‘Nudging’ both patients and providers boosts flu vaccine numbers
A new study shows that when patients got text messages from their primary care practice, and the providers were nudged themselves to boost vaccination numbers, rates jumped.
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Patients are 28% more likely to get a flu shot when they got a text message reminder and their primary care provider already had an order for the shot waiting, new research from the Perelman School of Medicine shows. The study is published in JAMA Internal Medicine.
“This is important given the rise in vaccine hesitancy, which has resulted in a downward trend in flu vaccination that coincided with a high rate of hospitalization this flu season,” says the study’s lead author, Shivan Mehta, associate chief innovation officer at Penn Medicine. “Many nudge interventions directed to patients only on vaccinations have shown limited effectiveness in the United States, so we wanted to make sure that we addressed both sides of the exam room: the patient and the clinician.”
The researchers believe these results might point to some strategies that could help boost how many people get the shot every year for an illness that has hospitalized up to 710,000 people each year since 2010—and killed as many as 52,000 Americans annually.
The study tested several forms of “nudging,” a behavioral science concept that means small tweaks that make the healthiest choices the easiest ones. Patients who were eligible for the vaccine received flu shot reminder texts (or automated voice recordings), had automatic orders for a flu shot waiting for their clinician to approve, and monthly personalized messages were sent to providers that compared their patients’ vaccination rates to their clinician peers.
More than 52,000 people were randomly assigned to two groups: one that received all of the nudges or a “standard care” control group at either the University of Pennsylvania Health System or the University of Washington’s health system, UW Medicine The standard care team didn’t get any of the nudges and followed the usual path for getting a flu vaccine, which relies largely on the clinician remembering to offer the vaccine based on information in the electronic health records. Researchers found that almost 3,000 more people got flu shots when they were nudged than would have been expected if they got normal care.
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