Information, New Technology Exchange for Rapid Action, Compliance and Treatment

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Vaccine preventable communicable respiratory illnesses are major causes of morbidity and mortality in US children and adults represent a major challenge to public health and clinician providers. From a public health perspective challenges include assuring immunization, especially in groups where immunization is voluntary, surveillance for these pathogens, case and contact investigation, and the public health burden of antibiotic resistance associated with treatment of viral respiratory infections. From a clinician perspective, time pressures limit their attention to the public health considerations associated with the prevention and treatment of vaccine-preventable respiratory infections. Treating physicians may have difficulty locating and interpreting public health guidelines, and these guidelines often lack specificity for treatment and do not include local surveillance data. We believe that these problems are fundamentally related to communication between public health and clinician providers. The goal of this project is to align public health and clinical practice by taking advantage of information technology to make public health practice more efficient and effective and to advance appropriate clinical management with respect to immunization, diagnostic testing, and prescribing of antiviral and antimicrobial medications. This project will focus on vaccine-preventable or potentially preventable respiratory infections due to influenza, pertussis, Neiserria meningitidis, Streptococcus pneumoniae, and respiratory syncytial virus. The specific aims are: 1) Extend a system for email communication, distribution of surveillance reports, and retrieval of reference information to public health and clinician providers in Utah, 2) Measure the effect of electronic information exchange system on knowledge, awareness, efficiency, and communication on the part of clinicians and public health personnel, 3) Conduct a nested trial, randomly allocating urgent care centers and primary care clinics to receive surveillance reports for vaccine preventable respiratory illnesses with or without tailored clinical management recommendations, 4) Measure the effect of receiving surveillance reports coupled with tailored clinical recommendations on therapeutic management endpoints including antimicrobial and antiviral use and on secondary endpoints of immunization rates in targeted populations. The project will be referred to as the Information and New Technology Exchange for Rapid Action, Compliance, and Treatment (INTERACT).