TY - JOUR AU - Wijesundara, Jessica G AU - Ito Fukunaga, Mayuko AU - Ogarek, Jessica AU - Barton, Bruce AU - Fisher, Lloyd AU - Preusse, Peggy AU - Sundaresan, Devi AU - Garber, Lawrence AU - Mazor, Kathleen M AU - Cutrona, Sarah L PY - 2020 DA - 2020/9/25 TI -提高早期流感疫苗接接率的电子健康记录门户信息和交互式语音响应呼吁:随机对照试验JO - J Med Internet Res SP - e16373 VL - 22 IS - 9 KW -电子健康记录KW -流感疫苗接种KW -患者护理KW -患者参与AB -背景:通过电子健康记录患者门户和交互式语音应答呼叫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。我们的主要结局是2015年11月测量的2015-2016年流感季节期间电子健康记录的早期流感疫苗接种情况。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)。我们将所有非门户用户随机分配到两组中的一组:(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自我报告在诊所外完成的流感疫苗接种情况。自我报告的流感疫苗接种数据被上传到电子健康记录，以提高现有由提供者指导的电子健康记录临床决策支持(疫苗接种警报)的准确性，但被排除在主要分析之外。 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 SN - 1438-8871 UR - //www.mybigtv.com/2020/9/e16373/ UR - https://doi.org/10.2196/16373 UR - http://www.ncbi.nlm.nih.gov/pubmed/32975529 DO - 10.2196/16373 ID - info:doi/10.2196/16373 ER -