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Electronic reminder increased influenza vaccination rates in late winter
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Study findings indicated that an electronic vaccination reminder that utilized immunization information from a population-based system increased influenza vaccination later in the winter when few vaccine doses are administered.
Using a cluster, randomized crossover design, researchers evaluated the impact of an influenza vaccination reminder among four community-based pediatric clinics in New York for the 2011-2012 influenza season.
“When a medical or nursing provider opened the [electronic health record] note-authoring module, the reminder automatically retrieved vaccination information from the hospital registry which synchronized data real-time with the [New York] Citywide Immunization Registry,” researcher Melissa S. Stockwell, MD, MPH, of Columbia University Medical Center, and colleagues wrote.
Melissa S. Stockwell
A color-coded message based on influenza vaccination status and the most recent seasonal and 2009 H1N1 vaccination dates appeared on the electronic health record screen. An orange color indicated the child was not up-to-date, green showed an up-to-date status, and yellow indicated the child was up-to-date but needed another upcoming dose.
There were 8,481 unique child-visits during the study period for patients aged 6 months to 17 years. The median age of the patients was 6.5 years, and almost 66% were from Spanish-speaking families.
Approximately 1,478 (17.4%) patients were up-to-date, 66 (0.8%) were vaccinated, of which 21 returned at the prescribed time for a second dose, and 6,958 were not up-to-date at presentation.
Overall, more children who were not current with their vaccinations were seen when the reminder was on rather than off, according to the researchers.
Stratified analyses indicated effects from reminders were seen more in the winter vs. the fall (P=.005).
When adjusting for clinic and age, a child seen in the winter when the reminder was on was less likely to remain unvaccinated (relative rate=0.83; 95% CI, 0.74-0.93).
Reminders had a significant impact on the first non-up-to-date visit of any kind in the winter but not in the fall (P=.01), the researchers wrote.
“An influenza vaccination reminder in the electronic health record linked with city immunization information system data resulted in modest but significant increases in influenza vaccination, primarily in the January-February period,” Stockwell and colleagues concluded. “The majority of influenza vaccine doses nationally are given in the October-December period, and providers may be more likely to remember to offer vaccine then. Therefore, an intervention that can have an impact on influenza vaccination after December may be particularly important.”
Disclosure: One researcher reports financial ties with Pfizer, Merck, and Sharp & Dohme. The other researchers report no relevant financial disclosures.
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