The impact of a computerized physician reminder and a mailed patient reminder on influenza immunizations for older patients.

PURPOSE

To examine the impact of a computerized physician reminder in combination with a mailed patient reminder on the rate of influenza immunizations for older adults in a large family medicine office in Delaware.

METHODS

In July of 1998, the Christiana Care Foulk Road Family Medicine Center (FMC) implemented an electronic patient record which included automated physician reminders for when influenza immunizations and other preventive interventions were due. In addition, FMC patients ages 65 years and older were sent a mailing urging them to receive an influenza immunization in 1998. Medical records were reviewed for active FMC patients ages 65 and older. Rates of receipt of influenza immunization were compared for the year before (1997) and after (1998) these two interventions were implemented. A secondary analysis compared influenza immunization rates for three different age groups (65-74 years, 75-85 years, over 85 years).

RESULTS

For the 344 patients in the main study population, influenza immunization rates increased from 50.4 percent in 1997 to 61.6 percent in 1998 (p < 0.001). Immunization rates were lowest for persons over age 85 years, and rates increased significantly in the two younger groups but not in those over age 85 years.

CONCLUSIONS

This study indicates that the use of a computerized physician reminder and a mailed patient reminder had a positive impact on influenza immunizations for older adults in a large family practice office. This combination strategy resulted in immunization rates that exceed published national goals, although there is still room for improvement, particularly for the oldest age group. These results support the notion that electronic patient records (EPRs) and other computerized reminder systems can significantly improve quality of care in office based settings.