08 May Office Practicum Medical Director, Dr. Kressly Uses Health Information Exchange to Improve Pediatric Immunization Rates
Dr. Susan Kressly is founder and President of Kressly Pediatrics, a three-physician National Committee for Quality Assurance Level 3 Patient-Centered Medical Home in Warrington, Pennsylvania. Due to her desire to integrate technology into medicine, Dr. Kressly opened her practice in 2004 with an electronic health record (EHR) system in place after leaving a large, paper-based pediatric practice. With the EHR system, Dr. Kressly and her colleagues are improving care coordination and immunization rates for their patients.
Tracking Pediatric Immunizations
One unique challenge for Dr. Kressly and her colleagues was maintaining complete pediatric immunization records. Immunizations are often delivered in multiple care settings, which made it difficult for the practice to keep track of patients’ immunization histories. “Parents’ records of their children’s vaccines are often incomplete, and when our practice staff tried to get immunization records from other practices, it often resulted in significant delays,” explained Dr. Kressly. The delays and confusion often forced Dr. Kressly to delay immunizations, meaning many children had to leave the office without up-to-date immunizations. “Inadequate immunization information was negatively affecting our ability to deliver high-quality health care,” said Dr. Kressly.
At the same time, Pennsylvania was challenged with low physician buy-in to a state bidirectional real-time interface registry called the Pennsylvania Statewide Immunization Information System (PA-SIIS). Dr. Kressly’s practice was asked to serve as a test site for PA-SIIS. “As a practicing physician, I was excited to test the functionality so PA-SIIS could expand to more providers in Pennsylvania,” said Dr. Kressly.
Health Information Exchange
As beta testers, Dr. Kressly and her colleagues connected their EHR system to PA-SIIS. Every hour, the practice’s EHR system automatically transmits immunization data to PA-SIIS. PA-SIIS also allows Dr. Kressly and her colleagues to search the registry for patients’ immunization histories. When a new patient arrives at Kressly Pediatrics, practice staff can query the registry to see if the patient has received vaccines at other practices and then use that information to update the patient’s information accordingly.
In addition to connecting the EHR system to PA-SIIS, Dr. Kressly and her colleagues are also using clinical decision support to improve health care quality. The practice’s EHR system incorporates immunization recommendations established by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices into its software. Dr. Kressly and her colleagues consult the system’s guidelines on immunization age requirements and schedules to ensure they provide the best care possible to their patients.
Improved Health Care Quality
With Health IT-driven clinical decision support, along with complete immunization data from PA-SIIS, infant immunization rates at Kressly Pediatrics have consistently exceeded 95%. “Health IT gives us more complete data,” explained Dr. Kressly. “I have the information I need to make sound decisions about patient care.”
Dr. Kressly’s patients have also seen the benefits of Health IT. The practice’s patient portal allows patients’ families to view and print immunization histories online, which is tremendously valuable to parents when enrolling their children in schools and daycares. Dr. Kressly has even received reports from parents who were able to access the patient portal and view their children’s immunization histories on mobile devices while their children were being seen in the emergency room. “It has been fun to witness the power of having information when you need it,” said Dr. Kressly.
Dr. Kressly and her colleagues plan to continue using health information exchange (HIE) to improve health care quality in Pennsylvania. Her practice is currently exchanging data with a local hospital through a community HIE. “HIE helps us ensure the right information is in front of the right people at the right time,” said Dr. Kressly. “We are using Health IT to improve patient care.”