EHR prompt increases flu vaccination rates by 9.5 percentage points

EHR reminders can help improve vaccination rates, according to a study published in JAMA Network Open.

Researchers conducted a retrospective, quality improvement study of 11 primary care practices at the University of Pennsylvania Health System in Philadelphia from Sept. 1, 2014, to March 31, 2017. They included 96,291 adults eligible for influenza vaccination in the study.

Of the 11 practices, three implemented an active choice intervention in the EHR, which prompted medical assistants to ask patients about influenza vaccination during check-in and created vaccination orders for physicians to review during the visit.

The study shows vaccination rates were 46.9 percent, 47.2 percent and 45.6 percent over the three-year study period at practices that did not use the EHR alert. Vaccination rates were 49.7 percent, 52.2 percent and 59.3 percent at practices that used the alert over the study period.

In adjusted analyses, the EHR alert was associated with a 9.5 percentage point increase in vaccination rates in practices that used the active choice intervention as compared with practices that did not.

Vaccination rates also differed according to time of day. Across all practices during the study period, vaccination rates were:

• 44 percent from 8 am to 10 am
• 41.2 percent by 11 am
• 38.3 percent at noon
• 40.2 percent at 1 pm
• 34.3 percent at 3 pm
• 32 percent at 4 pm

"The active choice intervention was associated with a significant increase in influenza vaccination rates that were similar in magnitude throughout the day," study authors concluded.

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