In response to a pandemic-fueled decline in vaccination rates in the U.S., the UTHealth Houston Healthcare Transformation Initiatives (HTI) department took a swift, proactive approach to communicate the importance of immunizations for HPV and other preventable illnesses to our patient population. In doing so, HTI also addressed the value of accurate vaccine records for patients of UT Physicians, the clinical practice of McGovern Medical School at UTHealth Houston.
Campaigns and other tools for improved HPV vaccination rates
“The pandemic had a profound impact on primary preventive care,” explains Yen-Chi Le, PhD, director of innovation and evaluations with HTI and UT Physicians. The drastic declines in well-child visits and immunization rates forced everyone in health care to think of new ways to reach patients. Research shows that the biggest predictor of HPV vaccination uptake is provider recommendation. But how does a provider give a recommendation when the patients aren’t coming into the clinics?”
To answer that question, Le and her colleagues designed an evidence-based intervention to send personalized electronic reminders that paired provider recommendation and brief education to eligible patients ages 9-25. Epic Campaigns was utilized to automate messages to patients and easily track whether patients took action after receiving an electronic reminder.
“It is a great tool to reduce human capital costs and improve care for patients,” Le said. “As a result of our HPV campaign, 18.28% patients/families took action by booking an appointment and/or receiving an HPV vaccination dose. I am grateful to leaders such as Andrew Casas, Sahar Qashqai, Dr. Robert Yetman, and Dr. Olasunkanmi Adeyinka for supporting our efforts to utilize evidence-based strategies and technology to improve the health of our patients.”
Closing preventive care gaps leads to better health care outcomes, due to higher vaccinations rates to reduce diseases, earlier diagnoses, and a reduction of chronic diseases, according to Olasunkanmi Adeyinka, MD, chief medical information officer for UT Physicians. “We are very proud of our work to utilize Epic’s Campaigns feature to reach out to patients who missed their HPV vaccinations, which led to more appointments and a higher immunization rate. This collaboration was made possible due to the strong foundational groundwork we built within Epic.”
The HTI led project was featured in an Epic Share article on closing preventive care gaps and improving population health with automated outreach. Le, along with Salim Rahimtoola and Sandra Stansberry, also presented the project at the Epic XGM conference this month. View the presentation.
Using interoperability to improve immunization accuracy
The pandemic also left health care organizations scrambling to keep accurate patient records for the worldwide response to the distribution of COVID-19 vaccines. A light was shone on the ability to provide accurate information sharing on an individual’s vaccine status for not only COVID-19, but many other immunizations recommended by physicians.
“To do that, operations including HTI worked with our colleagues in clinical technology to make the ImmTrac2 consent process easier and optimize bidirectional vaccine exchange with ImmTrac2,” said Le. “The effort included creating electronic ImmTrac2 consent forms that could be transmitted to ImmTrac2 in real time, monitoring for errors, error mapping, and work queue reviews to correct errors. This data allowed us to address vaccination errors using a centralized process.”
Brittney Townsend, BSN, RN, EHR application specialist IV with UTHealth Houston, said working on this project was very fulfilling.
“Having a nursing background, being able to bring a project like this to life firsthand, I get to see how it truly improves patient care and continuity of care in real time,” Townsend explained. “When I was in nursing, relying on accurate immunization cards or waiting on medical records for up-to-date immunization history could delay patient care. With the bidirectional interface, vaccine administration is documented in Epic files to the registry. Additionally, with the click of a button, users can ad hoc query the ImmTrac2 registry from within Epic to provide a more accurate picture of the patient’s immunization history.”
This project will be highlighted Tuesday, May 16, by Brittney Townsend and Rajesh Dikonda at the Epic XGM conference. View the presentation.
In support of these initiatives, funding was provided by the UTHealth Houston Academic Excellence Endowment and donors to The University of Texas MD Anderson Cancer Center’s Annual Fund.