High-risk Influenza Vaccine Alert

Not Applicable

Completed

Interventions: Behavioral: Alert
Behavioral: Salient alert features
Behavioral: High-risk Text
Behavioral: Risk factors

Brief Summary: The purpose of this study is to assess, prospectively, the effect on flu vaccination rates of salient alerts in the electronic health record that indicate a patient's high risk for flu and its complications. The investigators hypothesize that the salient alerts will lead to increased flu vaccination compared with a standard flu alert.

Detailed Description: The CDC (Centers for Disease Control) recommends a flu vaccination to everyone aged 6+ months, with rare exception; almost anyone can benefit from the vaccine, which can reduce illnesses, missed work, hospitalizations, and death. One barrier to vaccination is a lack of "cues to action," and, in particular, the lack of direct recommendation from medical personnel; this barrier is arguably the most effectively overcome by a simple nudge of clinicians, compared with barriers such as negative attitudes toward vaccination, low perceived utility of vaccination, and less experience with having received the vaccine.

Geisinger partnered with Medial EarlySign (Medial) to develop a machine learning (ML) algorithm to help identify people at risk for serious flu-associated complications based on existing electronic health record data. Eligible at-risk patients will be randomized to an active control group (clinician will be shown a standard flu alert) or one of two experimental groups (clinician will be shown an alert indicating patient's high risk, with or without describing the patient's factors contributing to that risk).

Recruitment & Eligibility

Inclusion Criteria

Age 18+
Have been determined to be in the top 20% of risk through Medial's ML algorithm
Attend an appointment where the flu alert fires (Geisinger sets when flu alerts start and end--between ~9/1/2022 and ~4/30/2023, as well as the trigger conditions for the alert, which includes valid departments and visits and excludes contraindications like Guillain-Barre syndrome)

Clinician Inclusion Criteria:

Any Geisinger clinician who sees patient-participants in our study for an appointment where their flu shot alert fires

Exclusion Criteria

Not provided

Arm && Interventions

Group	Intervention	Description
High-risk Alert	High-risk Text	Flu alert that indicates patient is at high risk for flu and its complications
High-risk Alert with Risk Factors	Alert	Flu alert that indicates patient is at high risk for flu and its complications and presents the factors contributing to this high risk
High-risk Alert with Risk Factors	High-risk Text	Flu alert that indicates patient is at high risk for flu and its complications and presents the factors contributing to this high risk
Standard Alert	Alert	Standard flu alert
High-risk Alert with Risk Factors	Salient alert features	Flu alert that indicates patient is at high risk for flu and its complications and presents the factors contributing to this high risk
High-risk Alert	Alert	Flu alert that indicates patient is at high risk for flu and its complications
High-risk Alert	Salient alert features	Flu alert that indicates patient is at high risk for flu and its complications
High-risk Alert with Risk Factors	Risk factors	Flu alert that indicates patient is at high risk for flu and its complications and presents the factors contributing to this high risk