Flu Alert: Influenza Vaccine Alerts for Providers in the Electronic Health Record

描述（由申请人提供）：问题：儿童流感的覆盖率远远低于其他儿童疫苗的覆盖率。提高流感疫苗覆盖率不仅对儿童的健康很重要，而且对儿童的家庭和社区也很重要。为6个月至18岁的儿童接种疫苗将大大减少美国流感病例的总数。因此，免疫实践咨询委员会目前的建议是，所有6个月至18岁的儿童都应接种流感疫苗。然而，即使有流感疫苗，儿科诊所的流感疫苗接种率也很低。流感覆盖范围很复杂；这种疫苗是季节性的，需要每年接种一次。提供者需要记住在流感季节的每一个机会提供它，而不仅仅是在儿童健康检查期间。即使提供者记得提供流感疫苗，提供者也可能不知道如何最好地沟通

DESCRIPTION (provided by applicant): Problem: Childhood influenza coverage rates are far below rates for the other childhood vaccinations. Increasing influenza vaccine coverage rates is important not only for the health of the child, but for that of the child's household and community. Vaccinating children 6 months to 18 years of age would significantly reduce the total number of influenza cases in the US. Therefore, the Advisory Committee on Immunization Practices' current recommendation is that all children 6 months through 18 years old receive the influenza vaccine. Yet, influenza vaccine delivery rates at pediatric clinics are low, even when the vaccine is available. Influenza coverage is complicated; the vaccine is seasonal and needs to be given every year. Providers need to remember to offer it at every opportunity during the influenza season, not just during well child checks. Even when the provider remembers to offer the influenza vaccine, providers may not know how to best communicate with families about the vaccine, particularly for families reluctant to vaccinate due to fears and misinformation. Methods: The proposed project will take advantage of existing health information technology to tailor, implement and evaluate influenza vaccine alerts in the electronic health record (EHR) for pediatric providers to help improve health care decision making. The implementation of this intervention is through a network of community health centers serving primarily low-income, minority families, where children often see multiple providers and the EHR is used to facilitate high quality care despite the lack of continuity. Qualitative and quantitative methods including focus groups, in-depth interviews, and surveys of nursing and medical providers and parents, will be used in order to develop provider alerts tailored to their specifications. These alerts will be different from standard alerts in that they will include patient specific co-morbid conditions, allergies, prior influenza vaccine history, visit history and talking points to help providers better communicate with parents about influenza vaccination. The content of these alerts will conform to the health IT clinical decision support best-practices, and implementation will be coordinated with clinical sites to avoid workflow issues. Expected Outcomes: We hypothesize that these provider alerts will increase influenza vaccine delivery rates for the thousands of children seen at the intervention sites during influenza season, leading to an increase in influenza coverage rates for the whole population of children affiliated with those sites. This intervention will be created within our commercial EHR Eclipsys Ambulatory Care Manager, which is among the most common EHR applications. Therefore, knowledge discovered as a result of this study will be directly transferable to many other real-world settings. We anticipate that successful implementation and dissemination of tailored, influenza vaccine alerts could lead to the development of a new "best practice" for clinical alerts. Successful results in the field of immunizations may also pave the way for researching and deploying these types of tailored alerts for other pediatric and adult health issues.