HPV Provider Spotlight: Dr. Rajiv Naik, MD

Dr. Rajiv Naik is a Pediatrician at Gundersen Health System in La Crosse Wisconsin. Some of his areas of interest include pediatric and adolescent medicine, pediatric infectious diseases, immunizations, evidence-based medicine and quality improvement. One of his specific accomplishments include his systematic approach to increasing HPV vaccination rates. Below are some of the key points of the process used within his department.

 

Comprehensive, Multimodal, Systematic Approach

  • Development of automatic electronic tools within the electronic health record system (EMR)

  • Instituting centralized, system-based processes

  • Health care provider and departmental staff education and training

  • Patient education and overall change of approach in engagement with patients/families

 

Methodology

  • Electronic Medical Record (EMR)

    • Utilize alerts, reminders, and electronic scheduling for additional visits

    • These tools support medical team

    • Use EMR prompts to address HPV myths with patients through education

  • Staff training

    • Training with entire staff (front desk to provider) regarding myths and facts, use the CASE approach

    • Different training strategies for family medical sites and pediatric sites

  • Reminder notices that engage the family noting due or overdue immunizations and recommended vaccines by age 13

  • Looking at QI data, able to target education and training at low performing sites/healthcare providers.

 

How to Improve HPV Vaccination Rates

  • Creation of automatic alerts and reminders within EHR for health care provider use

  • Centralized process for electronic alerts and reminders

  • Electronic scheduling of subsequent doses to help eliminate missed opportunities

  • System-wide health care provider education and training (C-A-S-E Approach)

  • HPV Myths: real-time health care provider prompting with simultaneous patient education

  • Targeted education and training for low performing sites and health care providers

 

 

Results

  • Dramatic increase in HPV Vaccine rates when electronic alerts, reminder, and centralized system (EMR) began.

  • Seeing continued improvement with training and additional EMR prompts/systems

  • Males still lag behind females in 3-dose series completion

  • Gundersen Health System female and male rates are above the national immunization survey rates for ages 13-17

 

Summary

  • Using a comprehensive, multimodal, systematic approach to improving HPV rates in an integrated health care system, steady rate improvements have been seen over a sustained period of time at every age in both females and males.

  • Similar approaches could be adopted in other health care system.

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