Improving Rates of Outpatient Influenza Vaccination Through EHR Portal Messages and Interactive Automated Calls: A Randomized Controlled Trial
Authors
Cutrona, Sarah L.Golden, Jessica G.
Goff, Sarah L.
Ogarek, Jessica
Barton, Bruce A.
Fisher, Lloyd D.
Preusse, Peggy
Sundaresan, Devi
Garber, Lawrence D.
Mazor, Kathleen M.
Document Type
Journal ArticlePublication Date
2018-01-30Keywords
electronic health recordsinfluenza vaccination
patient care
Health Information Technology
Health Services Administration
Health Services Research
Influenza Humans
Influenza Virus Vaccines
Metadata
Show full item recordAbstract
BACKGROUND: Patient reminders for influenza vaccination, delivered via electronic health record (EHR) patient portal messages and interactive voice response (IVR) calls, offer an innovative approach to improving patient care. OBJECTIVE: To test the effectiveness of portal and IVR outreach in improving rates of influenza vaccination. DESIGN: Randomized controlled trial of EHR portal messages and IVR calls promoting influenza vaccination. PARTICIPANTS: Adults with no documented influenza vaccination 2 months after the start of influenza season (2014-2015). INTERVENTION: Using a factorial design, we assigned 20,000 patients who were active portal users to one of four study arms: (a) receipt of a portal message promoting influenza vaccines, (b) receipt of IVR call with similar content, (c) both a and b, or (d) neither (usual care). We randomized 10,000 non-portal users to receipt of IVR call or usual care. In all intervention arms, information on pneumococcal vaccination was included if the targeted patient was overdue for pneumococcal vaccine. MAIN MEASURES: EHR-documented influenza vaccination during the 2014-2015 influenza season, measured April 2015. KEY RESULTS: Among portal users, 14.0% (702) of those receiving both portal messages and calls, 13.4% (669) of message recipients, 12.8% (642) of call recipients, and 11.6% (582) of those with usual care received vaccines. On multivariable analysis of portal users, those receiving portal messages alone (OR 1.20, 95% CI 1.06-1.35) or IVR calls alone (OR 1.15 95% CI 1.02-1.30) were more likely than usual care recipients to be vaccinated. Those receiving both messages and calls were also more likely than the usual care group to be vaccinated (ad hoc analysis, using a Bonferroni correction: OR 1.29, 97.5% CI 1.13, 1.48). Among non-portal users, 8.5% of call recipients and 8.6% of usual care recipients received influenza vaccines (p = NS). Pneumococcal vaccination rates showed no significant improvement. CONCLUSIONS: Our outreach achieved a small but significant improvement in influenza vaccination rates. Registration: ClinicalTrials.gov Identifier NCT02266277 ( https://clinicaltrials.gov/ct2/show/NCT02266277 ).Source
J Gen Intern Med. 2018 Jan 30. doi: 10.1007/s11606-017-4266-9. [Epub ahead of print] Link to article on publisher's site
DOI
10.1007/s11606-017-4266-9Permanent Link to this Item
http://hdl.handle.net/20.500.14038/46711PubMed ID
29383550Related Resources
ae974a485f413a2113503eed53cd6c53
10.1007/s11606-017-4266-9