1. National Immunization Partnership with the Academic Pediatric Association (NIPA) CDC Grant # 1H23IP000950

2. Agenda Attendance CORNET Data Implementing Provider Prompts How do you use prompts for acute visits/well visits? Midpoint – QI Lead/Site Champion scheduling a call February 2016 LC schedule Any questions?

4. Total Missed Opportunities

5. Percent of MOs by Visit Type

6. Reason Not Vaccinated

7. Implementing Provider Prompts Identify what provider prompt will be used Manual – staff assess immunization status and set prompts Paper-based: memos, stickers, VIS statement, etc EMR-based: vaccines needed written in visit note Computer-based – computerized algorithms to identify eligible patients Staff initiated: EHR or state registry, staff place generated prompt in the patient chart Computerized, entirely electronic: computerized algorithms identify eligible patients, and prompts are provided upon access to the EHR

8. More Implementation… Map out the process of prompting from the determination of vaccine eligibility through giving the vaccine Pay particular attention to communication between providers, nurses and staff Including: Identify who will determine HPV vaccine eligibility and who will place prompt (nurse, MA, administrative staff, other) Verbal reminder from clinic/practice staff Visual cues (exam room flag, exam room light, other)

9. It Takes More Than a EHR Reminder The reminder should include the entire office All providers must be in agreement about the schedule, strength of recommendation, and vaccinating at acute visits It must be accurate and clear Data used to trigger alert must be accurate The alert needs to be present at the right time, to the right person Too many alerts leads to ‘alert fatigue’

10. Barriers to Electronic Reminders Coordination between nurses and providers (also in removing prompt once complete) Addressing reminders while not with patient (documentation completed after patient gone) Workload (too time consuming) Lack of flexibility (not applicable) Poor usability (not enough options)

12. QI Lead/Site Champion scheduling a call

13. January Data is due February 5 th ! Learning Collaborative Schedule: Tuesday 2/23 @ 8am ET/ 7am CT/ 6am MT/ 5am PT Tuesday 2/23 @ Noon ET/ 11am CT/ 10am MT/ 9am PT Wednesday 2/24 @ 3pm ET/ 2pm CT/ 1pm MT/ Noon PT

14. Please contact: Nui Dhepyasuwan, MEd Phone: 703/556 9222 x103 I Fax: 703/556 8729 Email: nui@academicpeds.orgnui@academicpeds.org Holly Tyrrell, MSSW Phone: 703/556 9222 x113 I Fax: 703/556 8729 Email: hollyce@academicpeds.orghollyce@academicpeds.org

15. Questions?