Evaluation of the Impact of an Innovative Immunization Practice Model Designed to Improve Population Health: Results of the Project IMPACT Immunizations Pilot

Abstract

The goal of the initiative was to evaluate the impact of an innovative practice model on identification of unmet vaccination needs and vaccination rates. This was accomplished through a prospective, multisite, observational study in 8 community pharmacy practices with adults receiving an influenza vaccine with a documented vaccination forecast review from October 22, 2015 through March 22, 2016. When patients presented for influenza vaccinations, pharmacists utilized immunization information systems (IIS) data at the point of care to identify unmet vaccination needs, educate patients, and improve vaccination rates. The main outcome measures were the number of vaccination forecast reviews, patients educated, unmet vaccination needs identified and resolved, and vaccines administered. Pharmacists reviewed vaccination forecasts generated by clinical decision-support technology based on patient information documented in the IIS for 1080 patients receiving influenza vaccinations. The vaccination forecasts predicted there were 1566 additional vaccinations due at the time patients were receiving the influenza vaccine. Pharmacist assessments identified 36 contraindications and 196 potential duplications, leaving a net of 1334 unmet vaccination needs eligible for vaccination. In all, 447 of the 1334 unmet vaccinations needs were resolved during the 6-month study period, and the remainder of patients received information about their vaccination needs and recommendations to follow up for their vaccinations. Integration of streamlined principle-centered processes of care in immunization practices that allow pharmacists to utilize actionable point-of-care data resulted in identification of unmet vaccination needs, education of patients about their vaccination needs, a 41.4% increase in the number of vaccines administered, and significant improvements in routinely recommended adult vaccination rates.

Impact of student pharmacists on community influenza vaccination rates

“…When providing influenza vaccinations, pharmacists are in a perfect position to review the vaccination needs of their patients and recommend additional vaccinations that a patient may be eligible to receive. Pharmacists can contribute to the public health effort by ensuring that their patients are receiving the necessary vaccinations and staying up‐to‐date with current recommendations . Additionally, a recent study based out of an independent pharmacy in North Carolina showed an increase in the number of vaccinations given after pharmacy technicians were utilized to screen patients to determine what vaccinations they were eligible to receive.…”

“…Pharmacists can contribute to the public health effort by ensuring that their patients are receiving the necessary vaccinations and staying up-to-date with current recommendations. 18 Additionally, a recent study based out of an independent pharmacy in North Carolina showed an increase in the number of vaccinations given after pharmacy technicians were utilized to screen patients to determine what vaccinations they were eligible to receive. Through the screening of patients, it not only resulted in providing needed vaccinations to patients, but also opened the door for conversations regarding vaccinations.…”

Innovative Advances in Connectivity and Community Pharmacist Patient Care Services: Implications for Patient Safety

“…Many advances are under way to better connect community pharmacists to data that support safe patient care and facilitate collaboration with other members of the health care team . These innovations are driven by the growing provision of community pharmacist patient care services, through which community pharmacists provide care to patients across the entire medication use process.…”

“…One example of recent work around use of IIS in community pharmacy is Project IMPACT Immunizations . During the 2015–16 influenza season, eight community pharmacy practices in Washington State utilized IIS data via the ImmsLink technology interface to identify patients’ unmet vaccination needs . When patients presented to these pharmacies for their annual influenza vaccine, the IIS and its clinical decision support feature were used to forecast the patients’ additional vaccine needs.…”

“…During the 2015-16 influenza season, eight community pharmacy practices in Washington State utilized IIS data via the ImmsLink technology interface to identify patients' unmet vaccination needs. 36 When patients presented to these pharmacies for their annual influenza vaccine, the IIS and its clinical decision support feature were used to forecast the patients' additional vaccine needs. This strategy resulted in a 41.4% increase in the number of vaccines administered in the eight pharmacies.…”