@文章{信息:doi/10.2196/16373，作者=“Wijesundara, Jessica G和Ito Fukunaga, Mayuko和Ogarek, Jessica和Barton, Bruce和Fisher, Lloyd和Preusse, Peggy和Sundaresan, Devi和Garber, Lawrence和Mazor, Kathleen M和Cutrona, Sarah L”，标题=“电子健康记录门户信息和交互式语音响应呼吁提高早期流感疫苗接接率:随机对照试验”，期刊=“J Med Internet Res”，年=“2020”，月=“Sep”，日=“25”，卷=“22”，号=“9”，页=“e16373”，关键词=“电子健康记录;接种流感疫苗;病人护理;患者参与"，摘要="背景:通过电子健康记录患者门户和交互式语音应答电话提供流感疫苗接种患者提醒，为患者参与和改善患者护理提供了一种创新方法。目的:本研究的目的是测试门户网站和交互式语音应答外展在提高流感疫苗接种率方面的有效性，通过在9月初接种疫苗后不久针对患者。方法:2015年9月，利用电子健康档案门户信息和交互式语音应答电话开展流感疫苗接种推广活动。参与者包括马萨诸塞州中部一个大型多专业团体实践中的成年患者。我们的主要结果是电子健康记录——2015年11月测量的2015-2016年流感季节早期流感疫苗接种记录。我们将所有活跃的门户用户随机分配到两组中的一组:(1)接收推广流感疫苗的门户信息，列出即将到来的诊所，并提供在线疫苗预约安排(n=19,506)或(2)接受常规护理(n=19,505)。 We randomly assigned all portal nonusers to 1 of 2 groups: (1) receiving interactive voice response call (n=15,000) or (2) receiving usual care (n=43,596). The intervention also solicited patient self-reports on influenza vaccinations completed outside the clinic. Self-reported influenza vaccination data were uploaded into the electronic health records to increase the accuracy of existing provider-directed electronic health record clinical decision support (vaccination alerts) but were excluded from main analyses. Results: Among portal users, 28.4{\%} (5549/19,506) of those randomized to receive messages and 27.1{\%} (5294/19,505) of the usual care group had influenza vaccinations documented by November 2015 (P=.004). In multivariate analysis of portal users, message recipients were slightly more likely to have documented vaccinations when compared to the usual care group (OR 1.07, 95{\%} CI 1.02-1.12). Among portal nonusers, 8.4{\%} (1262/15,000) of those randomized to receive calls and 8.2{\%} (3586/43,596) of usual care had documented vaccinations (P=.47), and multivariate analysis showed nonsignificant differences. Over half of portal messages sent were opened (10,112/19,479; 51.9{\%}), and over half of interactive voice response calls placed (7599/14,984; 50.7{\%}) reached their intended target, thus we attained similar levels of exposure to the messaging for both interventions. Among portal message recipients, 25.4{\%} of message openers (2570/10,112) responded to a subsequent question on receipt of influenza vaccination; among interactive voice response recipients, 72.5{\%} of those reached (5513/7599) responded to a similar question. Conclusions: Portal message outreach to a general primary care population achieved a small but statistically significant improvement in rates of influenza vaccination (OR 1.07, 95{\%} CI 1.02-1.12). Interactive voice response calls did not significantly improve vaccination rates among portal nonusers (OR 1.03, 95{\%} CI 0.96-1.10). Rates of patient engagement with both modalities were favorable. Trial Registration: ClinicalTrials.gov NCT02266277; https://clinicaltrials.gov/ct2/show/NCT02266277 ", issn="1438-8871", doi="10.2196/16373", url="//www.mybigtv.com/2020/9/e16373/", url="https://doi.org/10.2196/16373", url="http://www.ncbi.nlm.nih.gov/pubmed/32975529" }