scholarly journals Electronic Health Record Portal Messages and Interactive Voice Response Calls to Improve Rates of Early Season Influenza Vaccination: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Jessica G Wijesundara ◽  
Mayuko Ito Fukunaga ◽  
Jessica Ogarek ◽  
Bruce Barton ◽  
Lloyd Fisher ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Influenza Vaccination ◽  
Usual Care ◽  
Interactive Voice Response ◽  
Care Group ◽  
Health Record ◽  
Electronic Health ◽  
Influenza Vaccinations ◽  
To Receive ◽  
Voice Response

BACKGROUND Patient reminders for influenza vaccination, delivered via an electronic health record patient portal and interactive voice response calls, offer an innovative approach to engaging patients and improving patient care. OBJECTIVE The goal of this study was to test the effectiveness of portal and interactive voice response outreach in improving rates of influenza vaccination by targeting patients in early September, shortly after vaccinations became available. METHODS Using electronic health record portal messages and interactive voice response calls promoting influenza vaccination, outreach was conducted in September 2015. Participants included adult patients within a large multispecialty group practice in central Massachusetts. Our main outcome was electronic health record–documented early influenza vaccination during the 2015-2016 influenza season, measured in November 2015. We randomly assigned all active portal users to 1 of 2 groups: (1) receiving a portal message promoting influenza vaccinations, listing upcoming clinics, and offering online scheduling of vaccination appointments (n=19,506) or (2) receiving usual care (n=19,505). We randomly assigned all portal nonusers to 1 of 2 groups: (1) receiving interactive voice response call (n=15,000) or (2) receiving usual care (n=43,596). The intervention also solicited patient self-reports on influenza vaccinations completed outside the clinic. Self-reported influenza vaccination data were uploaded into the electronic health records to increase the accuracy of existing provider-directed electronic health record clinical decision support (vaccination alerts) but were excluded from main analyses. RESULTS Among portal users, 28.4% (5549/19,506) of those randomized to receive messages and 27.1% (5294/19,505) of the usual care group had influenza vaccinations documented by November 2015 (<i>P</i>=.004). In multivariate analysis of portal users, message recipients were slightly more likely to have documented vaccinations when compared to the usual care group (OR 1.07, 95% CI 1.02-1.12). Among portal nonusers, 8.4% (1262/15,000) of those randomized to receive calls and 8.2% (3586/43,596) of usual care had documented vaccinations (<i>P</i>=.47), and multivariate analysis showed nonsignificant differences. Over half of portal messages sent were opened (10,112/19,479; 51.9%), and over half of interactive voice response calls placed (7599/14,984; 50.7%) reached their intended target, thus we attained similar levels of exposure to the messaging for both interventions. Among portal message recipients, 25.4% of message openers (2570/10,112) responded to a subsequent question on receipt of influenza vaccination; among interactive voice response recipients, 72.5% of those reached (5513/7599) responded to a similar question. CONCLUSIONS Portal message outreach to a general primary care population achieved a small but statistically significant improvement in rates of influenza vaccination (OR 1.07, 95% CI 1.02-1.12). Interactive voice response calls did not significantly improve vaccination rates among portal nonusers (OR 1.03, 95% CI 0.96-1.10). Rates of patient engagement with both modalities were favorable. CLINICALTRIAL ClinicalTrials.gov NCT02266277; https://clinicaltrials.gov/ct2/show/NCT02266277

scholarly journals Electronic Health Record Portal Messages and Interactive Voice Response Calls to Improve Rates of Early Season Influenza Vaccination: Randomized Controlled Trial

10.2196/16373 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e16373
Author(s):  
Jessica G Wijesundara ◽  
Mayuko Ito Fukunaga ◽  
Jessica Ogarek ◽  
Bruce Barton ◽  
Lloyd Fisher ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Influenza Vaccination ◽  
Usual Care ◽  
Interactive Voice Response ◽  
Care Group ◽  
Health Record ◽  
Electronic Health ◽  
Influenza Vaccinations ◽  
To Receive ◽  
Voice Response

Background Patient reminders for influenza vaccination, delivered via an electronic health record patient portal and interactive voice response calls, offer an innovative approach to engaging patients and improving patient care. Objective The goal of this study was to test the effectiveness of portal and interactive voice response outreach in improving rates of influenza vaccination by targeting patients in early September, shortly after vaccinations became available. Methods Using electronic health record portal messages and interactive voice response calls promoting influenza vaccination, outreach was conducted in September 2015. Participants included adult patients within a large multispecialty group practice in central Massachusetts. Our main outcome was electronic health record–documented early influenza vaccination during the 2015-2016 influenza season, measured in November 2015. We randomly assigned all active portal users to 1 of 2 groups: (1) receiving a portal message promoting influenza vaccinations, listing upcoming clinics, and offering online scheduling of vaccination appointments (n=19,506) or (2) receiving usual care (n=19,505). We randomly assigned all portal nonusers to 1 of 2 groups: (1) receiving interactive voice response call (n=15,000) or (2) receiving usual care (n=43,596). The intervention also solicited patient self-reports on influenza vaccinations completed outside the clinic. Self-reported influenza vaccination data were uploaded into the electronic health records to increase the accuracy of existing provider-directed electronic health record clinical decision support (vaccination alerts) but were excluded from main analyses. Results Among portal users, 28.4% (5549/19,506) of those randomized to receive messages and 27.1% (5294/19,505) of the usual care group had influenza vaccinations documented by November 2015 (P=.004). In multivariate analysis of portal users, message recipients were slightly more likely to have documented vaccinations when compared to the usual care group (OR 1.07, 95% CI 1.02-1.12). Among portal nonusers, 8.4% (1262/15,000) of those randomized to receive calls and 8.2% (3586/43,596) of usual care had documented vaccinations (P=.47), and multivariate analysis showed nonsignificant differences. Over half of portal messages sent were opened (10,112/19,479; 51.9%), and over half of interactive voice response calls placed (7599/14,984; 50.7%) reached their intended target, thus we attained similar levels of exposure to the messaging for both interventions. Among portal message recipients, 25.4% of message openers (2570/10,112) responded to a subsequent question on receipt of influenza vaccination; among interactive voice response recipients, 72.5% of those reached (5513/7599) responded to a similar question. Conclusions Portal message outreach to a general primary care population achieved a small but statistically significant improvement in rates of influenza vaccination (OR 1.07, 95% CI 1.02-1.12). Interactive voice response calls did not significantly improve vaccination rates among portal nonusers (OR 1.03, 95% CI 0.96-1.10). Rates of patient engagement with both modalities were favorable. Trial Registration ClinicalTrials.gov NCT02266277; https://clinicaltrials.gov/ct2/show/NCT02266277

Using Statewide Electronic Health Record and Influenza Vaccination Data to Plan and Prioritize COVID-19 Vaccine Outreach and Communications in Wisconsin Communities

2021 ◽  
Vol 111 (12) ◽  
pp. 2111-2114
Author(s):  
Jessica Bonham-Werling ◽  
Allie J. DeLonay ◽  
Kristina Stephenson ◽  
Korina A. Hendricks ◽  
Lauren Bednarz ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Influenza Vaccination ◽  
Data Visualization ◽  
Health Record ◽  
Health Departments ◽  
Potential Barriers ◽  
University Of Wisconsin ◽  
Electronic Health ◽  
The University ◽  
Zip Code

The University of Wisconsin Neighborhood Health Partnerships Program used electronic health record and influenza vaccination data to estimate COVID-19 relative mortality risk and potential barriers to vaccination in Wisconsin ZIP Code Tabulation Areas. Data visualization revealed four groupings to use in planning and prioritizing vaccine outreach and communication based on ZIP Code Tabulation Area characteristics. The program provided data, visualization, and guidance to health systems, health departments, nonprofits, and others to support planning targeted outreach approaches to increase COVID-19 vaccination uptake. (Am J Public Health. 2021;111(12):2111–2114. https://doi.org/10.2105/AJPH.2021.306524 )

Impact of Electronic Health Record-Based Alerts on Influenza Vaccination for Children With Asthma

PEDIATRICS ◽  
2009 ◽  
Vol 124 (1) ◽  
pp. 159-169 ◽  
Author(s):  
A. G. Fiks ◽  
K. F. Hunter ◽  
A. R. Localio ◽  
R. W. Grundmeier ◽  
T. Bryant-Stephens ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Influenza Vaccination ◽  
Health Record ◽  
Children With Asthma ◽  
Electronic Health

scholarly journals Variations in Influenza Vaccination by Clinic Appointment Time and an Active Choice Intervention in the Electronic Health Record to Increase Influenza Vaccination

2018 ◽  
Vol 1 (5) ◽  
pp. e181770 ◽  
Author(s):  
Rebecca H. Kim ◽  
Susan C. Day ◽  
Dylan S. Small ◽  
Christopher K. Snider ◽  
Charles A. L. Rareshide ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Influenza Vaccination ◽  
Health Record ◽  
Clinic Appointment ◽  
Active Choice ◽  
Appointment Time ◽  
Electronic Health

scholarly journals An ancillary genomics system to support the return of pharmacogenomic results

2019 ◽  
Vol 26 (4) ◽  
pp. 306-310 ◽  
Author(s):  
Luke V Rasmussen ◽  
Maureen E Smith ◽  
Federico Almaraz ◽  
Stephen D Persell ◽  
Laura J Rasmussen-Torvik ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Health Record ◽  
Test Results ◽  
Actionable Knowledge ◽  
Genomic Test ◽  
Electronic Health ◽  
To Receive

AbstractExisting approaches to managing genetic and genomic test results from external laboratories typically include filing of text reports within the electronic health record, making them unavailable in many cases for clinical decision support. Even when structured computable results are available, the lack of adopted standards requires considerations for processing the results into actionable knowledge, in addition to storage and management of the data. Here, we describe the design and implementation of an ancillary genomics system used to receive and process heterogeneous results from external laboratories, which returns a descriptive phenotype to the electronic health record in support of pharmacogenetic clinical decision support.

scholarly journals Electronic health record alerts for acute kidney injury: multicenter, randomized clinical trial

BMJ ◽  
2021 ◽  
pp. m4786
Author(s):  
F Perry Wilson ◽  
Melissa Martin ◽  
Yu Yamamoto ◽  
Caitlin Partridge ◽  
Erica Moreira ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Relative Risk ◽  
Confidence Interval ◽  
Electronic Health Record ◽  
Usual Care ◽  
Primary Outcome ◽  
Kidney Injury ◽  
Health Record ◽  
Care Practices ◽  
Electronic Health

Abstract Objective To determine whether electronic health record alerts for acute kidney injury would improve patient outcomes of mortality, dialysis, and progression of acute kidney injury. Design Double blinded, multicenter, parallel, randomized controlled trial. Setting Six hospitals (four teaching and two non-teaching) in the Yale New Haven Health System in Connecticut and Rhode Island, US, ranging from small community hospitals to large tertiary care centers. Participants 6030 adult inpatients with acute kidney injury, as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) creatinine criteria. Interventions An electronic health record based “pop-up” alert for acute kidney injury with an associated acute kidney injury order set upon provider opening of the patient’s medical record. Main outcome measures A composite of progression of acute kidney injury, receipt of dialysis, or death within 14 days of randomization. Prespecified secondary outcomes included outcomes at each hospital and frequency of various care practices for acute kidney injury. Results 6030 patients were randomized over 22 months. The primary outcome occurred in 653 (21.3%) of 3059 patients with an alert and in 622 (20.9%) of 2971 patients receiving usual care (relative risk 1.02, 95% confidence interval 0.93 to 1.13, P=0.67). Analysis by each hospital showed worse outcomes in the two non-teaching hospitals (n=765, 13%), where alerts were associated with a higher risk of the primary outcome (relative risk 1.49, 95% confidence interval 1.12 to 1.98, P=0.006). More deaths occurred at these centers (15.6% in the alert group v 8.6% in the usual care group, P=0.003). Certain acute kidney injury care practices were increased in the alert group but did not appear to mediate these outcomes. Conclusions Alerts did not reduce the risk of our primary outcome among patients in hospital with acute kidney injury. The heterogeneity of effect across clinical centers should lead to a re-evaluation of existing alerting systems for acute kidney injury. Trial registration ClinicalTrials.gov NCT02753751 .

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