Technology Helps Overcome Barriers to Vaccination

Electronic health records (EHRs) hold promise as tools to trigger reminders to clinicians and families to support on-time vaccination. Making sure that a child is immunized at the right time helps to provide the best defense against dangerous childhood diseases.

Pediatricians capture vaccine data and share these records with immunization information systems, formerly known as registries, which have been implemented in all 50 states to track vaccine receipt by children across practices. With the widespread use of EHRs, practices can use an EHR interface to populate these immunization records, and then the data can be used to expedite efforts to improve health outcomes.

In a recent editorial, Alexander Fiks, MD, MSCE, a faculty member at PolicyLab and Clinical Futures at The Children’s Hospital of Philadelphia, commented about a study appearing in the same issue of JAMA Pediatrics that described an approach to using health information technology to increase vaccination coverage. Allison Kempe, MD, MPH, of the Children’s Hospital Colorado, led the study team that conducted the randomized pragmatic trial.

The researchers targeted families of more than 18,000 children, comparing traditional practice-based vaccine reminders through telephone or mail versus multiple telephone and mail reminders delivered centrally by health departments working in collaboration with practices and using the Colorado Immunization Information System (CIIS) as a data source.

They found that those who received the collaborative centralized reminder not only had higher rates of vaccination, but also lower costs per child vaccinated. Of importance, vaccination rates were higher when reminder messages were specifically endorsed by a child’s practice.

In certain settings where the interests of the practice and public healthcare systems coincide, collaboration with health departments or other outside groups may prove effective, especially if they are built on existing relationships between families and clinicians, according to the JAMA Pediatrics commentary.

“With nearly 80 percent of pediatric practices now capturing data in EHRs, a remarkable opportunity exists to use these data to improve health outcomes,” Dr. Fiks wrote.