Provider Readiness to Leverage New Technologies for Reminder Notifications

Background: 

Newer technologies such as email and text messaging offer the potential to expand options for immunization reminder notification, although little is known regarding feasibility of their use in settings where childhood immunizations are delivered.

Objectives:  To assess technical capacity and perceived barriers to the use of newer technologies for immunization reminders to parents.

Methods:  Semi-structured interviews with clinical and administrative staff at a convenience sample of private and public sites in south-central Michigan that offer childhood immunizations. 

Results:  Interviews were conducted at 22 sites: 11 pediatrics, 7 family medicine, 3 local health departments, 1 Federally Qualified Health Center.  All sites had practice management systems used for either billing (22) or appointment scheduling (21).  Most sites reminded clients of upcoming appointments (9 live phone call, 5 autodialer, 4 live phone, followed by postal mail, 1 postal mail only), but less than half conducted immunization-specific reminders (4 live phone, 4 postal mail, 1 both).    Although each autodialer system had text messaging capability, none of the interviewed sites currently used text message reminders.  However, almost all practice management systems used currently have the capacity to distinguish between cell phone and landline numbers, which would facilitate text messaging.  No sites currently used email for appointment or immunization reminders, but 6 sites had begun collecting client information for potential future contact via email.  Practice personnel described several areas of concern about the use of text messaging and email notification, including costs, parent preferences, patient privacy, legal requirements for opt-in, and liability for unanswered email responses.

Conclusions:  Current systems for client reminders rely on telephone or postal mail, but some capacity exists for expansion to text messaging or email notification.   Perceived barriers to using text message or email reminders include legal or regulatory concerns.  Guidance to immunization providers on these issues could facilitate use of these technologies for reminder messaging.