Worker Health Assessment of Timely System‐based Vaccine Promotion (WHATSVP): HealthPartners Institute Initiatives to Expand Adult Immunizations 

HealthPartners Institute immunizations’ efforts are led by Zeke J. McKinney, MD, MHI, MPH, FACOEM and Alyse Haven, MPH. HealthPartners is a nonprofit healthcare organization, serving more than 1.3 million patients in Minnesota and Wisconsin and 1.8 million medical and dental health plan members nationwide. HealthPartners hosts Occupational Medicine and Environmental Health clinics in St. Louis Park, St. Paul, Downtown Minneapolis, Stillwater, and Hudson, Wisconsin, and serves as the only occupational and environmental medicine (OEM) residency in Minnesota.  HealthPartners is determined to encourage vaccines, bring awareness to the importance of immunizations, dispel misinformation, and educate those who are vaccine hesitate.  

The American College of Occupational and Environmental Medicine (ACOEM) was excited to partner with the HealthPartners team to advance adult immunizations. Shortly after onboarding to the Specialty Societies Advancing Adult Immunizations (SSAAI) grant project, Dr. McKinney and his team hit the ground running to contextualize the Centers for Disease Control and Prevention’s (CDC) Standards for Adult Immunization Practice. The grant project objectives included:  

  • Assessment – Develop and implement workflows to assess adult immunizations at every occupational medical clinic,  

  • Recommendation – Provide language appropriate educational resources to promote vaccination for employees,  

  • Administrate or Refer – Implement clinical processes to allow for the recommendation of missing vaccines during visits, and 

  • Documentation – implement processes to evaluate and monitor adult vaccination rates across different demographics. 

Addressing Workflow – Simplifying the Process 

HealthPartners’ eligible population included every patient who visited any of the two piloted OEM clinics. The team aimed to simplify the workflow and provide the patient with as much information about vaccinations as possible. They achieved this by giving the patient a copy of their immunization records available through the state’s Immunization Information Systems (IIS), the Minnesota Immunization Information Connection (MIIC). The rooming staff and the clinician briefly discussed immunizations with the patient. The patient would then decide if they would like to be vaccinated and the health care professional would place a referral on their record. The patient’s vaccinations record would provide more information about vaccinations in various languages as needed.    

Data Collection  

HealthPartners’ team developed a simple one-page paper form to capture the information that would be completed by the OEM healthcare providers. All eligible OEM patients who needed at least (1) vaccine were asked if they were willing to discuss vaccines and receive a vaccination referral. If a referral was placed in the electronic health record (EHR), the patient was then tracked to see if they received vaccination within three (3) months.  

Lessons Learned 

The team recognized some challenges with this process. These included that the referral orders were required independently, manual data entry was needed, and the form was cumbersome. Feedback from the OEM healthcare providers shared that the form was too long, and they did not have enough time during the visit to address it. Therefore, HealthPartners decided to reduce the number of questions in the form from ten (10) to four (4) and remove the referral process. This reduced the clinical workflow burden away from the clinical staff. HealthPartners’ team learned it was important to get buy-in from the clinical staff and determine if the OEM healthcare professionals believed that talking about vaccinations was valuable for short-term appointments. Moving forward, they also thought that it would be beneficial to provide patients with a vaccine handout that provided more concise information about adult vaccines.   

Future Plans 

In collaboration with the clinical support staff at the two pilot OEM sites, the group has continued to strategize on simplifying the questionnaire as much as possible to allow for clear and concise vaccine recommendations that do not take time away from the main reason for the patient’s scheduled visit. Additionally, future months will lend themselves to planning for adding additional vaccine types, such as Hepatitis B. The team hopes to expand this intervention into the other remaining OEM sites.  

ACOEM Resources for Adult Immunizations 

The Centers for Disease Control and Prevention (CDC) Standards for Adult Immunization Practice calls for healthcare professionals to help ensure that their adult patients are fully immunized. Learn more about the Standards for Adult Immunization Practice (SAIP) here.