Improving COVID-19 Vaccine Outreach with Data Analytics, EHRs

In a recent research letter, research authors examined how data analytics and electronic health records (EHRs) can assist in targeting marginalized populations to improve COVID-19 vaccine outreach efforts and eliminate health disparities.

Given how the COVID-19 pandemic has disproportionately impacted communities of color and those with lower socioeconomic status, vaccine outreach, and delivery equality have become priorities for medical professionals.

Health systems have primarily communicated vaccine availability and appointments through electronic patient portal messages, emails, or online methods. However, patient portal use and internet access are lower among rural populations, individuals with lower socioeconomic status, and racial and ethnic minority patients.

Additionally, patients with cancer are at increased risk of COVID-19 complications, making them a priority for vaccination.

Using data from the North Carolina Cancer Hospital of the University of North Carolina (UNC) Health System (Chapel Hill, North Carolina), the authors pursued an analytics-based approach to identify and contact patients who could benefit from target nonelectronic communication regarding the COVID-19 vaccine.

The authors identified patients receiving cancer therapy who didn’t have an active patient portal, valid email, or lived in a country with a higher than 20 percent poverty rate across multiple census points.

“We 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,” the authors wrote in their research letter.

A group of four nurses then made scripted, informational telephone calls to each identified patient providing education about the eligibility, safety, and logistics of vaccination. The approach was to help patients make informed decisions regarding the vaccine, address vaccine barriers as presented, and respond to patients’ questions and concerns.

Between January and March 2021, the research authors identified 536 potentially marginalized UNC patients eligible for the COVID-19 vaccine. Of those, 61 percent were non-Hispanic White and 32 percent were Black, with 14 percent from counties with persistent poverty.

Most identified patients were called, with 67 percent successfully reached and 9 percent reached by voicemail. Among Black patients, 75 percent were reached, and 93 percent were from counties with high poverty levels.

“As of April 2, 2021, 93 of 359 contacted patients (26%) were confirmed to have received vaccination via electronic health record review or self-report, with another 14 of 359 (4%) scheduled for a vaccination appointment at UNC,” the authors wrote.

The targeted outreach method identified and connected with patients who do not regularly used electronic communication and whose community network was likely impacted by social isolation due to the pandemic.

“This novel intervention demonstrated the potential benefits of an analytics-based strategy to reach marginalized patients at high risk for exclusion from electronic outreach and may be built on for future outreach programs,” the authors explained.

The research authors suspect that patients who had not been contacted would have missed electronic outreach efforts, impacting their decision to get vaccinated against COVID-19. Additionally, the calls identified numerous patients with unmet clinical or social needs, eliminating health disparities.