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Boston Children’s Hospital

Immunization Forecaster helps children receive vaccinations on time while hospital saves time and money

While pediatricians strive to ensure patients remain up to date on immunizations, new annual recommendations from the Centers for Disease Control and Prevention (CDC) can make it hard for providers to keep up with the recommended vaccine schedule. In addition, the complex recommendations can be difficult to integrate into electronic health record (EHR) workflows. When Boston Children’s Hospital leaders began using Cerner’s Immunization Forecaster in August 2018, they saved time, money and had a new tool to help keep children current on vaccinations.

“There is now less guesswork in determining if and when immunizations are due,” said Brenda Dodson, PharmD, clinical integration architect. “It’s much easier to figure out the next best time for an immunization visit because you get a good view of future appropriate dates.”

The forecaster embedded into the EHR leverages CDC clinical decision support of immunizations (CDSi) to help pediatricians know when patients need the next round of appropriate vaccines. This new functionality also reduces clinician time and effort assessing and deciding which vaccines may be due. Even if a child falls behind, it recommends a catch-up schedule.

“Clinicians can easily review data, and the forecasting is simply amazing,” said Dodson. “The new forecaster has all of this logic incorporated and has been really eye-opening.”

Boston Children’s Hospital saved money by reducing vaccine expenses utilizing the immunization enhancements. Before implementation, pediatricians often couldn’t accurately determine when children could receive immunizations provided by Massachusetts, through a program called Vaccines for Children, (VFC), and the hospital would frequently absorb the cost. Cerner created a calculator to determine if a patient was eligible for VFC. This allowed the hospital to accurately document and only pay for necessary vaccines, equating to more than 80% cost savings for the four highest volume inpatient vaccines, even though it distributed more vaccines.1 

Immunization Forecaster also helped improve patient safety.

“We’re leveraging barcodes from the manufacturer at the point of administration, said Dodson. “By scanning the barcode, we can verify medication rights while also capturing automated entry of lot number, expiration date, manufacturer and funding source. Being able to do this has been a big satisfier from a safety perspective.”

In addition, Immunization Inventory Worklist also saved staff time by improving vaccine supply management. At the end of each month, pharmacists and technicians need to reconcile inventory, place the order with the state, then process and complete inventory intake. Previously, staff scheduled 43.5 hours of overtime monthly to complete intake, but now they’ve eliminated that overtime.

“Inventory intake used to take an inordinate amount of time from both technician and pharmacist staff,” said Dodson. “Now that the burden has been reduced, those resources can be redeployed to other necessary functions within the hospital.”

Pharmacists also saved time in documentation. Previously they created an auxiliary label on every vaccine vial for documentation. Immunization Forecaster allows staff to use the manufacturer’s barcode label, eliminating the need for pharmacists to print and affix another label.

“This has been a huge success,” said Dodson. “We’re quite pleased with how the solution helped improve our vaccine administration in a multitude of ways.”

For more information, check out our Immunization Registry Model Experience page.

1 Comparing 842 Pentacel, hepatitis B, influenza and PCV 13 vaccinations between September 2017 - February 2018 which cost $45,193, to 888 Pentacel, hepatitis B, influenza and PCV 13 vaccinations from September 2018 - February 2019, which cost $8,440.65. Time frames of September - February selected as they correspond with the highest times of vaccine administration.

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Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.