Increasing Immunization Rates Utilizing Reminder and Recall systems
The COVID-19 pandemic has resulted in declining immunization rates. Pediatricians can use immunization reminder and recall systems to identify and notify families whose children are behind on immunizations (recall) or due soon (reminder). Using these systems may be one of the most powerful ways to catch up those who are behind and ensure optimal vaccination rates. Many state immunization information systems (IIS) and electronic health records (EHR)s can easily run reports that can be used by your practice to contact patients who are overdue. Building those practices into patient flow is key.
Steps to identify overdue patients may include:
- Decide on an age range to focus on, if it is not reasonable to check all patients.
- Run an IIS query for all patients in your selected age range who are 30+ days behind on vaccination.
- Run the same query in the EHR. If you are unsure about whether your EHR system has this capability, it is best to talk to your EHR vendor.
- Pull the records for everyone who came up on the lists.
- Reconcile the lists and update the EHR or IIS with missing information. Remove any patients who have moved or gone elsewhere from the list. Note that reconciliation between IIS and EHR should be done periodically.
Choosing a Reminder or Recall Strategy
Once you have a list of patients overdue or due soon for vaccines, you can start reaching out to them. Consider one or more of the strategies below. When selecting a strategy, consider the communication preferences of patients and families in your practice. What percent of patients actively utilize the patient portal? Do patients respond to mailed reminders, or are patients/families more responsive to individual phone calls? Do families find text messages more convenient?
- Phone calls placed by office staff tend to be more effective than auto-dialer calls, but often cost more in staff time.
- Auto-dialers automatically dial phone numbers and either play a recorded message or connect the call to a live person. Such systems also can be used for appointment reminders.
- Mail reminder cards or letters (“snail mail”) may be printed and provided to you by your IIS or you can pull a list from your EHR. Another approach is to have the family fill out the reminder card for the next visit (eg, dose 2 or 3 of HPV vaccine) when in your office.
- Text messages can be sent to remind parents or adolescents about vaccinations; however, they will need to “opt in”. Obtaining this permission might be easiest during a visit.
- Patient Portals are a common feature in most EHR systems. Practices can use this feature to send e-mails to patients or parents prompting them to check their patient portal, which will remind them of vaccinations that are due.