Research ArticleImpact of Electronic Point-of-Care Prompts on Human Papillomavirus Vaccine Uptake in Retail Clinics
Section snippets
INTRODUCTION
Experts recommend all U.S. children complete the human papillomavirus (HPV) vaccine at age 11–12 years. Yet, among adolescents aged 13–17 years living in the U.S., in 2016 only 43.4% of adolescents (49.5% of females, 37.5% of males) were up-to-date with the HPV vaccination series.1 This compares poorly with rates of tetanus, diphtheria, acellular pertussis vaccination (88.0%) and the first dose of meninigococcal vaccine (groups A, C, W, Y) (82.2%)—both due at age 11–12 years as well. All three
Study Population
The study sites were two similarly sized retail care clinics located in shopping areas, in Rochester, Minnesota, both owned and operated by Mayo Clinic. The retail clinics’ titles are “Mayo Clinic Express Care.” These clinics are open to the public and available to empaneled primary care patients of Mayo Clinic cared for in the Southeast Minnesota region. Empaneled patients are defined as those who have a primary care provider at Mayo Clinic. Mayo Clinic Employee and Community Health initiative
RESULTS
A total of 3,234 visits for empaneled patients ages 9 through 26 years were eligible to receive a dose of HPV vaccine. Table 1 compares the patients seen in the first 22 weeks (pre-prompt) with the patients seen after the initiation of the electronic point-of-care prompt. There were no differences between the 1,469 eligible patient visits in the pre-prompt time period and the 1,765 patient visits in the post-prompt time period in terms of age, race/ethnicity, visit site, or doses due. However,
DISCUSSION
This study demonstrates a significant increase of HPV vaccination rates in the retail clinic setting with the use of the point-of-care prompt. Patients and parents found it convenient having HPV vaccine available and helpful being reminded of HPV vaccine during the visit. This may be the first study to demonstrate the impact of a point-of-care prompt in the retail clinic setting for HPV vaccines. Studies have shown that point-of-care prompts increased HPV vaccine uptake, but none were conducted
CONCLUSIONS
This study demonstrates a significant increase of HPV vaccine rates in the retail clinic setting with the use of the point-of-care prompt that utilized the patients’ electronic medical records. The increased growth of retail clinics and using point-of-care prompts in electronic medical records provides additional opportunities for improving HPV vaccine uptake. Point-of-care prompts in the retail clinics may pave the way for addressing other lapses in routine immunizations and preventive
ACKNOWLEDGMENTS
We thank all nurse practitioners and nurses at the retail clinics for their help with the intervention and data collection. Thank you to Alicia Meek, Mayo Clinic research coordinator, with guidance in IRB process and with data entry. A thank-you to Dr. Maya Kessler, Primary Care Internal Medicine, Mayo Clinic, for providing general oversight during the intervention development and study implementation. No compensation was provided for these contributions beyond usual salary.
The Mayo Clinic
REFERENCES (18)
- et al.
Factors associated with parents’ attitudes to the HPV vaccination of their adolescent sons: a systematic review
Prev Med
(2017) - et al.
A quality improvement initiative to increase HPV vaccine rates using an educational and reminder strategy with parents of preteen girls
J Pediatr Health Care
(2014) - et al.
Systematic review and meta-analysis of interventions to improve access and coverage of adolescent immunizations
J Adolesc Health
(2016) - et al.
Communication technologies to improve HPV vaccination initiation and completion: a systematic review
Patient Educ Couns
(2017) - et al.
Patterns of use of human papillomavirus and other adolescent vaccines in the United States
J Adolesc Health
(2017) - et al.
Association of physicians perceived barriers with human papillomavirus vaccination initiation
Prev Med
(2017) - et al.
Adolescent primary care visit patterns
Ann Fam Med
(2010) - et al.
Barriers to human papillomavirus vaccination among U.S. adolescents: a systematic review of the literature
JAMA Pediatr
(2014) - et al.
A national study of HPV vaccination of adolescent girls: rates, predictors, and reasons for non-vaccination
Matern Child Health J
(2013)
Cited by (9)
Provider Focused Interventions to Improve Child and Adolescent Vaccination Rates
2021, Academic PediatricsCitation Excerpt :A study that included a combination of clinician education, EHR alerts, and performance feedback increased captured opportunities for HPV vaccine initiation by 9 percentage points.26 A point of care prompt combined with provider education increased HPV vaccination rates in retail clinics as well.27 For such prompts to be effective, they need to be directed at the right person at the right time, and be easy to respond to.25
A group decision-making approach for exploring trends in the development of the healthcare industry in Taiwan
2021, Decision Support SystemsCitation Excerpt :For example, it is difficult for groups that cannot express physical and mental sensations (e.g. infants, small children, people with severe disabilities) to communicate effectively with medical staff, so data such as body temperature, pulse rate, and blood glucose levels must be obtained through sensors. In addition, both retail clinics and telemedicine need a strong knowledge system to help determine the patient's condition [5]. Finally, we handed over the results of this study to the Ministry of Economic Affairs and medical practitioners to jointly formulate several recommendations:
Intervention to Increase Human Papillomavirus Vaccine Initiation Rates in Adolescent Males
2020, Journal for Nurse PractitionersCitation Excerpt :The EMR prompt within the health records of the cohort of interest was widely accepted and reported by the providers as the most effective part of the intervention to increase initial HPV vaccine rates. This intervention has been shown as an effective strategy to aid provider awareness of patients who require a vaccination.2,10-13 This prompt was positioned in the charts as an alert that appeared upon opening of the health record.
A systematic review of interventions to promote HPV vaccination globally
2023, BMC Public HealthEffect of immunization registry-based provider reminder to initiate HPV vaccination at age 9, Washington state
2023, Human Vaccines and Immunotherapeutics