JMIR Publications

ABSTRACT

Background:

Physician-prompting is shown to increase the provision of preventive care services in general.28 However, the evidence of the effect of prompts on improving adolescent vaccine rates has not been consistent.

Objective:

To assess the effect of an electronic medical record (EMR) clinical decision prompt on HPV vaccination rates in the clinic setting.

Methods:

We employed a quasi-experimental design with a retrospective chart audit to evaluate the effect of a clinical decision prompt in improving HPV immunization rates in different specialty settings. We introduced an EMR prompt to remind providers to recommend the HPV vaccine when seeing appropriate patients in an Obstetrics & Gynecology, Pediatrics, and Family Medicine clinic in a large multispecialty academic group located along the Texas-Mexico border. We assessed HPV vaccination rates in all the departments involved before and after introducing the prompts. Participants included male and female patients between the ages of 9 and 26, presenting at the clinics between January 2014 and December 2015.

Results:

We reviewed over 2,800 charts in all three clinics. After adjusting for age, ethnicity, race, type of insurance, preferred language, and clinic, the odds of immunization was 92% (p:< .0001) higher in patients after the EMR prompt implementation. Rates of improvement varied by specialty clinic, with pediatrics seeing the most substantial increase with an adjusted odds ratio of 4.01(2.8, 5.8). HPV vaccination rates statistically improved in our pediatric and family medicine clinics after implementing the EMR prompt.

Conclusions:

Prompts in the electronic medical record are useful in increasing HPV vaccination rates in multiple specialties and are a low-cost intervention for improving vaccination rates.