Archived NEws

2020

Newsletter November, 2020
COVID-19 Update

In the past few weeks we have started seeing more patients coming in with respiratory symptoms such as cough and runny nose, with or without fever. All of these “sick patient” visits were seen on the second floor through our back entrance, in keeping with our policy to keep our first floor safe for well patients. Most of these patients were tested negative for COVID-19. A history of exposure to COVID-19 is more predictive of a positive test in patients than those without an exposure history. Because of an increase in the number of positive cases across the state of Massachusetts, we are seeing a delay in the time for test results, now averaging 5-7 days.

For those who are interested in getting tested elsewhere, the link below is the Massachusetts COVID-19 test site locator:
https://memamaps.maps.arcgis.com/apps/webappviewer/index.html?id=eba3f0395451430b9f631cb095febf13

By following the established guidelines and protocol of wearing masks, protective gowns and gloves, and hand-washing or disinfecting prior to examining a patient, we have so far been able to stay healthy to serve our patients. We can also see patients remotely via Zoom for patients who have access to MyChart, the patient portal. We strongly encourage our patients and parents to sign up for access to MyChart.

Because of the state mandate this year for flu vaccine for all students before December 31, we have seen an increase in the number of patients getting the flu vaccine. We encourage patients to call our office to schedule for the flu vaccine before we run out of the vaccine.

Even though there has been an increase in sick patients in the last 2 months compared to the summer, the number of sick patients is still less than the numbers in prior years. We have seen very few sick patients on Sundays. Therefore, we have decided that for this winter our office will be closed on holidays such as Thanksgiving, Christmas and New Year. A doctor will continue to be available on call for telephone advice on those days.

The Coronavirus vaccines by Pfizer and Moderna both showed very good protective effect against the virus, according to news reports. It is likely that at least one of them will be approved by FDA before the end of the year. Pfizer is also recruiting adolescents 12 years and older for a similar clinical trial of the vaccine to establish safety and efficacy in this age group. Many hospitals across the nation are helping in the recruitment of subjects, among them are Boston Medical Center and U. Mass Memorial Medical Center in Worcester.

Some people already are questioning whether the vaccine is safe or necessary. Regarding the question on safety, the FDA will need to review the data and will give approval only if there have not been significant safety concerns. For those who already had the infection, they are unlikely to catch it again, so the vaccine may not be necessary for them. Those who are at high risk for catching the disease or at high risk for having a severe disease will be getting the vaccine first. Thus, the first-line responders and the elderlies will probably be the ones getting the vaccine first. Until one gets the vaccine, the recommended safety measures, such as wearing mask, washing hands, and keeping physically distant, remain the best protection one can do for himself/herself and for those nearby.

Have a safe Thanksgiving.

Sincerely,
Pediatric Associates of Malden


Newsletter September, 2020

By now most schools have resumed classes.  Some schools offer only remote learning due to city ordinance, while other schools offer a choice of remote, on-site, or a hybrid of the two learning modes. Parents have to decide which mode of learning is best for their children, trying to balance safety concerns because of SARS-COV2 with advantages of learning and socialization in a school setting.   As mentioned in our last newsletter, the best scenario that we can hope for is that everyone follows the guidelines of wearing mask at all times in public, keeping physically distant, and washing/disinfecting hands often. Then we may expect to see very few sick patients from SARS-COV2 and other respiratory illnesses.  

In the month of August and first half of September, we have seen a “near normal” number of well visits, while the number of sick visits remained low. Because of the reduced sick visits, we have decided to cut back on the evening hours.  Starting the week of 9/14, the office will close at 7 PM, Monday through Friday.  Saturday hours are 9 AM-1PM.  Sunday hours are 9AM-1PM for sick visits by appointment only. We may close early (e.g. 11 AM or12 PM) on Sundays if there are no calls by then for sick visits. Therefore, we encourage parents/patients to call early and schedule for an appointment if a child has a fever, rather than waiting till 12PM and call for an appointment at that time.   

As many of our patients already know, we have decided to keep our front door locked so that any visitor is first screened negative by phone for any history of contact with COVID19 and any symptoms of COVID19, before the visitor is allowed entry. A door bell with camera has been installed at the entrance. Any patient who has a positive screen and needs to be seen will be led by a staff member to come in by the back entrance to the second floor, which our landlord has allowed us to use for sick visits.   

Our first shipment of flu vaccine has arrived.  We are vaccinating all children 6 months and older against influenza. We encourage patients to call and schedule an appointment for the flu vaccine. Because of our locked-door policy, patients who come for the flu clinic will need to wait in the parking lot until our nursing staff let them in.   

For patients who come without a car, whether for a sick visit, a well visit, or flu clinic, please inform our staff and we will make sure that they are not left outdoors for long. 

We continue to encourage patients and parents to sign up for access to MyChart, the patient portal to our electronic medical record system.  Parents of children between 13-17 years can have a limited access to the record based on our adolescent confidentiality policy. However, having access to MyChart also means you can communicate with us by email, including sending photos of any skin conditions of concern, and setting up virtual visits via Zoom application. We can also send notifications to you, such as this newsletter. Therefore, please inform your friends who are also patients of this practice and who have not yet signed up for MyChart. Simply call us at (781) 322-5101 and provide us with your email address, and we will send instructions and an activation code to you.

Sincerely,
Pediatric Associates of Malden


Newsletter August, 2020

In another few weeks, the school is going to start. How school will open appears to be variable for each city or town. For children who will attend school on-site, the only way to lower the risk of catching SARS-COV2 is by wearing mask, washing/disinfecting hands regularly, and staying physically apart by at least 6 feet, especially at lunch time.

As we enter the Autumn season, some people who have allergy to ragweed will start sneezing or coughing, and those who have asthma may develop wheezing and have trouble breathing. Wearing a mask and staying indoors will help to reduce the exposure to the pollen allergens.  In the Spring season, when people were quarantined at home due to SARS-COV2 pandemic, we had actually seen very few patients with allergic complaints. The best scenario would be that we will also see very few patients with respiratory complaints this Autumn and Winter because everyone will be wearing masks. The worst scenario would be that one or more students get sick with a respiratory infection and then spread it to other students.

While we hope for the best, we will need to prepare for the worst. The SARS-COV2 pandemic is still here.  Patients who have asthma are at higher risk for severe disease with any respiratory infection. It should be noted that because SARS-COV2 can be transmitted by aerosol, we have been advised by infectious disease experts to not use nebulizers in our office, as the nebulizer blows aerosol into the air and may spread the virus further than the usual 6 feet. We have bought albuterol inhalers and a number of spacers to be used for patients who come in with wheezing and need to be treated for asthma exacerbation. However, we highly recommend that every patient who has asthma and has an inhaler and spacer should bring them in to be used in the office for asthma exacerbation. We will also have our front desk receptionist to provide that reminder when a patient calls to schedule for such an appointment.
 
As in the past, we recommend influenza vaccine for all children aged 6 months and older before the flu season begins. Only about 68% of our patients heeded our advice in previous years. We anticipate that number will increase this year, as the Department of Public Health of Massachusetts just announced a policy for all students to be vaccinated before December 31, 2020. When the first shipment of the flu vaccine arrives sometime in September, we will offer the vaccine at Well child visits. The Flu Clinic will start in October. We welcome calls or email requests via MyChart now for an appointment with the flu clinic.

Starting September, we will resume our previous schedule that includes Sunday 9am-1pm for sick visits. Labor Day will still be closed.

As mentioned in our previous newsletter, we send nasopharyngeal or oropharyngeal swabs to Quest Lab for testing of SARS-COV2.   The test result can take 2 to 9 days. Because of the limited number of swabs we have on hand, we do not do screening tests on patients who have no symptoms. The web site below is the COVID19 test site locator if you wish to get tested elsewhere:
https://memamaps.maps.arcgis.com/apps/webappviewer/index.html?id=eba3f0395451430b9f631cb09 5febf13

Sincerely,
Pediatric Associates of Malden


Newsletter  July 31, 2020

Over the past month, the state of Massachusetts has seen a reduced number of people testing positive for COVID19 and has started to allow reopening of businesses.  Our office, which has remained open through the past few months, albeit at reduced hours, has also started to see some increase in well and sick patient visits. We have decided that starting August 1st, our office will resume our usual office hours of 9 AM-8 PM for Monday-Friday, and 9 AM-1 PM on Saturday. However, Sundays will remain closed for August, because we anticipate that there will still not be many sick patients for that month. We encourage our patients to not postpone any well visits that include vaccinations that are due.

The sick visits so far have mostly been attributable to insect bites, joint sprains, cuts and bruises related to increased outdoor activities.  There have been a few patients who did test positive for COVID19.  These patients most likely got the infection by contact with a close adult relative who had the infection.  Our office does process the nasopharyngeal or oropharyngeal swabs and send to the Quest Laboratory to do the test for COVID19. Because of a nation-wide increase in testing, the Quest Laboratory’s capacity to do the test has been strained, and the waiting period for test results has increased from 2-4 days in the past to 9-10 days recently. As we have only a limited supply of testing kits for SARS-COV2, we do not do tests on patients who are asymptomatic. The state has several sites in Chelsea, Everett, and Revere which provide free testing. The protocol below has been established in our office since March in order to ensure that our office is safe for our patients:


1: Cleaning/disinfecting of frequently touched surfaces*Before the day starts and then every 2 hours for the waiting room during the workday.*For exam rooms, the disinfection occurs after each patient visit.Frequently touched surfaces include: door knobs, door handles, light switches, chairs, and exam tables.  The disinfectant we use currently is diluted bleach (Clorox). 

2: All staff members wear masks when interacting with each other, patients and visitors during work hours.  Handwashing is done before each patient contact.

3: A staff member is advised to not come to work if he/she has any symptoms of cough, runny nose, sore throat, diarrhea, vomiting or fever, or if he/she has been exposed to anyone with these symptoms or anyone with a known diagnosis of COVID19 without wearing mask/gloves, until he/she has been tested negative for SARS-COV2.

4: All well patients > 2 years of age and accompanying visitors must wear masks upon entry to our office.

5: All well patients will be asked the screening questions about respiratory symptoms and exposure history upon entry to the office or when calling to make an appointment.

6: All patients who screen positive for respiratory symptoms or fever and need to be seen as a sick visit will wait in the back parking lot upon arrival and call in to inform our receptionist. Our staff will come out in full PPE (gown, facial covering, gloves) to bring the patient/accompanying adult to the second floor through the back entrance.

We encourage all patients to sign up for access to MyChart, the patient portal to our electronic medical record system Epic. It allows non-urgent communication by email, virtual visit by Zoom between patient and physician, request for medication refills, request for appointment scheduling, and access to lab test results.

In preparation for the flu season, we have ordered flu vaccines, which should arrive in September. We will notify every patient via MyChart when the vaccine is available and when our flu clinic hours will be. Vaccine for SARS-COV2 will be unlikely to be available for children this year. Wearing of a facial covering, washing hands often, and keeping distance from others are the only sure things we can do to prevent the spread of this and other respiratory viruses.   


Sincerely,
Pediatric Associates of Malden


Newsletter – April, 2020

As this Coronavirus epidemic sweeps through Massachusetts, we have seen a decrease in the number of sick visits and well visits in the past 3 weeks.   To isolate sick patients from well patients, we have already changed all sick visits to 9 am -12 pm and 5 pm-6 pm, and well visits to 1 pm- 5 pm.   All visits need to be prescheduled by phone or email.   Each sick patient with fever or respiratory symptoms will need to call on arrival and wait in the car in the rear parking lot.   A staff member will bring in the patient via the back entrance to the second floor.As part of the Pediatric Physicians’ Organization at Children’s (PPOC), we are now able to schedule a virtual visit by video, using Zoom App on your smart phone.  However, only those who have access to MyChart, the patient portal to our electronic medical record system, can schedule for such a visit.  So for patients who prefer to not come in to the office, we encourage you to contact our office and sign up for MyChart.  For patients under 13, a parent (or a proxy) needs to sign up for access to MyChart.  A patient who is 13 years or older needs to be active on MyChart him/herself. Both MyChart and Zoom apps should be updated to the most recent version.The following are instructions about steps to take to a Virtual Visit on your phone:

Step 1: Log on MyChart at the pre-scheduled appointment time. (Make sure Zoom app is also downloaded)
Step 2: Click on “Appointments” under Activities
Step 3: Click on "Pre-Visit Validation"
Step 4: Use Edit to correct any information in error, then click “This information is correct” to validate.
Step 5: Begin Visit and it would automatically open into Zoom   Hit  “Join Meeting”

For children who do not need vaccinations at a well visit, a “virtual well visit” can be done to review growth, nutrition, development, school, family and safety issues.  We would need you to do weight, height and temperature measurements at home and answer the developmental questionnaire before the virtual visit, so that we can discuss them during the visit itself.  There are even apps on the phone you can download to check a pulse (heart rate) and do height measurements.  Of course, there are things we cannot do virtually, such as vaccinations, ear examination, throat, blood and urine tests.

Let’s utilize the technology and stay connected despite the epidemic.

Sincerely,
Pediatric Associates of Malden


Newsletter - Spring, 2020

As everyone knows, the Coronavirus that originated in China is now a pandemic across the globe.  It is now named SARS-COV-2.  A person who has symptoms due to the infection is someone who has COVID-19 (coronavirus induced disease-2019).  A national emergency has been declared by the president, and the governor of Massachusetts has also declared a state emergency, banning any gathering of >25 people, and shuttering schools and restaurants across the state for the next month.  Locally, so far there has been only one patient with confirmed case of COVID-19 in Malden and another in Medford.  Even though Mystic Valley Regional School was closed before the declared emergency because of a concern for possible exposure to a student who had returned from China via Vietnam, there was no confirmation that the student actually has COVID-19.   

What does this emergency mean for our pediatric practice and our patients?

1. Our practice will remain open to our patients.  We continue to see patients who are scheduled for Well Child visits. We understand that some parents may be concerned about possible exposure to a sick child in the office.  This is why we have the policy statements below to minimize that risk.  To reduce unnecessary office visits, we would like to remind everyone that in addition to telephone calls, you can use MyChart, the patient portal to our electronic medical record system, to send in emails on any questions.  Soon you can even do video virtual visits via Zoom with MyChart.  For those who have not yet signed up for MyChart, please do so now by contacting our office.

2. We ask all patients who are sick to call ahead for appointments.  

3. We will not accept Walk-in patients (who has not called ahead.)  If a patient shows up without an appointment, we will provide him/her with our telephone number so the patient can call and set up an appointment.

4. To separate well patients from sick patients, our schedule will be changed for sick and well visits: sick patients will be seen from 9am to 12pm and from 6pm to 8pm, and Well Visits will be limited from 1 PM to 5 PM.

5. We will follow the recommended protocol by DPH for COVID-19 screening:  All patients who call for an appointment will be asked:  

i. Within the last 14 days have you/your child or a household member had close contact with a symptomatic person diagnosed with COVID-19?
ii. Have you/your child traveled to Europe, China, Iran, South Korea, King County WA, Westchester County NY, or Solano County CA in the past 14 days?

If the answer to either of the 1st two questions is yes, a third question is asked:
iii. Do you/your child have fever OR cough OR difficulty breathing?

If the response to question iii is also yes, then the patient has screened positive.
The patient may be scheduled to be seen in the parking lot first by a physician in mask, gown and gloves to assess the severity.  A nasopharyngeal swab test for SARS-COV2 can be done with the patient in the car/parking lot.  If the patient is deemed well enough to go home, he/she will be instructed to be in quarantine at home for at least 2 weeks or until the test is negative.  

If the answer is No for first 2 questions, but Yes to the 3rd question, an appointment may be provided, and the patient will be given a mask and gloves to wear on entry to the office.  An alternative to an actual visit is to have the physician do a virtual visit by phone. 

6. Our medical staff will wear mask and gloves or washing hands before treating patients with any respiratory symptoms.

7. There will be no toys or books in the waiting room or examination rooms.  

8. Because we are short on masks, we strongly recommend that families limit the number of people that come with the patient to only 1 responsible adult.If you want your child be tested for SARS-COV-2, even though there is no history of exposure, please call and speak to one of our physicians to determine if it is necessary. We do not test everyone who wants a test. We are hopeful that the policy and protocol above will be followed and will keep our patients and our staff healthy through this pandemic. 

Best Wishes,
Pediatric Associates of Malden

2019

July, 2019
Greetings to our patients and parents.

It has been almost 2 years since we adopted Epic as our electronic medical record system.  With this system, there is a patient portal that is called MyChart. Through MyChart, a patient (or parent/legal guardian) may do the following: 1. Access test results that have been reviewed by the physician; 2.  two-way communication with physician via email: examples include sending non-urgent questions to the physician, including photos, and receiving a response or notification from physician such as reminders for an annual check-up; 3.  Request to schedule an appointment; 4. Request refills for your medications. With any email, the response time depends on the person who receives the email.  If he or she does not check the email frequently, there would be a delay. Therefore, questions that are sent via MyChart should be on non-urgent issues.  

To sign up for MyChart, a patient of 14 years or older, or a parent/legal guarding of a patient under 14 years of age, can contact our office and provide an email address. A password will then be provided for access to MyChart. If a parent of a patient of 14 years and older wishes to access MyChart, the teenager has to sign a consent agreement.   

For urgent matters, i.e. if your child is sick, you can either call to schedule an appointment or to ask to speak to a physician.  Since we do have office hours everyday of the year, a sick visit can usually be scheduled within 24 hours. Our website has a Symptom Checker from the American Academy of Pediatrics which may assist you in deciding whether your child should be seen urgently.  When the office is closed, our physicians are on-call. Our hope is that with these web-based tools, our easy-access office hours, and our on-call service in the afterhours, we can reduce unnecessary visits to the emergency rooms. 

We strive to provide our patients the most up-to-date information on medicine and health. Our Epic system is in fact linked to a software program called UpToDate. We also have a Facebook page, on which we present some of the current medical and health related issues that may be of interest to you. We are interested in getting feedback from you on how we can serve you better. You are welcome to send us your comments and suggestions either via email, on paper or verbally when you come to our office. 

Every summer season there are certain medical conditions we see more often, usually related to outdoor activities, such as insect bites, sun burn, poison ivy dermatitis, and chemical dermatitis from sun blocks. Preventive measures include: testing a sun block on an arm or leg before putting it on the face; apply insect repellent for kids over 6 months of age if you are exploring forests, ponds or lakes; and familiarize yourself with poison ivy’s appearance and inspect your backyard. Take breaks from activities in the sun and drink plenty of water to avoid heat stroke. Enjoy the summer.

Sincerely,
Pediatric Associates of Malden


2018

2017

To Our Patients and Parents:

We hope you are enjoying the summer.  In this letter we have four announcements.

In the past year and half Ashley Flynn, LMHC, has been a member of our practice to provide consultation to our patients and families on a variety of behavioral and psychological issues.  She helped our patients tremendously by counseling in the areas of ADHD, anxiety, depression, parenting, and the like.  Ashley now will be moving elsewhere and taking another position by the end of August.  We are grateful for what she has given to our patients and will look forward to a future replacement counselor to fill her position.  In the interim, we will utilize other mental health counselors in the area for our patients.

We are excited to announce that we will be changing our electronic medical record/information system to a new, more advanced system called Epic.  This will begin at the end of August, 2017.  As we are part of the PPOC, we will join many other pediatric practices around Boston in making this change.  The decision was based on an agreement that a new system would help us deliver better service for patients.  We are currently training for Epic and will make our best attempt toward a smooth transition.  We ask our patients to be mindful of this as we work out the transfer of patient information.  We may, during your next visit, need to update items such as insurance and contact information.

We have been providing free books to our patients starting at age 6 months until 5 years of age during the well child visits as part of the Reach Out and Read program.   The purpose of the program is to promote reading by parents to children to encourage the joy of reading as well as language development.  The program’s major source of funding in the past came from the state, while contribution from our own practice accounted for some 10-15% of the books.   Then since the beginning of 2017 the state eliminated the funding entirely.   Our practice is now shouldering the entire cost of the books.   We are hoping that the state  may renew the funding for 2018.  Until then, I hope that some of our parents may donate some old children’s books that your children no longer read and help us sustain this program.   You may bring the books in a paper bag and inform our front desk, so we can acknowledge your kindness.

We developed a new logo for our practice, as shown below.  We hope you approve.

Sincerely,

Pediatric Associates of Malden

2016

Greetings to our patients and patients’ families.  This newsletter is intended to provide an update on our practice and recommendations for our patients.

First, it is that time of the year for flu vaccine again.  Please do call and make an appointment for the vaccine.  This year the flu vaccine in the form of nasal spray is no longer recommended for use because recent studies on its efficacy showed that it was not effective. Therefore, all flu vaccines recommended for this year are administered by injection.   Is the vaccine safe?  Rare adverse events may occur, such as Guillain-Barre syndrome, but it is more likely to occur with the actual flu infection than the vaccine.  The vaccine does not weaken the immune system, but trains the immune system to be stronger and more prepared for the real infection.  Is the vaccine necessary? Usually a viral infection such as a common cold can induce a fever response that lasts 2-4 days.  The flu tends to induce a fever that lasts longer.  So each time a school aged child has a respiratory infection such as flu, there is a good chance he/she may miss school for 4 days or more.  Each day a child is sick means a day of school is missed (for the child), and a day of work/wage is lost for the parent who has to stay home to care for the child.    The cough, nasal congestion and runny nose can last 2-3 weeks.  Other people who are close to the sick child can catch the virus and get sick as well.  Therefore, even from a financial point of view, vaccination against flu makes sense.

Second, we have been teaching first- and second-year medical students from Tufts Medical School and nurse practitioner students from Regis College and elsewhere.  With your consent, we teach the students on how to obtain a medical history, take vital signs, do a physical examination, analyze the problem(s), make a diagnosis, and then prescribe a treatment.  However, we feel that such “teaching” visits benefit our patients as well, because sometimes a student may ask questions about a patient’s illness that a parent, patient or physician has not thought of and may help in the diagnosis and treatment.  Therefore, it is a process of learning for them and for us, and extra time may sometimes be needed for a patient visit.

Third, Ashley Flynn, a Licensed Mental Health Counselor, has been providing counseling to our patients since March at our office.  She can provide advice to parents about how to deal with children with behavioral problems at home or at school.  She can offer advice to patients with attention deficits disorder, and she can offer counseling on grief, anxiety and depression. The advantage of having her available on site is that we physicians can talk to her about a patient’s needs directly and we can also get feedback from her more conveniently.  We believe that her presence allows us to be a more complete Medical Home for our patients.

Fourth, another person who is vital to the Medical Home is the Medical Home Care Coordinator.  We are fortunate to have Kelly Daugherty, who joined us in October to fulfill that role.  Kelly had previously worked in a similar role in Medford and Lynn.  She will help our patients with special needs to get appointments with specialists and to obtain services through various government or private agencies.  She will also send out reminders to our patients who are due or overdue for an annual well visit, and she will reach out to families who may have barriers to obtain healthcare for their children.

Fifth, a schedule of preventive health, or “well-child” visits has been recommended by the American Academy of Pediatrics, and those visits are all covered by health insurance plans.  During these visits, we have screening questionnaires for patients/parents to fill out and for the physician to review and to address any concerns raised by the questionnaires.  We usually review a child’s growth, nutrition, dental health, school readiness/performance, physical activities, habits, safety, mental health, and family situations, and we will address any existing medical problems, such as asthma, allergies, diabetes, etc.  Therefore, please do raise any concerns you have during these “well-child” visits, even if they are not on the questionnaires.  Eventually, when we adopt a new electronic medical record system next year, we will be able to have these questionnaires sent via internet to our patients/families so that they can be filled out on-line 1-2 days prior to the visit.  We recommend that you schedule your next well visit before you leave the office every time.

Sincerely,

Tien-Lan Chang, M.D.

Pediatric Associates of Malden

Fall, 2015

Policy On Vaccines

Greetings to Our Patients and Parents,

It is already middle of the fall season. We are administering influenza (flu) vaccines to our patients during well and sick visits, and we have added staff on Saturday morning and Tuesday afternoons for patients who come just for the flu vaccine.  This year all flu vaccines are provided by the state of Massachusetts.  We recommend the vaccine to all children 6 months and older unless there is a medical reason against it.   The reason for vaccination is to protect children from serious illness and complications caused by the flu virus, which account for many emergency room visits, hospitalizations and deaths.   Although most people will recover from the illness, they will still be affected by losses in time and money due to school absences for patients and missed work for parents. This year the flu vaccine contains 4 strains of the flu virus.  If the flu virus strains that come around this winter season are among the strains contained in the vaccine, then those who are vaccinated are likely to be protected by the vaccine.  Your decision about whether your child should be vaccinated should be based on these facts, not based on false myths or fears such as “the vaccine causing flu symptoms” myth, or that there are chemical poisons in the vaccine.

Second, starting November 2015, our Electronic Medical Record  (EMR) system will be linked with the Massachusetts Immunization Information System (MIIS), a confidential, web-based system.  Vaccine records for Massachusetts residents of all ages will be collected and stored by the Massachusetts Department of Public Health.  This system will allow us to access the vaccine record of patients who had moved from another part of the state to our practice or who had vaccinations at a school or a pharmacy.   Similarly, if you go to an emergency room with an injury, the physician there can check the MIIS to find out if you are up-to-date with the tetanus vaccine.  Additionally, school nurses are able to access MIIS, making school registration more efficient for parents.  Parents who are concerned about privacy of vaccine information will have the right to opt out of sharing vaccine information with other facilities by signing a waiver form, though the vaccine information will still be registered with MIIS.

Third, I encourage those families who have not yet signed up for patient portal to do so.  With our current EMR system, patients can access laboratory results and vaccine record via patient portal, request appointments, refills, and referrals, as well as email your non-urgent questions through this portal.  To register, simply call the office during regular business hours and our staff will gladly help you through the process.  Please understand, due to Massachusetts privacy laws, parental access to medical records is restricted to children of ages 12 years and younger.

Last, but not least, I want to announce that by the spring of 2016, we will likely have a mental health counselor at our pediatric office.  Establishing this service at our location is exciting for all of us because it will more comprehensively serve our patients by providing convenient, accessible counseling for many mental health issues including those related to anxiety, depression, school difficulties and bullying. We here at Pediatric Associates of Malden look forward to give the highest care for all patients that come to us. Stay tuned for further updates and important notices.

Sincerely, Tien-Lan Chang, M.D.

January, 2015

We recommend vaccines to children, because vaccines are the best way to prevent infections. This recommendation is based on solid, evidence-based scientific research on the safety and efficacy of the vaccines. An unvaccinated child is at higher risk of getting an infection that is vaccine-preventable compared to a vaccinated child, and that child, once infected, also increases the risk of infection for other children. We welcome thoughtful questions and discussions on the vaccines, so that we can share educational information with each other. However, we want our patients to know that we try our best to provide a safe environment in our medical office. Therefore we have adopted the policy of not accepting any patient whose parents refuse all vaccines.

Tien-Lan Chang, M.D.