Article Title

System Alignment for VaccinE Delivery (SAVED): A Technology-Based Intervention to Improve Influenza and Pneumococcal Vaccination

Publication Date



flu vaccine, patient portal


Background/Aims: Influenza and pneumococcal vaccines are beneficial but underutilized. Using health information technology and patient self-reported data within our Epic electronic health record (EHR), we aim to improve rates of influenza and pneumococcal vaccination in a large multispecialty group practice in central Massachusetts.

Methods: We have undertaken a multifaceted vaccine promotion program with patient-, provider- and system-level components. We conducted patient, physician, nurse and medical assistant qualitative interviews to inform development of provider educational materials and patient outreach materials. Provider education was delivered via in-person brief presentations at practice sites given by research team physicians (respected members of the group practice). Patient outreach will target patients eligible but overdue for influenza vaccine (some are also overdue for pneumococcal vaccine). In November 2014, we will randomize 20,000 patients who are active users of electronic patient portals to (a) receipt of a portal message providing education and access information on flu and pneumococcal vaccines, (b) receipt of an interactive voice recognition (IVR) call with similar content, (c) both, or (d) neither (usual care). Patients without electronic portals (10,000 patients) will be randomized to (a) receipt of IVR call, or (b) usual care. Both outreach methods will invite patients to report receipt of flu vaccines outside of the medical group and will automatically update the EHR with self-reported vaccine completion (increasing accuracy of existing EHR provider alerts). Both methods will (a) use questionnaires to elicit barriers for unvaccinated patients, and (b) deliver information targeted to patient concerns.

Results: We are using multilevel interventions and technological innovation to increase rates of recommended vaccine completion in our population and to improve the accuracy of existing provider-directed EHR vaccine alerts. To date, factors contributing to success include (a) research team’s inclusion of physician thought-leaders well-known within the practice; and (b) alignment of study goals with the mission of the group practice (improving delivery of preventive care, improving accuracy and efficiency of EHR without interfering with workflow, and achieving meaningful use goals by inviting patient communication via e-portals).

Discussion: Aligning our research with the existing goals and values of the medical group practice has yielded effective collaborations and facilitated project success.




April 1st, 2015


April 28th, 2015