Reducing Missed Opportunities to Vaccinate while Aligning with HEDIS Measures


Tracking immunizations is an important HEDIS measure as well as an essential element of practice change.  This resource tip comes from a Practice Manager with two large practices, working to increase adolescent vaccination rates using the 4 Pillars™ Transformation Program.  

Near the end of each week, the Practice Manager prints out the schedule of appointments (well visits, nurse visits and acute visits) for the population of interest, in this case adolescents 11-17 years old.  She then checks each chart in the EMR for eligibility for HPV vaccine and records whether it had been given, and if not, whether there was documentation that the provider had recommended the vaccine and the reason for refusal.  

  • In the first week of this tracking she was shocked to discover 79 missed opportunities to vaccinate and no documentation as to why the HPV vaccine was not given.

With these findings, she emailed all clinical staff to encourage them to recommend HPV vaccine and to document that the recommendation was made and accepted or refused, as appropriate.

  • Over several weeks of tracking and reporting, missed opportunities began to decline significantly to approximately ¼ of their baseline level, while documentation increased.

The Practice Manager notes that this process takes her a few hours each Friday to do.  She notes that she could run a report within the EMR but that would only provide numbers of HPV vaccines given each week and not the corresponding documentation.  She has found it to be such an effective method for reducing missed opportunities and increasing chart documentation for those who do not receive the vaccine that she feels her time is well spent because of the increased revenues associated with meeting HEDIS measures for childhood immunizations.