Electronic health records make it easier to automatically remind patients about upcoming immunizations, but healthcare providers say barriers to using such reminders remain, according to a study published this week in the journal BMC Medical Informatics and Decision Making.
Limited financial and human resources were two of the major barriers, both for tracking paper immunization records and for getting technical assistance to use EHRs to capture information and send out reminders--without automatically generating reminders to people who already had been immunized.
Other barriers mentioned by providers included:
- Lack of reliable immunization records, patient contact information, and integrated systems to facilitate data-sharing among multiple providers.
- Concern that electronic pop-up reminders during a patient visit can add to physician overload, prompting the doctor to ignore all the messages.
- Questions about the accuracy of reminder algorithms used by various electronic records.
- Privacy issues.
- Varying expectations about the value of immunizations for different populations, and about who is responsible for reminding patients when immunizations are due.
The authors said electronic records that automatically generate computerized immunization reminders for doctors can save both time and money, but noted that some practices or geographic regions adhere to different immunization schedules, causing programming challenges.
Other challenges ensue when vaccines are administered by different providers, including public health departments and non-primary care physicians. A single regional immunization registry would help resolve that problem and reduce the risk of patients being over-immunized, the researchers said.
In researching the article, the authors combed through other studies and articles published between 1990 and 2011.
Another recent study, published in the Journal of the American Board of Family Medicine, found that standing orders in electronic health records improve patient care in a variety of areas including immunizations, screenings and diabetes care. One reason for the improvement: Nurses and other staff members don't have to wait for a doctor to examine a patient to initiate preventive-care measures.