Melissa Stockwell, M.D, Columbia University Vagelos College of Physicians and Surgeons https://ps.columbia.edu, with funding from the Agency for Healthcare Research and Quality (AHRQ), https://www.ahrq.gov began her research in 2009 with grant funding from AHRQ.
She used the funding to research how point-of-care technology could be used to improve the delivery of immunizations such as flu shots for pediatric and adolescent patients, particularly those from underrepresented communities.
Expanding the research further in her second AHRQ-funded project, Dr. Stockwell moved beyond flu alerts to reminders for all age appropriate immunizations. Her team linked centralized immunization data from New York City’s immunization information system to the local clinic’s EHR which made it easier for clinicians to have information at their fingertips while accessing patients’ records.
With instant access, local providers were able to quickly determine the immunization status of their patients and avoid over or under immunizations. This is common when patients see multiple providers, have incomplete medical records, and lack overall continuity in care. This intervention helped to improve the immunization status for all age groups.
“However, immunizations involving children with chronic health conditions may require additional vaccines beyond the normal age appropriate vaccines delivered to other pediatric patients,” according to Dr. Stockwell.
She was able to use additional AHRQ funding to test the integration of immunization data with clinical decision support at local clinics serving more than 12,000 patients. This model provided front line clinicians with instant information not only on routine immunizations, but also condition-specific immunizations, ensuring that each child received the vaccinations that were appropriate for their health condition.
Continuing to see promise in the use of technology to improve vaccinations, Dr. Stockwell began looking at using mobile technologies such as text messaging to increase vaccination rates. She used AHRQ funding to investigate how to improve completion of the HPV immunization series among predominantly Latino adolescents.
Dr. Stockwell and her team then compared conventional text messages with brief information on vaccine due dates using text messaging along with educational information. The team learned that using text messages was effective at increasing completion of the HPV vaccine series in children 9 to 17. Dr. Stockwell and the team concluded, “Basic text messages are a cost efficient intervention that can be scaled up for even wider use and be implemented to improve vaccination rates.”