immunization Recommendation	4	Yes	Yes	125000	?
Email VIS document	When a row created in Immunizations (assume one doc per vaccine)	8	Yes	No	62000	?
Get Environment Variable	Child flow From other flows	3	N/A	N/A	166000	No
Send Invitation Email	When an Invitation record is created	5	Yes	N/A	100000	No
Send Email (Phase Opening)	Child flow From Email Booking Confirmation flows	5	N/A	N/A	100000	No
Send Email (Generic)	Child flow From Email Booking Confirmation flows	5	N/A	N/A	100000	No
Bulk Appointment Slots Creator	When a new site Schedule is created	32 + days x intervals x slots per interval x 20	No	No	Depends on steps, which depend on number of slots need to be created in each run	?
Process Automatic Phase Opening	When the following are true: Automate option on a Phase is set to Yes Booking on a Phase is set to Yes There are any Automate Remaining recommendations set	5	No	No	Depends on the number of different Phases running an automation process at the same time	?
Process Phase Opening	When a Phase Opening Booking is set to Yes and there are any recommendations to be sent	14 (with phase re-evaluation enabled) 13 (without phase re-evaluation enabled)	Yes (when phase re-evaluation enabled)	Yes	Depends on number of records the phase is opened for. Max 35,000 records per day with phase re-evaluation enabled. Max 38,000 records per day without phase re-evaluation enabled	?

New environment configurations

Configure environment variable: RegistrationPortalUrl (the base URL to the Portal).
Example: contoso.powerappsportals.com
Don’t include https or other parameters.
Configure connections.
1. Open configuration solution and add or edit Office 365 Outlook connection and set the connection. Create a new one if needed.
2. Open configuration solution and add or edit Flows CDS Connection #1 connection and set the connection. Create a new one if needed.
3. Open configuration solution and add or edit Flows CDS Connection #2 connection and set the connection. Create a new one if needed.
Turn on flows.
1. Open Vaccination Management Flows solution.
2. Turn on these flows one at a time:
  - Get Environment Variable
  - Send Email - all copies
  - Send Email with Attachment (Base)
3. Filter the list to only show Cloud Flow.
4. Select all and choose Turn on from the top menus.
At this point, you should have all flows turned on without any error. You can check the flows status in the Status column.
Update email templates.

Scale Send Email flow

All flows send email using a child flow called Send Email (Base). There are three copies of this flow in the solution:

Send Email (Registration) for registration confirmation emails.
Send Email (Phase Opening) for phase opening and 1st dose reminder.
Send Email (Generic) is shared with all other flows needed to send emails.

Out of box, these base flows use Outlook connections to send email, with a 10,000 email per day limit per mailbox. You can use other email providers to increase the capacity.

Scaling Up

Each Send Email flow has five steps, which means it can run up to 100,000 times per day (500,000/5). Maximum emails per day: 100,000.

Scaling Out

You can create more copies of the Send Email flows to scale out.

Third-party connector

Another option to scale Send Email flows is to use a third-party connector with higher daily limits in this flow, for example, SendGrid on the Azure Marketplace.

You might still need to scale out, depending on how many steps the Send Email flow has.

Scale Registration flows

Registration uses a scheduled flow to query recently added records to send the confirmation email. By default, there are two flows working in parallel, each handling a range of last names:

Email Registration Confirmation (Lastname: A-M) only processes records with last names starting from A-M.
Email Registration Confirmation (Lastname: N-Z) only processes records with last names starting from N-Z.

Each flow has a loop with four steps to process each record, which means it can run up to 125,000 (500,000/4) records per day. By default, these flows run every three minutes.

Scaling Out

To increase capacity, you can create more copies of Email Registration Confirmation, so each handle smaller section of last names.

If you use this option, you'll also need to update the FilterConditions variable in the flows.

Note

Email Registration Confirmation flows internally call child flow Send Email (Registration) to send email. If you add more copies, you might need to also scale Send Email (Generic).

Scale other flows

You can use other flows to send email or handle other processes in the solution. Each of these flows also needs to scale to prevent reaching the 500,000 steps per day limit. Because all email-sending flows internally call the child flow Send Email to send email, scaling Send Email becomes more critical to handle higher demands.

The other child flow Get Environment Variable can also become a bottleneck, because many other flows use it.

Email sending flows

Email Booking Confirmation

Name	Value
Trigger	Every record created in Appointments (Vaccination) entity
Steps in each run	2
Max run per day	250,000
Email child flow	Yes (Send Email Generic)
Env Var child flow	Yes

Email Appointment Reminder

Name	Value
Trigger	Every 1 hour (max 5,000 records per run)
Steps in each run	7
Max run per day	71,000
Email child flow	Yes (Send Email Generic)
Env Var child flow	Yes

Email Booking Cancellation (Resident Cancelled)

Name	Value
Trigger	Every record update in Appointments (Vaccination) entity and marked as canceled
Steps in each run	2
Max run per day	250,000
Email child flow	Yes (Send Email Generic)
Env Var child flow	Yes

Email Booking Cancellation (Provider Cancelled)

Name	Value
Trigger	Every record update in Appointments (Vaccination) and marked as canceled pending
Steps in each run	3
Max run per day	166,000
Email child flow	Yes (Send Email Generic)
Env Var child flow	No

Email Vaccine 1st Dose Reminder

Name	Value
Trigger	When a row created in Immunization Recommendation
Steps in each run	4
Max run per day	125,000
Email child flow	Yes (Send Email Phase Opening)
Env Var child flow	Yes

Email Vaccine 2st Dose Reminder

Name	Value
Trigger	When a row created in Immunization Recommendation
Steps in each run	5
Max run per day	100,000
Email child flow	Yes (Send Email Generic)
Env Var child flow	Yes

Email VIS Document

Name	Value
Trigger	When a row created in Immunizations
Steps in each run	8 (assume one doc per vaccine)
Max run per day	62,000
Email child flow	Yes (Send Email with attachment)
Env Var child flow	No

Resend Email Appointment Reminder

Name	Value
Trigger	Every record update in Appointments (Vaccination) and Resend field is enabled
Steps in each run	4
Max run per day	125,000
Email child flow	Yes (Send Email Generic)
Env Var child flow	Yes

Email Unsubscribe from Notifications

Name	Value
Trigger	Every record update in Contacts when the Email Opt In field is set to no
Steps in each run	2
Max run per day	250,000
Email child flow	Yes (Send Email Generic)
Env Var child flow	Yes

Process Phase Opening

Name	Value
Trigger	When a Phase is set to Booking Open yes and there are recommendations to send
Steps in each run	14 with phase re-evaluation enabled 13 without phase re-evaluation enabled
Max run per day	Max 35,000 records per day with phase re-evaluation enabled. Max 38,000 records per day without phase re-evaluation enabled
Email child flow	Yes (when phase re-evaluation enabled)
Env Var child flow	Yes

Send Invitation Email

Name	Value
Trigger	When an Invitation record is created
Steps in each run	5
Max run per day	100000
Email child flow	Yes
Env Var child flow	No

Email Vaccination Recovery Process

Name	Value
Trigger	When an Invitation record is created
Steps in each run	7 If Registration Phase 10 If Schedule Phase 11 If Reminder Phase
Max run per day	71,000 If Registration Phase 50,000 If Schedule Phase 36,000 If Reminder Phase
Email child flow	Yes
Env Var child flow	No

Child flows

Get Environment Variable

Name	Value
Trigger	From other Flows
Steps in each run	3
Max run per day	166,000

Send Email (Registration)

Name	Value
Trigger	From Email Booking Confirmation flows
Steps in each run	5
Max run per day	100,000

Send Email (Phase Opening)

Name	Value
Trigger	From Process Phase Opening flow
Steps in each run	5
Max run per day	100,000

Send Email (Generic)

Name	Value
Trigger	From flows other than booking confirmation and phase opening
Steps in each run	5
Max run per day	100,000

Send Email (Registration) is used for registration confirmation emails.

Send Email With Attachment (Base)

Name	Value
Trigger	Every record update in Appointments (Vaccination) and Resend field is enabled
Steps in each run	5
Max run per day	100,000

Processor flows

Bulk Appointment Slots Creator

Name	Value
Trigger	When a new site Schedule is created
Steps in each run	32 + days x intervals x slots per interval x 20
Max run per day	Depends on steps, which depend on number of slots need to be created in each run
Email child flow	No
Env Var child flow	No

Process Automatic Phase Opening

Name	Value
Trigger	When a Phase Opening Booking is set to Yes, Automate is set to Yes and there are Automate remaining recommendations to send
Steps in each run	5
Max run per day	100,000
Email child flow	No
Env Var child flow	No

Process Unattested Registrations

Name	Value
Trigger	Every 2 hours
Steps in each run	6
Max run per day	83,000
Email child flow	No
Env Var child flow	No

Process No-Show Appointments

Name	Value
Trigger	Every 1 hour
Steps in each run	3
Max run per day	166,000
Email child flow	No
Env Var child flow	No

Process Tentative Slots

Name	Value
Trigger	Every 1 hour
Steps in each run	5
Max run per day	100,000
Email child flow	No
Env Var child flow	No

Process Null Appointments

Name	Value
Trigger	Every 1 hour
Steps in each run	3
Max run per day	166,000
Email child flow	No
Env Var child flow	No

Microsoft Vaccination Management flows

The cloud flows in this section are available in the Vaccination Management Flows solution.

Cloud flow name	Description
Bulk Appointment Activity Status Cleaner	Manual execution of updating appointments (vaccinations) with an activity status. Max execution of 5000 records per execution. Rerun until list records returned is 0.
Bulk Appointment Slot Cleaner	Fills the Vaccine, Day, Month, Year, and Dose fields of lost records that don't have data. Depending on the slots records, this flow should be run multiple times (up to 5000 updates per run).
Bulk Appointment Slots Creator	Generate appointment slots when a new schedule is created.
Email Appointment Reminder	Send an email about 36 hours to 12 hours before the appointment to remind the resident about their upcoming appointment. This will process up to 10,000 records in each run.
Email Booking Cancellation (Provider Cancelled)	Sends an email notifying a resident when their appointment is canceled by the provider.
Email Booking Cancellation (Resident Cancelled)	Sends an email notifying a resident when their appointment is canceled.
Email Booking Confirmation	Notify the resident that their appointment is booked successfully. Provides the appointment details, QR code, location address, and date and time of the appointment.
Email Registration Confirmation (Lastname: A-M)	Notify residents with last names that start from A-M that their registration is successfully submitted. Also notify if they're eligible for the current phase or not.
Email Registration Confirmation (Lastname: N-Z)	Notify residents with last names that start from N-Z that their registration is successfully submitted. Also notify if they're eligible for the current phase or not.
Email Unsubscribe From Notifications	Sends an email of unsubscription to the user with the URL to resubscribe.
Email Vaccine 1st Dose Reminder	Every time a new immunization recommendation is created, this flow will send a reminder email to resident with the appointment portal URL.
Email Vaccine 2nd Dose Reminder	Every time a new immunization recommendation is created with dose number equal to 2, this flow will send a reminder email to the resident with the appointment portal URL.
Email VIS Document	Send an email to resident after they've received the vaccine with VIS docs.
Process Automatic Phase Opening	Processes the automation part of the phase opening. It will use the functionality of the Process Phase Opening flow to trigger the evaluation of eligibility.
Process Clean Custom Email Generator Entity	Deletes the email generator records created by the actions for email templates.
Process no-show appointments	Runs periodically and marks any appointment that is marked as booked and past due for more than 8 hours to no-show.
Process Null Appointments	Runs everyday to delete all appointments with null status.
Process Phase Opening	When a phase is updated or opened, a set of residents (specified in the phase record) will be sent invitations to set up an appointment or re-register to reassess eligibility.
Process Tentative Slots	Runs periodically and marks any Slot that is in Busy Tentative state to free if it hasn't been updated in the last one hour.
Process unattested registrations	A recurring flow that removes eligibility records that are unattested. Also removes the associated contacts if they have no attested eligibility.
Re-Send Email Appointment Reminder	When an appointment is updated with Resend set to true, resends an appointment reminder to the resident on the appointment.
Send Email (Generic)	Flow to send emails not otherwise categorized by other send email flows. This is intended for flows that won't have much traffic.
Send Email (Phase Opening)	Flow to send emails to residents to either set up an appointment or resubmit eligibility when a phase is opened or updated.
Send Email (Registration)	Flow to send registration email confirmation for the resident.
Send Email With Attachment (Base)	Flow to send an email including an attachment.
Vaccination - Clear Web Form Session Cookies Hourly	Hourly recurring flow that will delete web form session cookies older than a specified time.
Vaccination - Clear Web Form Sessions Hourly	Hourly recurring flow that deletes Web Form Sessions that haven't been modified for a specified time period.
Vaccination - Clear Web Session Challenge	Hourly recurring flow that deletes Web Session Challenges that haven't been modified for a specified time period.

Microsoft Vaccination Management actions for email templates

These actions are available in the Vaccination Management Email Actions solution.

Process name (Action)	Description
ComposeHeaderAndFooter	Composes the email header and footer that will be replicated in all the compose email actions.
ComposeAppointmentConfirmation(FirstDose)	Composes the email body for the confirmation of the first dose of a resident.
ComposeAppointmentConfirmation(SecondDose)	Composes the email body for the confirmation of the second dose of a resident.
ComposeAppointmentCancellationEmail(FirstDose)	Composes the email body for the cancellation when the patient cancels their first dose.
ComposeAppointmentCancellationEmail(SecondDose)	Composes the email body for the cancellation when the patient cancels their second dose.
ComposeProviderCancellationEmail	Composes the email body for the cancellation when the provider cancels an appointment in the Vaccination management app.
ComposeVaccineAppointmentReminderEmail	Composes the email body for the cancellation when the option to send the reminder is set in the Vaccine management app.
ComposeEligibilityConfirmationEmail	Composes the email body for the eligibility when the patient isn't going to get a shot immediately and is put in another phase different than phase 1.
ComposeEligibilityReCheckEmail	Composes the email body for the phase opening process so patients can recheck their eligibility.
ComposeUnsubscribeEmail	Composes the email body to unsubscribe from emails.
ComposeFollowUpVISAndLinkEmail	Composes the email body for the email that should be sent with the VIS document attached; this is for the first dose of a vaccine with two doses. This email should include the option to reschedule for the second dose.
ComposeFollowUpVISOnlyEmail	Composes the email body for the email that should be sent with the VIS document attached; this is for the first dose of a vaccine with two doses.
ComposeFollowUpSingleDoseEmail	Composes the email body for the email that should be sent with the VIS document attached; this is for the vaccines that are single dose only.
ComposeFollowUpSecondDoseEmail	Composes the email body for the email that should be sent with the VIS document attached; this is for the second and final does of a vaccine with two doses.
ComposeScheduleAppointmentEmail(FirstDose)	Composes the email body for the patients to schedule their first dose if eligible.
ComposeScheduleAppointmentEmail(SecondDose)	Composes the email body for the patients to schedule their second dose.

For information about how to configure email templates used in these actions, go to Configure actions for email templates.

Microsoft Vaccination Management workflows

The workflows in this section are found in the Vaccination Management Workflows solution.

Process name (Workflow)	Description
Vaccination - Vaccine Phase set Pending to Send	Resets To Send after copying that value to Pending to Send
Vaccination - Set Performer Full Name	Concatenates the performer’s first name and last name on Vaccination performer.
Vaccination - Set Eligibility Contact 1 to 1	Populates the Vaccination Eligibility onto the Contact form to create a 1 to 1 relationship.
Vaccination - Set Contacts Eligibility 1 to 1	Populates the Contact onto the Vaccination Eligibility form to create a 1 to 1 relationship.
Vaccination - Set Appointment Fulfilled on Vaccinated	Updates the appointment status to Fulfilled when the patient is vaccinated.
Vaccination - Recommendation copy session cookie value	Copies the Web Form Session Cookie Value Insert into the Web Form Session Cookie Value and then clears the value in Web Form Session Cookie Value Insert.
Vaccination - Generate recommendation from phase	Creates a first or second dose recommendation depending on the inputs from the eligibility record.
Vaccination - Email Update From Contact	Copies the patient associated with the Eligibility into the Email Update field.
Vaccination - Eligibility Phase Determination	Used to determine which Phase group a patient is eligible to be in by evaluating the eligibility form submitted.
Vaccination - Eligibility Email Update	Copy the email provided in the eligibility into the Contact’s primary email field.
Vaccination - Create 2nd Dose Immunization Recommendation	Generates a second Immunization Recommendation when the first appointment is fulfilled (if applicable for the scheduled vaccine).
Vaccination - Complete Vaccination Information	Ensures that the fields on the Vaccination record are populated with the vaccine information. If not specified, determines the vaccination education to be associated with the vaccine and updates the appointment with an actual end date and time and associates the vaccination record.
Vaccination - Cancel Appointment	An on-demand workflow that updates the appointment status to Cancelled.
Vaccination - Appointment cancellation	If an appointment is canceled, free up the slot and recommendation by removing the association with the appointment.
Vaccination - Appointment (EMR) Booked with Primary Slot	Updates the appointment information with the information in the selected slot, and then updates the status of the slots to busy.