Issue link: https://beckershealthcare.uberflip.com/i/821337
87 Executive Briefing more likely to see disease and illness spread in cases where vaccines could have prohibited their contraction. The rate of hospitalizations for influenza was double in neighborhoods with at least 20 percent of households below the fed- eral poverty level compared to the rate among neighborhoods where less than 5 percent lived below the poverty line, according to a 2016 study in the CDC's Morbidity and Mortality Weekly Report. Most market place health plans are re- quired to offer coverage for various pre- ventive health services — including im- munizations — eliminating a vaccine cost barrier Americans previously experienced. Still, many adults don't take advantage of this opportunity partly because they them- selves may not perceive its benefit. "The value [for patients] is that, relatively speaking, immunizations have a very low cost based upon the value you receive," says Dr. Bulger. "The value lies in not ex- periencing the secondary complications related to illness like missing work or ending up in the hospital, which can be very costly. What you save by getting a vaccine is really very significant." For this reason, it's important for provid- ers to communicate the value of immuni- zations to patients and encourage them to comply with best-practice vaccination recommendations. Previous studies have shown clinician encouragement can sig- nificantly influence whether an adult pa- tient decides to get a vaccine. One 2014 study of flu vaccination rates found adult immunization rates across ethnic groups could increase 50 percent or more if providers offered to administer flu shots more frequently, according to the Journal of General Internal Medicine. How hospitals and health systems can boost adult immunization Hospitals and health systems can take three steps to begin improving adult immuniza- tion rates in the communities they serve. 1. Population-level assessment. "The first thing to do is understand your own data and the population you're trying to serve," says Dr. Bulger. "If there's a gap between the number of patients and the number of people in your population who want to vaccinate, then you can ask what are the barriers to vaccines — is it cost, is it conve- nience — and take steps to address those barriers." This involves using health data to measure incidence of illness within a certain population, as well as the distribu- tion of illness within the region. 2. Get involved in trade associations. Dr. Bulger recommends hospitals and health systems join trade associations that pro- vide resources and support designed to boost adult immunization rates. By partic- ipating in these peer groups, health sys- tems can gain valuable insight into best practices, effective intervention strate- gies and thought leadership. 3. Leverage interdisciplinary partnerships. Forming teams of providers from across disciplines to champion and implement new care strategies is essential to ensure the success of any hospitalwide initiative. Increasing the rates of adult immuniza- tion is ultimately going to occur at the provider-patient interaction level. Teams comprised of physicians, nurses and pharmacists can help entrench new care approaches into the workplace culture. Adult immunization strategy in action AMGA is an example of an organization that has helped members make substantial improvements in adult immunization rates. From February 2015 to April 2016, the AMGA conducted the Adult Immuniza- tion Best Practices Learning Collabora- tive. The 14-month pilot program was focused on improving rates of pneumo- coccal vaccines among patients 65 years of age and older per CDC guidelines. The initiative enrolled seven member organizations and used the Optum One population health analytics platform to enable providers to identify vaccine can- didates and track immunization rates. "The first thing that these groups all did was measure. They took an inventory and asked what is our flu vaccine rate both in our senior patient population and other high-risk patient groups," says Dr. Penso, who leads best practices learning col- laboratives for more than 400 member groups in his role at AMGA. "Then they formed multidisciplinary teams — which could consist of pharmacists, physicians and nurses — to work together to change work flows to address the issue." Changes at participating organizations included gearing EMR alerts to notify providers of patients who may be due for vaccination. The overall strategy, accord- ing to Dr. Penso, was threefold: • Measure • Form care teams • Redesign care The pilot program successfully increased rates of compliance with CDC's pneumo- coccal vaccine guidelines across the col- laborative organizations from 4 percent to 34 percent, collectively. This percentage increase is representative of approximate- ly 190,000 additional patients vaccinated. Based upon the success of this pilot pro- gram, AMGA Foundation and Optum — with the support of Pfizer — launched an expanded collaborative effort this year. "We're working with 40 of our groups right now," says Dr. Penso in reference to the expanded collaborative. "Hundreds of thousands of patients will benefit from this program." Health systems and hospitals can also get involved with coalitions working to facili- tate the sharing of best practices in regards to adult immunizations. From May 9-11, the Immunization Action Coalition hosted the National Adult and Influenza Immuni- zation Summit in Atlanta. At the summit, experts gathered to discuss strategies and difficulties pertaining to the improvement of adult influenza vaccination in a rapidly changing healthcare environment. [Note: Becker's will be publishing a whitepaper in the near future on the key discussions and takeaways from the event.] Addition- ally, the summit's website provides access to adult immunization resources, including information on how to properly code and bill for adult vaccinations. A call to action While adult immunization rates have been historically low, the emphasis on improving health value for patients is driving hospi- tals and health systems to find new ways to intervene. Low rates of adult immuniza- tion should no longer be accepted as the status quo. It's time for hospitals and health systems to take advantage of the resourc- es available to improve vaccination rates among their adult patient populations. n The Immunization Action Coalition (IAC), a 501(c)(3) non-profit organization, is the nation's premier source of child, teen, and adult immuniza- tion information for healthcare professionals and their patients. IAC works to increase immunization rates and prevent disease by creating and distributing educational materials for health professionals and the public that enhance the delivery of safe and effective immunization services. The National Adult and Influenza Immunization Summit (NAIIS) is a year round partnership which includes an annual meeting. The NAIIS is dedicated to addressing and resolving adult and influenza immunization issues and improving the use of vaccines recommended by CDC's Advisory Committee on Immunization Practices. The NAIIS consists of over 700 partners, representing more than 130 public and private organizations.