How a Pediatric Provider Used a Data-Driven Outreach Program to Increase Vaccinations

A clinically integrated network (CIN) of pediatric providers used population health analytics tools to create outreach campaigns that cut through conflicting information and successfully encouraged parents to bring in their children for well-child visits and vaccinations.

Lurie Children’s Pediatric Partners (LCPP) is a CIN in northern Illinois that serves more than 130,000 children in six value-based commercial and Medicaid plans. LCPP was established in 2014 and its network includes 1000 physicians. The medical practices under LCPP’s network integrate 12 different electronic health records (EHR) systems and three different sets of payer claims data, but LCPP works hard to pull these records together to improve care

Due to the COVID-19 pandemic in early 2020, LCPP participants saw declines in well-child visits and vaccinations that put children at risk for delayed diagnoses and infectious diseases, and significantly impacted operations.

Population Health Analytics Conquer Challenges of Disparate Data

A CIN is an effort among physicians, in collaboration with a hospital or health system, to develop active and ongoing clinical initiatives designed to improve the quality of healthcare services and control costs. Other benefits of CINs can include sustaining independence for physicians, and positioning providers to take on higher levels of accountability to effectively manage utilization and health of populations.

Before beginning its outreach campaign, LCPP had to first analyze EHR and claims data to identify which patients had not received vaccines and needed to be contacted. However, given that LCPP’s independent physicians used so many different information systems and data sets, this was no easy task.

For example, clinical data in EHRs often was missing scheduling and vital signs data. Claims data diverged by payer, with various payers offering different file formatting and field definitions. To overcome the challenges of disparate data, LCPP invested in a population health management analytics platform that would aggregate claims and clinical data to be used for quality improvement initiatives, such as vaccine outreach.

The population health management system features five key data-access tools:

• Quality Improvement: Measure performance, compare patient panels, and generate outreach lists.
• Cost and Utilization: See patterns and trends for populations and side-by-side comparisons of data.
• Patient Management: Identify outreach and care-gap opportunities.
• Clinical Risk: Use EHR data for risk measurement.
• Data Warehouse Replica: Access a hosted copy for deeper data dives.

After aggregating and analyzing the data to determine which patients needed which vaccinations, LCPP was ready to begin its outreach campaigns.

Reaching the Right Patients Through Text Messaging

LCPP had previous experience with a phone-calling outreach campaign, which it had launched in 2018 to encourage well visits for children with asthma. The program offered several advantages, including closing gaps in care across the network, improving patient engagement in their own care and alleviating the burden on practices to perform manual outreach to their patients.

However, the program included several notable drawbacks, including that calls were made to some parents who had already scheduled an appointment, calls originated from area codes outside the location of many of LCPP’s practices, parents were less likely to answer calls from unfamiliar numbers and LCPP had difficulty measuring the effectiveness of the outreach.

To improve on previous efforts, LCPP made several changes to its 2020 and 2021 outreach campaigns, which included key initiatives to encourage well visits and flu vaccinations. The most notable adjustment was switching to text-message-based outreach as opposed to phone calls.

Leveraging data aggregated via its population health analytics platform (Arcadia), LCPP sent text messages that were linked to a “real-time” refresh of data and scheduling data availability, enabling practices to track patients who scheduled an appointment or received a vaccine – avoiding unnecessary outreach. Further, all texts were sent from the same area code as the practice location and referenced the name of the practice and/or the patient’s preferred provider.

For the well visits and immunization campaign that LCPP launched in mid-2020, nearly 700 patients with open care gaps received outreach messages. Results showed that 11% of patients who received messages made an appointment within the first week of outreach, 16% made an appointment within the first month of outreach and 47% had an encounter within three months of outreach.

LCPP’s flu vaccination campaign, launched in late 2020, demonstrated similar success. Of the nearly 2300 patients with open care gaps who received text messages through the campaign, 15% had the flu vaccine administered within one month of outreach and 28% obtained it within three months of outreach.

Lessons Learned

Among LCPP’s key lessons learned involved the importance of engaging individual practices in outreach to their own patients and using reliable data to guide decision-making. LCPP offers its practices a patient outreach tool that sends text messages to patients who meet specific criteria. However, practices can control the patients who receive texts and the frequency of texts. LCPP then administers outreach based on the text settings preferred by each practice.

To implement its data-driven strategy, LCPP adopted a model of “plan – do – study – act.” Ultimately, the goal of the initiative was to answer a pressing patient quality need and related business questions by using patient-level data to gain insights. By aggregating and analyzing the data, then following where it led to deliver needed outreach, LCPP accomplished exactly that.

Disclaimer: The views and opinions expressed are those of the author(s) and do not necessarily reflect the official policy or position of the Population Health Learning Network or HMP Global, their employees, and affiliates. Any content provided by our bloggers or authors are of their opinion and are not intended to malign any religion, ethnic group, club, association, organization, company, individual, or anyone or anything.