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Electronic Reminders Increase Tdap Booster Rates in Practices Using Them

ANN ARBOR, MI – Patients were significantly more likely to get a critical booster shot if their healthcare providers received an electronic nudge that they needed one, according to a new study.

Electronic reminders used at University of Michigan Health System clinics helped increase rates of the Tdap booster, which protects against tetanus, diphtheria, and whooping cough, reported the study published recently in the American Journal of Public Health.

Adolescents and adults ages 11 and up should receive a single dose of the Tdap vaccine for booster immunization even if they have had a tetanus and diphtheria vaccine within the past 10 years, practice guidelines state.

Thanks to the electronic prompt-and-reminder system, 76% of 31,195 patients ages 19-64 and 85% of 3,278 patients aged 11-18 were up-to-date on their immunization, according to study authors from the University of Michigan Medical School. That was compared to 59% of a similar cohort of adults during the same time period in clinics within the same health system that did not use the automated prompts.

"This research shows how technology can be used to dramatically change the way preventive services are delivered and improve preventative health care," senior author Grant M. Greenberg, MD, said in a University of Michigan Health System press release.

The electronic prompt-and-reminder system was developed at five U-M family medicine clinics to identify patients 11-64 years old who were in need of the Tdap booster vaccine between 2008 and 2011. Among patients visiting the clinics who had not received their boosters, Tdap vaccination rates increased from about 16% to 47%, while the clinics not using reminds saw increases from 14% to only about 30%.

"Today's primary care environment requires managing complex immunization schedules and meeting the growing demands of caring for a large and often sick patient population," explained lead author Cameron G. Shultz, PhD, MSW. "We found that when boosters were administered and documented automatically, as a routine part of care, this dramatically changed and improved preventive care services. These types of changes may potentially also help improve outcomes for other health initiatives, including preventive care, disease screening, and chronic disease management.”