Evaluation of the Impact of an Innovative Immunization Practice Model Designed to Improve Population Health: Results of the Project IMPACT Immunizations Pilot

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Abstract
The goal of the initiative was to evaluate the impact of an innovative practice model on identification of unmet vaccination needs and vaccination rates. This was accomplished through a prospective, multisite, observational study in 8 community pharmacy practices with adults receiving an influenza vaccine with a documented vaccination forecast review from October 22, 2015 through March 22, 2016. When patients presented for influenza vaccinations, pharmacists utilized immunization information systems (IIS) data at the point of care to identify unmet vaccination needs, educate patients, and improve vaccination rates. The main outcome measures were the number of vaccination forecast reviews, patients educated, unmet vaccination needs identified and resolved, and vaccines administered. Pharmacists reviewed vaccination forecasts generated by clinical decision-support technology based on patient information documented in the IIS for 1080 patients receiving influenza vaccinations. The vaccination forecasts predicted there were 1566 additional vaccinations due at the time patients were receiving the influenza vaccine. Pharmacist assessments identified 36 contraindications and 196 potential duplications, leaving a net of 1334 unmet vaccination needs eligible for vaccination. In all, 447 of the 1334 unmet vaccinations needs were resolved during the 6-month study period, and the remainder of patients received information about their vaccination needs and recommendations to follow up for their vaccinations. Integration of streamlined principle-centered processes of care in immunization practices that allow pharmacists to utilize actionable point-of-care data resulted in identification of unmet vaccination needs, education of patients about their vaccination needs, a 41.4% increase in the number of vaccines administered, and significant improvements in routinely recommended adult vaccination rates.

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