Improving Influenza Vaccination Delivery Across a Health System by the Electronic Health Records Patient Portal

通过电子健康记录患者门户改善整个卫生系统的流感疫苗接种

基本信息

批准号：
10319923
负责人：
PETER G SZILAGYI
金额：
$ 74.31万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-01-16 至 2023-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10319923
关键词：
Address Adoption Adult Advisory Committees Age Age-Months Algorithms American Appointment Appointments and Schedules Centers for Disease Control and Prevention (U.S.)Cessation of life Child Chronic Disease Clinic Communication Communities Community Health Complex Cost Analysis Cost Measures Custom Data Education Electronic Health Record Electronic Mail Emergency Situation Emergency department visit Health Personnel Health Services Health system Hospitalization Hour Human Resources Image Immunization Improve Access Influenza vaccination Internet Intervention Link Los Angeles Low Income Population Low income Medical Methods Modality Morbidity - disease rate Neighborhood Health Center Nurses Online Systems Outpatients Patient Schedules Patients Persons Population Preventive service Primary Health Care Process Measure Protocols documentation Provider Randomized Randomized Clinical Trials Reach Effectiveness Adoption Implementation and Maintenance Reminder Systems Reporting Research Resources Schedule Seasons Secure Services Subgroup System Telephone Testing Text Vaccination Vaccines Visit arm base care systems chronic care model compare effectiveness cost cost effectiveness design effectiveness evaluation evidence base flu health services network improved influenza epidemic influenza outbreak influenza virus vaccine innovation pandemic influenza patient health information patient portal prevent primary outcome provider portal scale up systematic review vaccination strategy vaccine access

项目摘要

Abstract Annual epidemics of influenza cause substantial morbidity in the US with up to 40,000 deaths/year and many hospitalizations, emergency department visits, outpatient visits, and costs. The Advisory Committee on Immunization Practices (ACIP) recommends annual influenza vaccination for all people above 6 months of age. However, less than half of all Americans receive the influenza vaccine. Two sets of interventions that can improve influenza vaccination rates include patient reminders (generally by mail or phone), and enhancing access and ease of obtaining the vaccine. However, due to resource limitations and difficulty scaling up reminders, only a small proportion of practices or health systems remind patients about the need for vaccination, and few systems implement innovative strategies to ease access to influenza vaccination. A technological breakthrough that might overcome these barriers is the electronic health records patient portal. Patient portals are secure, web-based communication systems, embedded within electronic health records (EHRs), allowing patients and providers to communicate via email and the internet. Portal-based reminder has the potential to raise vaccination rates for several reasons: the messages come from the patient's provider, portal reminders are easily scalable, portal messages can be personalized by drawing on information found in the patient's medical record, and portals can facilitate access by helping patients schedule their own appointments for vaccination. This study will implement and evaluate a portal reminder system for influenza vaccination across a large UCLA-wide health system that serves >275,000 patients in 49 primary care practices, half of whom use the portal. For Aim 1 we will adapt algorithms, educational messages, and protocols previously used for mailed or phone influenza vaccine reminder/recall to create a patient portal research platform. For Aim 2, we will assess the impact of portal reminders, and key design features of these reminders, on influenza vaccination rates and costs using 3 sequential RCTs over 3 flu seasons. RCT #1 will test the optimal number of portal reminders (3, 2, or 1 vs. 0). RCT #2 will test the additional benefit of adding patient direct appointment scheduling to the portal reminder system. RCT #3 will test the additional benefit of linking portal reminders with the EHR to customize portal messages. For Aim 3 we will develop an adoption guide/toolkit for use by other health systems. We will disseminate the portal reminder system in a network of Los Angeles Department Health community health centers serving more than 30,000 low-income patients. By study end we will have an advanced influenza vaccine portal reminder system, ready for dissemination.

抽象的流感的年度流行病在美国导致大量发病率，每年40,000人死亡，许多住院，急诊室就诊，门诊就诊和费用。咨询委员会免疫实践（ACIP）建议对6个月以上的所有患者进行年度流感疫苗接种年龄。但是，不到一半的美国人接受了流感疫苗。两套可以提高流感疫苗接种率的干预措施包括患者提醒（通常通过邮件或电话），并增强获取疫苗的访问和便捷性。但是，由于资源限制和难以扩大提醒，只有一小部分的做法或卫生系统提醒患者涉及接种疫苗的需求，很少有系统实施创新策略以缓解访问权限流感疫苗接种。电子健康记录患者可能会克服这些障碍的技术突破门户网站。患者门户网站是安全的，基于网络的通信系统，嵌入了电子健康中记录（EHR），允许患者和提供者通过电子邮件和互联网进行交流。基于门户网站提醒有可能出于多种原因提高疫苗接种率：这些消息来自患者的提供商，门户的提醒很容易扩展，可以通过借鉴来个性化门户信息在患者的病历中找到的信息，门户可以通过帮助患者安排来促进访问他们自己的疫苗接种任命。这项研究将实施和评估门户提醒系统，用于跨大型流感疫苗接种 UCLA范围内的卫生系统为49种初级保健实践中的275,000名患者提供服务，其中一半使用门户网站。对于AIM 1，我们将调整以前用于邮寄或电话流感疫苗提醒/召回以创建患者门户研究平台。对于AIM 2，我们将评估门户提醒的影响以及这些提醒的关键设计特征，对流感疫苗接种率和在3个流感季节中使用3个顺序RCT的成本。 RCT＃1将测试最佳门户提醒的数量（3， 2，或1 vs. 0）。 RCT＃2将测试将患者直接预约时间表添加到门户提醒系统。 RCT＃3将测试将门户提醒与EHR链接到的其他好处自定义门户消息。对于目标3，我们将开发一个采用指南/工具包，以供其他健康系统。我们将在洛杉矶部门Health网络中传播门户提醒系统社区卫生中心为30,000多名低收入患者提供服务。按研究端，我们将拥有先进的流感疫苗门户提醒系统，准备传播。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Evaluation of behavioral economic strategies to raise influenza vaccination rates across a health system: Results from a randomized clinical trial.

对提高整个卫生系统流感疫苗接种率的行为经济策略的评估：随机临床试验的结果。

DOI：
10.1016/j.ypmed.2023.107474
发表时间：
2023
期刊：
Preventive medicine
影响因子：
5.1
作者：
Szilagyi,PeterG;Casillas,Alejandra;Duru,OKenrik;Ong,MichaelK;Vangala,Sitaram;Tseng,Chi-Hong;Albertin,Christina;Humiston,SharonG;Ross,MindyK;Friedman,SarahR;Evans,Sharon;Sloyan,Michael;Bogard,JonathanE;Fox,CraigR;Lerner,
通讯作者：
Lerner,

Patient Portal Reminders for Pediatric Influenza Vaccinations: A Randomized Clinical Trial.

DOI：
10.1542/peds.2020-048413
发表时间：
2021-08
期刊：
Pediatrics
影响因子：
8
作者：
Lerner C;Albertin C;Casillas A;Duru OK;Ong MK;Vangala S;Humiston S;Evans S;Sloyan M;Fox CR;Bogard JE;Friedman S;Szilagyi PG
通讯作者：
Szilagyi PG

Effect of Personalized Messages Sent by a Health System's Patient Portal on Influenza Vaccination Rates: a Randomized Clinical Trial.

DOI：
10.1007/s11606-021-07023-w
发表时间：
2022-03
期刊：
Journal of general internal medicine
影响因子：
5.7
作者：
Szilagyi PG;Albertin CS;Casillas A;Valderrama R;Duru OK;Ong MK;Vangala S;Tseng CH;Humiston SG;Evans S;Sloyan M;Bogard JE;Fox CR;Lerner C
通讯作者：
Lerner C