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23.03.2017 | Original Research

Using Active Choice Within the Electronic Health Record to Increase Influenza Vaccination Rates

verfasst von: Mitesh S. Patel, MD, MBA, MS, Kevin G. Volpp, MD, PhD, Dylan S. Small, PhD, Craig Wynne, MD, Jingsan Zhu, MBA, Lin Yang, MS, Steven Honeywell Jr., BS, Susan C. Day, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 7/2017

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Abstract

Background

Despite the benefits of influenza vaccination, each year more than half of adults in the United States do not receive it.

Objective

To evaluate the association between an active choice intervention in the electronic health record (EHR) and changes in influenza vaccination rates.

Design

Observational study.

Patients

Adults eligible for influenza vaccination with a clinic visit at one of three internal medicine practices at the University of Pennsylvania Health System between September 2010 and March 2013.

Intervention

The EHR confirmed patient eligibility during the clinic visit and, upon accessing the patient chart, prompted the physician and their medical assistant to actively choose to “accept” or “cancel” an order for the influenza vaccine.

Main Measures

Change in influenza vaccination order rates at the intervention practice compared to two control practices for the 2012–2013 flu season, comparing trends during the prior two flu seasons adjusting for time trends and patient and clinic visit characteristics.

Key Results

The sample (n = 45,926 patients) was 62.9% female, 35.9% white, and 54.4% black, with a mean age of 50.2 years. Trends were similar between practices during the 2 years in the pre-intervention period. Vaccination rates increased in both groups in the post-intervention year, but the intervention practice using active choice had a significantly greater increase than the control (adjusted difference-in-difference: 6.6 percentage points; 95% CI, 5.1–8.1; P < 0.001), representing a 37.3% relative increase compared to the pre-intervention period. More than 99.9% (9938/9941) of orders placed during the study period resulted in vaccination.

Conclusions

Active choice through the EHR was associated with a significant increase in influenza vaccination rates.

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Titel: Using Active Choice Within the Electronic Health Record to Increase Influenza Vaccination Rates
verfasst von: Mitesh S. Patel, MD, MBA, MS
Kevin G. Volpp, MD, PhD
Dylan S. Small, PhD
Craig Wynne, MD
Jingsan Zhu, MBA
Lin Yang, MS
Steven Honeywell Jr., BS
Susan C. Day, MD, MPH
Publikationsdatum: 23.03.2017
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe 7/2017
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-017-4046-6

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Using Active Choice Within the Electronic Health Record to Increase Influenza Vaccination Rates

Abstract

Background

Objective

Design

Patients

Intervention

Main Measures

Key Results

Conclusions

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Abstract

Background

Objective

Design

Patients

Intervention

Main Measures

Key Results

Conclusions

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