Tracking Vaccination Rates among HIV-Positive Patients with a Computerized Reminder System

Abstract

Objective This study deterimined vaccination rates at a Veterans Affairs HIV clinic before and after the 1997 implementation of a computerized reminder system. Methods Before implementation of a computerized reminder system, vaccinations were not always recorded on patients' medical records. After implementation, vaccinations were documented in the computer record and the system alerted providers when patients became due for a pneumococcal vaccine, tetanus booster, or other immunization. Charts for all patients (n = 211) enrolled in the HIV clinic were assessed for vaccination dates. Vaccination rates for patients (n = 71) enrolled before 1997 were compared with rates for patients (n = 140) enrolled after the computerized system was installed. The new system enabled the clinical pharmacist to monitor vaccination rates on a quarterly basis and facilitate patient appointments. Results Vaccination rates for patients enrolled before 1997 were 100% for initial pneumococcal vaccination and 100% for tetanus. Seventy-six percent of patients due for a pneumococcal vaccine booster had received it. In contrast, patients enrolled after 1997 had vaccination rates of 94% for pneumococcal vaccine; eight recently enrolled patients did not have documentation of vaccination. The clinical pharmacist scheduled these patients and the rate increased to 97%. Due to a product shortage, only 61% of patients enrolled after 1997 had received tetanus vaccine. Conclusions A computerized reminder system allows for reliable tracking of vaccination rates and can be used by pharmacists to improve preventive care for HIV-positive patients. Overall vaccination rates were well above the national norm.