736. Electronic Medical Record Based Automated Inpatient Screening Tool for Targeted Pneumococcal Immunization with PCV13 and PPSV23 in High Risk Patients
Session: Poster Abstract Session: Vaccines: Improving Delivery
Thursday, October 27, 2016
Room: Poster Hall

Background: In 2012 the Advisory Committee on Immunization Practices (ACIP) recommended using both pneumococcal conjugate vaccine (PCV13) and polysaccharide vaccine (PPSV23) for people aged 19-64 years old with certain medical conditions. The vaccine schedule can be challenging for healthcare workers and patients alike. In 2013, we developed an automated screening tool using our inpatient electronic medical record (EMR) in order to optimize pneumococcal immunization in high risk conditions as defined by the ACIP 2012 recommendations. The purpose of our study was to evaluate the effect of this intervention on immunization of patients with high risk of developing invasive pneumococcal disease (IPD), including PCV13.

Methods: We reviewed yearly pneumococcal vaccine utilization data in high risk patients aged 18-64 admitted to Westchester Medical Center from 2012 to 2015. 

Results: A total of 1142 patients were identified as being at risk conditions (Table 1).  Implementation of our screen appears to steadily increase vaccine administration with each successive year. Also, there was an increased utilization of targeted PCV13 after using the automated screen (Figure1).

Year

2012

2013

2014

2015

At Risk Conditions

202

232

380

328

PCV13

0

1

37

37

PPSV23

63

81

183

222

Total

63

82

220

259

%

31%

35%

58%

79%

Table 1: Patients with at risk conditions who received vaccine

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Figure 1: Number of patients vaccinated with PPSV23 vs PCV13

Conclusion: We demonstrated that automated pneumococcal immunization via the EMR was able to increase immunization rates. This is important given the complexity of both screening for patients at risk for invasive pneumococcal disease and giving PCV13 and PPSV23 in the recommended sequence. Our data also show increased targeted use of PCV13 based on the current ACIP recommendations. The data were unable assess appropriateness of vaccine utilization in all patients. They do not account for an individual provider’s judgment which may reduce vaccine administration, as in cases of deferment due to illness. We hope to expand the automated screening tool to include the newer ACIP guidelines for the elderly. This intervention could be broadened to other immunization practices.

Stephen Lobo, MD, Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY and Abhay Dhand, MD, Transplant Infectious Diseases, Westchester Medical Center, Valhalla, NY

Disclosures:

S. Lobo, None

A. Dhand, Pfizer: Speaker's Bureau , Speaker honorarium

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