Integrating an active choice intervention into electronic health record (EHR) systems was tied to a significant increase in flu vaccination rates in primary care clinics, according to research in JAMA Network Open.

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Though vaccination rates declined as the day progressed, adjusted analyses showed that practices that implemented the intervention had a 9.5 percentage point increase in vaccination rates compared with previous practices over time (95% CI 4.1-14.3, P<0.001), reported Mitesh S. Patel, MD, of the University of Pennsylvania in Philadelphia, and colleagues, writing in JAMA Network Open.

They noted that “‘nudges’ can have outsized effects on medical decision making,” but that while a prior study found an order to accept or decline influenza vaccinations in the EHR increased vaccination rates, it “could lead to clinician alert fatigue.” Prior to expanding the practice, the authors then redirected the alerts to medical assistants, who could ask patients about influenza vaccination and “template orders in the EHR for clinicians to review.”