Charged with leading the immunization initiative,
Nissen and Aaron West, Novant Health’s director
of safety, analyzed performance reports pulled
from the electronic health records (EHR) system
(Epic Healthy Planet) which showed which clinics
had the highest immunization rates. Once they
identified the top 10 sites, Nissen and West held
conference calls and webinars with those sites to
understand what they were doing to produce such
positive results. From these meetings, five best
1 Address gaps in care at every visit. If a patient comes in with, say, a hurt ankle, and
the EHR indicates that a vaccination is due, notify
the physician and place the vaccination order, if
appropriate. In contrast, low-performing clinics
neither immunized during sick visits nor scheduled
follow-up visits to administer vaccines.
2 Use a team approach. Improving immuniza- tion rates is everyone’s job, from the
appointment scheduler to the medical assistant
to the physician. For example, top-performing
clinics encourage all staff to remind patients of
the importance of vaccination. If a patient declines
a vaccine, the physician will then have an additional conversation with that patient.
3 Engage in pre-visit planning. For well-child visits and annual physicals, do not wait until
the patient’s arrival to determine which immunizations are needed. Pre-visit planning includes
reviewing the patient’s record in the state immunization registry.
4 Use EHR Best Practice Alerts (BPAs) consistently. Paying attention to BPAs
coupled with health maintenance topics is
standard practice to identify the patient’s
5 Use the EHR registry to bring in attributed patients. Remind patients who are due and
recall patients who are overdue for a well visit,
and get those patients immunized.