Improving immunization delivery using an electronic health record: the ImmProve project.

OBJECTIVE: Though an essential pediatric preventive service- immunizations are challenging to deliver reliably. Our objective was to measure the impact on pediatric immunization rates of providing clinicians with electronic health record-derived immunization prompting. METHODS: Operating in a large- urban- hospital-based pediatric primary care clinic- we evaluated 2 interventions to improve immunization delivery to children ages 2- 6- and 13 years: point-of-care- patient-specific electronic clinical decision support (CDS) when children overdue for immunizations presented for care- and provider-specific bulletins listing children overdue for immunizations. RESULTS: Overall- the proportion of children up to date for a composite of recommended immunizations at ages 2- 6- and 13 years was not different in the intervention (CDS active) and historical control (CDS not active) periods/ historical immunization rates were high. The proportion of children receiving 2 doses of hepatitis A immunization before their secon