Text vs Patient Portal Messaging to Improve Influenza Vaccination Coverage: A Health System-Wide Randomized Clinical...

Area of Science:

• Public Health
• Health Informatics
• Preventive Medicine

Background:

• Increasing influenza vaccination rates is a critical public health objective.
• Health systems utilize electronic health record (EHR)-based patient portal and text message reminders to encourage vaccination.
• The effectiveness of these digital reminder systems requires rigorous evaluation.

Purpose of the Study:

• To compare the efficacy of EHR-based patient portal reminders versus text message reminders in boosting influenza vaccination rates.
• To assess the impact of different reminder strategies, including fixed vs. responsive and preappointment vs. no preappointment messages.

Main Methods:

• A 3-arm randomized clinical trial involving over 262,000 primary care patients at UCLA Health.
• Interventions included standard care, portal reminders, and text message reminders.
• Nested designs evaluated variations in reminder timing and responsiveness.

Main Results:

• No significant improvement in influenza vaccination rates was observed across all intervention arms, with approximately 47% vaccination coverage in each group.
• Neither portal nor text message reminders, nor variations in their delivery, demonstrated a statistically or clinically significant impact.
• The study included a diverse population of adults and children across 79 primary care practices.

Conclusions:

• Digital reminders via patient portals and text messages were ineffective in increasing population-level influenza vaccination rates.
• Vaccine hesitancy may be a significant barrier, suggesting the need for more intensive public health interventions.
• Further research into novel strategies is essential to enhance influenza vaccine coverage.