Computerized Decision Support Boosts Postpartum Vaccination

Implementation of algorithm dramatically increases rate of postpartum Tdap vaccination
By Jeff Muise
HealthDay Reporter

THURSDAY, June 24 (HealthDay News) -- A computer-based clinical decision-support algorithm can dramatically increase rates of tetanus, diphtheria, and acellular pertussis (Tdap) vaccination of postpartum women, according to a study in the July issue of Obstetrics & Gynecology.

William E. Trick, M.D., of the Stroger Hospital of Cook County in Chicago, and colleagues compared the number of women who received Tdap vaccination postpartum before the implementation of a computer-based decision-support algorithm -- a method that uses a woman's electronic medical record to provide diagnostic or therapeutic guidance to physicians -- with the number of women who received the vaccination after the implementation. The system was set up so the physician viewed the automatic guidance when ordering iron supplements or hospital discharge.

Prior to the implementation of the decision-support algorithm, the researchers found that none of 183 postpartum women received vaccinations compared to 147 of 248 women (59 percent) after the implementation. After the implementation, among the 232 women who met the criteria for automatic activation of the decision-support algorithm, 146 (63 percent) were vaccinated compared with one of 16 (6 percent) among those who did not meet the criteria for automatic activation.

"We implemented a computer-based clinical decision-support algorithm that dramatically increased Tdap vaccination of postpartum women. Deployment of our algorithm in hospitals that have clinical decision-support systems should increase rates of this important postpartum preventive intervention," the authors write.

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