Note to flu-shot makers: EHR reminders for doctors could boost vaccination rates

Combining the "active choice" mechanism with electronic health record could help boost vaccination rate.

Flu vaccination rates have been far from ideal in recent years, but a new study suggests that physician prompts on electronic health records could make a big difference.

Scientists at the University of Pennsylvania's Perelman School of Medicine used EHRs to alert physicians when a patient was eligible for flu vaccination. The EHR prompts, which drew on a behavioral economics technique, were designed to push care providers to not only discuss flu shots, but also to push for a “yes” or “no” decision.

According to study results published in the Journal of General Internal Medicine, flu vaccinations increased by 6% during the 2012-13 flu season at a clinic that used the online alert system, compared with two clinics in a control group. That represented a 37% relative increase in flu vaccinations from the previous year.

The CDC estimates that only 41.7% adults in the U.S. received flu vaccines during the 2015-16 flu season. The agency also estimates that, if vaccination coverage had increased by 5 percentage points among adults aged 18 to 64 years, 300,000 additional influenza cases and 2,000 additional hospitalizations could have been prevented.

“Our results indicate that this simple intervention could be an effective and scalable approach to use the design of electronic health records to increase the rate of flu vaccinations,” study lead author Mitesh Patel said in a press release.

After the positive finding, Penn Medicine tweaked and expanded the approach to all of its outpatient clinics, according to the press release.

RELATED: Looking to sales growth, Merck rolls out vaccine adherence plan

Pop-up alerts in EHRs actually are not a new trick for vaccination promotion. Merck & Co., for example, sponsored a similar approach for use in Practice Fusion—another EHR management tool—to remind patients of vaccinations. That program rolled out in 2014, included 20,000 healthcare providers over four months, and it triggered a 73% relative increase in vaccinations compared with a control group of patients.

Practice Fusion, with the help of Pfizer, recently implemented in its EHR platform an influenza and pneumococcal vaccination alert program for older patients. During a five-month period, the program helped achieve a year-over-year 113% increase in pneumococcal vaccine administration and 33% increase in flu vaccine uptake, according to a white paper put forward by the company.

Ogilvy CommonHealth Worldwide, in a seminar for its pharma and healthcare clients last year, also stressed the potential for EHR communications.

Editor's note: The story's been updated with Practice Fusion's EHR vaccine alert program result from February.