Use of Clinical Decision Support to Increase Influenza Vaccination: Multi-year Evolution of the System

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This article studies the use of CDS to increase flu vaccinations. [1]

First Review

Background

This study talks about how CDS improved compliance with influenza vaccinations over 3 seasons during implementation of an EMR.

Methods

Stroger Hospital implemented Cerner and studied how CDS improved influenza vaccination. During Year 1, CPOE was not yet available for medications so orders were on paper. They used a preselected order set to order the flu vaccine. In Year 2, nurses used an electronic kardex to view their task list. In Year 3, medication CPOE was active and medications were routed to an eMAR.

Results

Over the 3 seasons, as CDS functionality improved, there was also a significant increase in patient flu vaccination. Year 1 = 0/36 Year 2 = 8/66 Year 3 = 286/805

Conclusion

There are several ways of using CDS. Having it for both the physicians and nurses increase compliance significantly. Over time the physicians were more accepting of pre-selected vaccination orders. In order to have a successful CDS implementation one must look at the workflow and culture of the organization.[1]

Comments

As our technology advances, CDS should be used to help ensure compliance. But at the same time, we should also consider the possibility of alert fatigue.

Second review

Background

Successful utilization of CDS has been proven to improve patient care but some believe proper infiltration has not been recognized. This article explores the use of technology specifically to "increase influenza vaccination."

Methods

During an Electronic Medical Record Implementation (EMR), CDS was used to set a criteria for patients who are due for an [[1]]influenza vaccination. Over a three year period, standing orders, pre-selected physician orders, and provider reminders were evaluated.

Results

This use of CDS increased physician acceptance to pre-selected vaccination orders.

Conclusion

Incorporating CDS into health care settings can have positive results. CDS in this case made patients more aware and have a better opportunity to get vaccinated and potentially avoid catching the flu.

Comments

This was a great way to use CDS in a hospital setting. I would hope ambulatory clinics have adopted similar uses of CDS in their environments. This was a perfect example of how the use of EHRs, EMRs & CDS really do improve patient care.

References

  1. 1.0 1.1 Mary N. Gerard , William E. Trick , Krishna Das , Marjorie Charles-Damte , Gregory A. Murphy , Irene M. Benson. Use of Clinical Decision Support to Increase Influenza Vaccination: Multi-year Evolution of the System. Journal of the American Medical Informatics Association Nov 2008, 15 (6) 776-779. http://jamia.oxfordjournals.org/content/15/6/776