August 17, 2015

Tdap booster vaccine rates triple using automated reminders

A family medicine study finds that an electronic reminder system helped boost rates of vaccination against tetanus, diphtheria, and whooping cough.

Vaccination rates for a critical booster shot tripled after clinics began using electronic prompts alerting them of patients needing the Tdap vaccine that protects against tetanus, diphtheria, and whooping cough, according to a new study from the University of Michigan Health System.

The results appear in the American Journal of Public Health.

Grant Greenberg, MD, MHSA, MA
Grant M. Greenberg, M.D. M.H.S.A., M.A.

“This research shows how technology can be used to dramatically change the way preventive services are delivered and improve preventative health care,” says senior author Grant M. Greenberg, M.D., M.H.S.A., M.A., assistant professor and associate chair for information management and quality and member of the U-M Institute for Healthcare Policy and Innovation.

The Tdap vaccine protects against serious, life-threatening diseases, including tetanus, diphtheria (which can lead to heart failure, breathing problems, paralysis, and death) and whooping cough (pertussis).  Guidelines recommend that adolescents and adults ages 11 and up receive a single dose of the Tdap vaccine for booster immunization even if they have had a Td (tetanus and diphtheria) vaccine within the past 10 years.

The electronic prompt-and-reminder system was developed at five U-M family medicine clinics to identify patients 11 to 64 years old who were in need of the Tdap booster vaccine between 2008 and 2011.

Tdap vaccination rates among patients seen and who had not yet received one  increased from roughly 16 to 47 percent within U-M family medicine clinics that used the system while other clinics saw vaccine rates increase from 14 to 30 percent.

“Today’s primary care environment requires managing complex immunization schedules and meeting the growing demands of caring for a large and often sick patient population,” says lead author Cameron G. Shultz, Ph.D., M.S.W.

“We found that when boosters were administered and documented automatically, as a routine part of care, this dramatically changed and improved preventive care services. These types of changes may potentially also help improve outcomes for other health initiatives, including preventive care, disease screening, and chronic disease management.”

Additional Authors: Jean M. Malouin, M.D., M.P.H and Melissa Plegue, M.A., both of U-M, and Lee A. Green, M.D., M.P.H., professor emeritus with U-M’s Department of Family Medicine and Chair of Family Medicine at the University of Alberta.

Disclosures: None

Reference: “A Systems Approach to Improving Tdap Immunization Within 5 Community-Based Family Practice Settings: Working Differently (and Better) by Transforming the Structure and Process of Care,” Aug. 13, 2015, American Journal of Public Health.