PowerPoint Presentation

Sustainable Adult Immunization Activities

Julie Morita, M.D.Medical Director, Immunization ProgramChicago Department of Public Health

1ChicagoTotal population: 2.7 million*NH-White: 45%NH-Black: 33%Hispanic: 29%

Area of Chicago: 229 square miles

* 2010 US Census2Prevention and Public Health FundAdult Initiative, CDCJuly 1, 2012-December 31, 2013Required projectsPharmaciesWorkplace

Optional projectsCommunity Health Centers

Funding: $740,0003Sustainable ActivitiesVaccinate Illinois WeekLocalized celebration of National Influenza Vaccination Week

Community Health Center (CHC) InitiativeQuality improvement interventionsVaccine provision 317, local funds

CHC 265,000Public information campaign VIW 30,0004Increase community demand for vaccinationsMass and small mediaOutreach and tracking of clients

Enhance access to vaccination services

Include interventions directed at providersEducational activities

Community Based Interventions Implemented in CombinationIndependent, nonfederal, unpaid group appointed by Centers for Disease Control and Prevention (CDC)

Members represent research, practice, and policy expertise in community preventive services, public health, health promotion, and disease prevention

5Vaccinate Illinois WeekLocal observance of National Influenza Vaccination Week, December 8 - 14, 2013PartnersState and local health departmentsProfessional organizations (ACP, AAP, AAFP, ACOG)Blue Cross Blue Shield of IllinoisPharmacies (Walgreens, CVS, Osco)Immunization coalitionMedicare QIO

6Print and Outdoor Ads RadioSocial Media

Flyer distribution (electronically, in-person)

Community Outreach

7Traditional media (Chicago)Newspapers (e.g., RedEye Sun Times, Tribune)2 million readers600,00 impressionsRadio (WGCI, WVAZ, WGRB, WNUA)19,000 listeners6 million impressionsTraditional media (outside Chicago)Several earned media interviews (radio, newspaper)N/ASocial mediaFacebook, Twitter70,000 reachedOutreachCanvassed communities, CTA transit bus and train (Red, Blue, Green and Pink) line around flu clinic sites. Also, canvassed Thompson Center and Ford City Mall before clinics. 6,126 people; 111 businesses, 459 homes

8Increasing Access to VaccinesCDPH clinics

Universities of Chicago and Illinois sitesIDPH clinics

Walgreens

Flu vaccine voucher: 28,000 Chicago area9ClinicsCommunity-based (CDPH, Walgreens, U of C)1,000 (Chicago) vaccinatedRetail pharmacies17.5% increase from 2011 (Walgreens)Illinois outside Chicago VouchersCommunity organizations receiving vouchers 11 counties (19 organizations) 1,654 vouchers distributedChicago Flu Clinic Locator

www.chicagoflushots.org

CDPH clinics, retail pharmacies including CVS, Dominicks, Osco and WalgreensMore than 2,500 visits and more than 10,000 clicks on sites. 10Provider InterventionsDisease and Vaccine UpdatesNewsletter articlesProfessional organizationsVaccines for Children ProgramBlue Cross Blue Shield of Illinois

Influenza Disease Update WebinarCDC and Families Fighting Flu speaker

11Provider educationWebinar or in person trainings300Print or electronic newsletters30,000SummaryPublic Health can bring together partners from many sectors

Partners bring resources

Coordinated and consistent messaging facilitates communication

Expansion to early and late season, 2014-201512Community Health Center (CHC) InitiativeMonthly, CDPH convened CHC staff to guide interventions and provide technical assistance

Alliance of Chicago Community Health ServicesNetwork of CHCs (7) with 15 sitesBeloved Community Family Wellness Center1 siteNear North Health Services Corporation6 sites

Alliance- vision to promote thoughtful use of health information technology in the Safety Net to promote access, improve quality and efficiency 100K ~ 50 locationsNear North Health Services 8 locations 80KBeloved Community Family Wellness Center 1 location 85K

13InterventionsQuality improvement initiatives that incorporated electronic health record (EHR) modificationsCoverage levels using EHR dataStanding orders, patient and/or provider remindersInterface with immunization information system (IIS)

CDPH provided Tdap, pneumococcal, influenza hepatitis B and zoster vaccines317 and local funds

CDPH used local and 317 funds to purchase Tdap, influenza and hep A/B vaccines for participating CHCs 14AgencySitesCoverage levelsVaccines

Interventions

InterfaceAlliance(7 CHCs)

15Pre and post intervention coverage levels determinedTdap InfluenzaPPV23Hep BZosterEducational materialsEHR huddle reports*Order sets*Patient remindersProvider reminders* TrainingCentricity ICARE in production

Beloved

1Coverage levels determined monthlyTdap InfluenzaPPV23Hep BZosterPatient remindersProvider reminders* (huddle reports, color chart flags)Standing orders*Training Next Gen ICARE *Near North

6Pre and post intervention coverage levels determinedTdap Influenza PPV23 Hep BZosterEducational materialsPatient reminders Provider reminders*Standing orders*Training

Centricity ICARE in production* Public Health Node state funded program to assist with development of interface 10 FQHCS with 48 sites participatingCDPH provided guidance for coverage level determinationsFQHCs struggled with doing thisCDPH evaluated CoCasa as potential tool for adult immunization coverage levels influenza, pneumococcal vaccines not includedCDPH created programs to determine adult immunization coverage levels will determine baseline coverage levels for clinics while they are creating own programs for their EHRs15Vaccine DistributionAgency NameHep BTdapZosterPneumoInfluenzaAlliance7051,5301,3401,5956,600Beloved025060230150Near North5201,0555651,3051,90016SummaryCHCs reluctant to invest in adult vaccine systems because vaccine supply inconsistent

CDPH provided vaccine Addressed vaccine insecurity Vaccine linked to technical assistance

CDPH will make adult vaccine available to CHCs through an application process

1. Alliance is a lead IT agency for 11 FQHCs high level of EHR support, low level of engagement of staff at individual FQHCsBeloved is a small FQHC with low level EHR support and high level of engagement of staff

2. 2/3 contracts issued

3. CoCasa to be updated. Interim solution is CDPH program. 17DiscussionHouseFlu_2010_30_RadioCDCRadio, track 11030093.281