Measles have not yet reached the St. Louis area but, in an effort to thwart an outbreak, area clinics are reaching out to a group of parents whose children aren’t fully vaccinated. These children missed their vaccinations not for medical or religious reasons but because, quite simply, they may have forgotten.
That’s now a relatively easy problem to address because of the widespread use of Electronic Health Records, or EHR’s.
The Centers for Disease Control's recommended vaccine guidelines, call for the average child to get up to 30 shots before her 19th birthday. Vaccinations range from Hepatitis B, to polio, to MMR, a three-in-one vaccine that covers measles, mumps and rubella. Having so many shots for different diseases leaves plenty of room for error. For example, a parent might cancel an appointment because a child fell ill, and then they never rescheduled.
According to the Missouri Department of Health and Senior Services, about 4 percent of students in the city of St. Louis are not up-to-date with their measles vaccines. Fewer than 1 percent are not immunized for religious or medical reasons.
Amy Pogue, an office manager for two Mercy Clinic locations, said she was given a list of about 1,900 names of patients who were out of compliance or nearing due dates for their vaccinations. Pogue said she started making calls, and booked 40 appointments in the first couple of days — a feat which would have been much more time-consuming just a few years ago.
“It’s much easier now. Before, you used to have to pull in charts one by one,” Pogue said. “It’s actually shocking how many parents do not realize what the vaccine schedule is, and thought they had already had the measles vaccine.”
In addition to letting parents know their children may be at risk of contracting measles, Pogue said she’s hopeful that bringing patients in now will help lessen the demand for appointments in the months before the school year starts.
The federal government has provided financial incentives for health providers to implement EHR’s since 2009. Depending on the size of a practice, electronic systems can cost tens of thousands of dollars per physician. The Affordable Care Act set a 2015 deadline for clinics to use electronic records, or else pay a penalty, but a small percentage of providers remain reluctant to make the move from paper records.
Dr. Howard Schlansky, Mercy Clinic’s medical director for pediatrics, said it took only 72 hours for IT technicians at Mercy to pull together the patient lists through the electronic records. Clinics will be contacting patients in the coming weeks through phone calls, secured e-mails and direct mail.
“It’s potentially a matter of time before (measles) arrives in the St. Louis area,” Schlansky said. “As much as we’re trying to protect all of our patients, we especially want to be able to protect infants under a year of age who are not routinely included in the vaccination schedule.”
The CDC recommends that children have two doses of the MMR (measles, mumps and rubella) vaccine; one between 12 and 15 months, and another between four and six years of age. Although there have been no reported cases of the measles in St. Louis this year, at least 125 people have been diagnosed with the disease in 17 states since Jan. 1. Most of them are linked to an outbreak at Disneyland.
Schlansky said that Mercy Hospital clinics frequently use their records to remind patients when the flu vaccine is available, but this is the first time they’ve done the same for the measles vaccine.
