FluAlert: A qualitative evaluation of providers' desired characteristics and concerns regarding computerized influenza vaccination alerts

Objective. To explore pediatric providers' perceived barriers to influenza vaccine delivery, and desired characteristics and potential concerns regarding an influenza vaccine alert integrated into the electronic health record (EHR). Methods. Four focus groups with providers (n = 21) and five individual interviews with practice leaders in an urban, pediatric primary care network affiliated with an academic medical center in New York City were conducted. Data were collected during the 2009-10 influenza season and analyzed using thematic analysis. Results. Participants identified several barriers to influenza vaccine delivery, including remembering to vaccinate during sick visits, need to review multiple sources of immunization information, time shortages and inadequate staffing. They felt that an alert could help many of these challenges. They desired the following alert characteristics: 1) alerting providers early in the visit, 2) accurately determining patients' vaccine status by merging multiple sources of immunization information, 3) facilitating vaccine ordering, and 4) generating appropriate documentation in the EHR when vaccines were refused or otherwise not given. Potential concerns regarding the alert included reliability and accuracy of alert, workflow interruptions and forced actions. Conclusions. This study highlights providers' interest in a well-integrated, accurate alert that streamlines assessment of vaccination eligibility, ordering and documentation without impeding work-flow. (C) 2011 Elsevier Inc. All rights reserved.