Introduction and Objective: Efforts to improve influenza vaccination rates among patients with diabetes can be enhanced with accurate documentation of vaccination status in the electronic medical record (EMR). This quality improvement project aimed to identify factors contributing to inaccurate vaccination status in the EMR documentation.Methods: Ambulatory patients with diabetes presenting for routine follow up were included. We conducted a workflow assessment at the beginning of the 2023/2024 influenza season. We identified and implemented a modification to our patient rooming process to incorporate routine assessment of influenza vaccination status. We established protocols to allow our clinic staff to recommend, administer or refer patients for influenza vaccination when indicated. At the end of the influenza season, we downloaded vaccination status information from our EMR. We then conducted manual EMR review and queried the State Immunization Information System (IIS) to reconcile vaccination information with the EMR.Results: Out of 803 patients evaluated, 186 (23%) had influenza vaccination documented on the downloaded EMR records (initial vaccination rate). Chart review and IIS query revealed that for the remaining 617 patients, 214 had influenza vaccination documented in the IIS while 367 did not. The records of 36 patients were not found on the IIS. Hence, our final vaccination rate was 49.8% (186 plus 214 patients) for the influenza season. The reasons for the lower initial vaccination rate included – IIS record was not up to date at the time of the clinic visit (123 patients), staff did not query the IIS during the visit (65 patients) and vaccination was administered after the clinic visit (26 patients).Conclusion: Efforts to improve accuracy of influenza vaccination status documentation should include incentivizing timely update of the IIS by vaccine providers and improving data exchange between the IIS and EMR to reduce the need for manual reconciliation.
N. Delcid: None. K.K. Mercado: None. K. Izuora: Research Support; Novo Nordisk.
Specialty Societies Advancing Adult Immunizations Grant, funded by the CDC and coordinated through the Council of Medical Specialty Societies.
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