%0期刊文章@ 1438- 8871% I JMIR出版物%V 22%卡塔尔世界杯8强波胆分析 N 9% P e16373% T电子健康记录门户信息和交互式语音应答呼叫以提高早期流感疫苗接种率:随机对照试验%A Wijesundara,Jessica G %A Ito Fukunaga,Mayuko %A Ogarek,Jessica Barton,Bruce Fisher,Lloyd Preusse,Peggy Sundaresan,Devi Garber,Lawrence Mazor,Kathleen M %A Cutrona,Sarah L +创新中心，Edith Nourse Rogers纪念医院，退伍军人健康管理局，美国马萨诸塞州贝德福德，01730,70号楼，1 508 856 4046，Sarah.Cutrona@umassmed.edu %K电子健康记录%K流感疫苗接种%K患者护理%K患者参与%D 2020 %7 25.9.2020 %9原始论文%J J医学Internet Res %G英文%X背景:通过电子健康记录患者门户网站和交互式语音响应呼叫传递的流感疫苗接种患者提醒，提供了一种创新方法来吸引患者并改善患者护理。目的:本研究的目的是测试门户网站和交互式语音应答外联在提高流感疫苗接种率方面的有效性，方法是在9月初疫苗接种可用后不久以患者为目标。方法:使用电子健康记录门户信息和交互式语音响应电话促进流感疫苗接种，于2015年9月开展外展活动。参与者包括马萨诸塞州中部一个大型多专科小组的成年患者。我们的主要结果是电子健康记录，记录了2015-2016年流感季节的早期流感疫苗接种，测量时间为2015年11月。我们将所有活跃的门户用户随机分配到两组中的一组:(1)接收宣传流感疫苗的门户消息，列出即将到来的诊所，并提供在线疫苗接种预约(n=19,506)或(2)接受常规护理(n=19,505)。我们将所有非门户用户随机分为两组:(1)接受交互式语音应答呼叫(n=15,000)或(2)接受常规护理(n=43,596)。干预措施还要求患者在诊所外完成流感疫苗接种的自我报告。 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 %M 32975529 %R 10.2196/16373 %U //www.mybigtv.com/2020/9/e16373/ %U https://doi.org/10.2196/16373 %U http://www.ncbi.nlm.nih.gov/pubmed/32975529