As public health leaders double down on efforts to get shots to the 30% of eligible people in the U.S. that remain unvaccinated, STAT News featured UNC Health’s unique strategy to reach those who might have fallen through the cracks.
During the early days of vaccine rollout “we realized that the vast majority of this communication was being done either by email or by MyChart messaging,” said Jacob Stein, MD, a fellow in the division of oncology and first author of a research letter published in JAMA Oncology.
The letter recognizes how relying on digital communication can leave some patients behind, and that older people might be less likely to frequently check online patient portals. Rural residents could also have limited internet access, and many patients don’t own a device to check up on providers’ messages.
Stein and a team at the UNC Cancer Hospital decided to use records differently. Using the electronic health record, they identified patients who received cancer therapy during the past year with follow-up scheduled, without an active patient portal account, no valid email on file, or who lived in a county with a greater than 20% poverty rate across multiple census points. They applied eligibility criteria for vaccination in North Carolina as they evolved, commencing with those older than 75 years. These criteria were developed over 3 weeks by the analytics and quality-improvement team within the cancer hospital, comprising physician and nursing leadership. A group of 4 nurses then placed scripted, informational telephone calls to each identified patient to provide standardized education about the eligibility, safety, and logistics of vaccination. Their approach was to aid patients in making informed decisions about vaccination, address identified barriers to vaccination when able, and respond to patients’ questions or concerns.
As a result, they identified numerous patients with unmet clinical or social needs, and although not the intended goal of the project, mitigating barriers became an integral part of the effort. The authors recognize that this may have yielded positive patient experiences and increased the ability for patients to become vaccinated.
Additional authors include Megan Fasold, BSN, MBAKaryn Jean Daguerre, BSN, MPH, OCN;
Read the article in STAT News. Read the original article in JAMA Oncology.